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Adolescent concussion – preliminary brain and behavioral findings
Melissa Pangelinan, Ph.D. 28 July 2015
Overview
• Studying Cortical Thickness • Age-Related Changes in Cortical Thickness • Saguenay Youth Study • Preliminary Results
– Cortical Thickness – Behavioral Analysis
• Future Directions
Measuring Cortical Thickness
Fischl & Dale (2000) PNAS
Age-Related Differences in Cortical Thickness
Tamnes et al. (2013) NeuroImage
Impact of Concussion on Brain Aging
• NHL Study – Dr. Carrie Esopenko & Dr. Brian Levine
• Signs of Accelerated Aging
Westlye et al. (2010) NeuroImage
Saguenay Youth Study (SYS)
• Genetic founder population
• Family structure
• Prenatal maternal cigarette exposure
Main Measures of Interest
MRI
Questionnaires
o Brain – Cor>cal Thickness
o Concussion Inventory o Lifestyle – Sport/Ac>vity Par>cipa>on
Neuropsych o MANY measures!
Cortical Thickness - FreeSurfer
Concussion Inventory • Self-report inventory (11 items)
– Concussion (y/n) – Memory Loss/Confusion – Embarrassment – Date of Most Recent (within last 2 years) – How (sport, car accident, other) – Loss of Consciousness – Diagnosis (coach, EMT, doctor, other) – Hospitalization – How Many Total – How many during sports – How many during “other”
Cognitive Testing
• Manual Dexterity/Speed – Pegboard, Tapping • Stroop (Interference) • Memory Scales, Digit Span • Fluency • Academic Skills (Math, Reading, Spelling) • IQ
– Performance – Verbal – Full Scale
Subjects
Neuropsych
Concussion
MRI
All Tested o N = 1020 (492 male/528 female)
o N = 112 (69 male/43 female)
o N = 108 (66 male/42 female)
o N = 98 (60 male/38 female)
Demographics/Matching
Males Females
DOF T-‐Value P-‐Value DOF T-‐Value P-‐Value
Age T(130) 0.98 0.75 T(82) 0.32 0.75
Exposure Status T(130) 0.00 1.00 T(82) 0.22 0.83
Income T(130) 0.14 0.89 T(82) -‐0.16 0.87
Maternal Educa>on T(126) 0.27 0.79 T(82) -‐1.38 0.17
Paternal Educa>on T(124) -‐0.45 0.65 T(81) -‐0.25 0.80
Thickness Results – Overall Group Differences
Thickness Results - Males
Thickness Results – Overall Group Differences
Thickness Results - Females
Thickness Results – Take-Home
• Concussed > Controls: Executive function and decision making – Superior frontal – Rostral middle frontal – Orbitofrontal
• Concussed > Controls: Visuospatial function – Superior parietal
• Controls > Concussed: memory functions – Entorhinal and parahippocampal
Cognitive Differences – Movement Impairments in Concussed Females
Cognitive Differences – Movement Impairments in Concussed Females
Cognitive Differences – Interference Susceptibility in Concussed Females
Cognitive Differences – Poor Long-Term Memory in Control Females
Cognitive Differences – Higher IQ in Concussed Females
Cognitive Differences – Higher IQ in Concussed Females
Behavioral Results – Take-Home
• Some evidence for degraded motor and executive function for concussed females despite high IQ
• Poor memory performance in control females
• Brain-behavior connections – BUT, data are noisy!
Future Directions
• Additional variables of interest
• Dose effects? – Number – Hospitalization – Recency
• Age at concussion
Future Directions – Neck Muscle Segmentation
Thanks for your attention!