Preliminary evidence of reduced brain network activation in patients with post-traumatic migraine following concussion
- 670 Downloads
Post-traumatic migraine (PTM) (i.e., headache, nausea, light and/or noise sensitivity) is an emerging risk factor for prolonged recovery following concussion. Concussions and migraine share similar pathophysiology characterized by specific ionic imbalances in the brain. Given these similarities, patients with PTM following concussion may exhibit distinct electrophysiological patterns, although researchers have yet to examine the electrophysiological brain activation in patients with PTM following concussion. A novel approach that may help differentiate brain activation in patients with and without PTM is brain network activation (BNA) analysis. BNA involves an algorithmic analysis applied to multichannel EEG-ERP data that provides a network map of cortical activity and quantitative data during specific tasks. A prospective, repeated measures design was used to evaluate BNA (during Go/NoGo task), EEG-ERP, cognitive performance, and concussion related symptoms at 1, 2, 3, and 4 weeks post-injury intervals among athletes with a medically diagnosed concussion with PTM (n = 15) and without (NO-PTM) (n = 22); and age, sex, and concussion history matched controls without concussion (CONTROL) (n = 20). Participants with PTM had significantly reduced BNA compared to NO-PTM and CONTROLS for Go and NoGo components at 3 weeks and for NoGo component at 4 weeks post-injury. The PTM group also demonstrated a more prominent deviation of network activity compared to the other two groups over a longer period of time. The composite BNA algorithm may be a more sensitive measure of electrophysiological change in the brain that can augment established cognitive assessment tools for detecting impairment in individuals with PTM.
KeywordsSport-related concussion Brain network activation Electroencephalography Post-traumatic migraine
Compliance with ethical standards
This study was funded by ElMindA, Ltd. through a research contract with the University of Pittsburgh.
Conflict of interest
Authors Reches, Dickman, Laufer, Geva, and Shacham are employed by ElMindA, Ltd. With regard to the study data, Drs. Reches, Dickman, Laufer, Geva, and Shacham were not involved in data collection, entry, or analysis; they were only involved in blinded data transformation using the BNA algorithm and data interpretation of the BNA and EEG-ERP findings. Author Collins owns a 10 % share in ImPACT Applications, Inc. With regard to the study data, Dr. Collins was not involved in data collection, entry or analysis; he was only involved in data interpretation. Authors Kontos, Elbin, and DeWolf declare no conflict of interest.
All procedures performed in studies involving human participants were in accordance with the ethical standards of the institutional and/or national research committee and with the 1964 Helsinki declaration and its later amendments or comparable ethical standards.
Informed consent was obtained from all individual participants included in the study.
- Brier, M. R., Ferree, T. C., Maguire, M. J., Moore, P., Spence, J., Tillman, G. D., et al. (2010). Frontal theta and alpha power and coherence changes are modulated by semantic complexity in Go/NoGo tasks. International Journal of Psychophysiology, 78(3), 215–224. doi: 10.1016/j.ijpsycho.2010.07.011.CrossRefPubMedGoogle Scholar
- Covassin, T., Elbin, R. J., Harris, W., Parker, T., & Kontos, A. (2012). The role of age and sex in symptoms, neurocognitive performance, and postural stability in athletes after concussion. American Journal of Sports Medicine, 40(6), 1303–1312. doi: 10.1177/0363546512444554.CrossRefPubMedGoogle Scholar
- Gosselin, N., Bottari, C., Chen, J. K., Huntgeburth, S. C., De Beaumont, L., Petrides, M., et al. (2012). Evaluating the cognitive consequences of mild traumatic brain injury and concussion by using electrophysiology. Neurosurgical Focus, 33(6), 1–7. doi: 10.3171/2012.10.FOCUS12253. E7.CrossRefGoogle Scholar
- Guskiewicz, K. M., Marshall, S. W., Bailes, J., McCrea, M., Harding, H. P., Jr., Matthews, A., et al. (2007). Recurrent concussion and risk of depression in retired professional football players. Medicine and Science in Sports and Exercise, 39(6), 903–909. doi: 10.1249/mss.0b013e3180383da5.CrossRefPubMedGoogle Scholar
- Headache Classification Subcommittee of the International Headache, S. (2004). The international classification of headache disorders: 2nd edition. Cephalalgia, 24(Suppl 1), 9–160.Google Scholar
- Kontos, A. P., Elbin, R. J., Lau, B., Simensky, S., Freund, B., French, J., et al. (2013). Posttraumatic migraine as a predictor of recovery and cognitive impairment after sport-related concussion. American Journal of Sports Medicine, 41(7), 1497–1504. doi: 10.1177/0363546513488751.CrossRefPubMedGoogle Scholar
- Lau, B. C., Kontos, A. P., Collins, M. W., Mucha, A., & Lovell, M. R. (2011). Which on-field signs/symptoms predict protracted recovery from sport-related concussion among high school football players? American Journal of Sports Medicine, 39(11), 2311–2318. doi: 10.1177/0363546511410655.CrossRefPubMedGoogle Scholar
- McCrory, P., Meeuwisse, W. H., Aubry, M., Cantu, B., Dvorak, J., Echemendia, R. J., et al. (2013). Consensus statement on concussion in sport: the 4th international conference on concussion in sport held in Zurich, November 2012. Journal of the American College of Surgeons, 216(5), e55–71. doi: 10.1016/j.jamcollsurg.2013.02.020.CrossRefPubMedGoogle Scholar
- Mihalik, J. P., Register-Mihalik, J., Kerr, Z. Y., Marshall, S. W., McCrea, M. C., & Guskiewicz, K. M. (2013). Recovery of posttraumatic migraine characteristics in patients after mild traumatic brain injury. American Journal of Sports Medicine, 41(7), 1490–1496. doi: 10.1177/0363546513487982.CrossRefPubMedGoogle Scholar
- Reches, A., Laufer, I., Ziv, K., Cukierman, G., McEvoy, K., Ettinger, M., et al. (2013). Network dynamics predict improvement in working memory performance following donepezil administration in healthy young adults. NeuroImage, 88C, 228–241. doi: 10.1016/j.neuroimage.2013.11.020.PubMedGoogle Scholar
- Reches, A., Levy-Cooperman, N., Laufer, I., Shani-Hershkovitch, R., Ziv, K., Kerem, D., et al. (2014). Brain network activation (BNA) reveals scopolamine-induced impairment of visual working memory. Journal of Molecular Neuroscience, 54(1), 59–70. doi: 10.1007/s12031-014-0250-6.CrossRefPubMedGoogle Scholar
- Shahaf, G., Reches, A., Pinchuk, N., Fisher, T., Ben Bashat, G., Kanter, A., et al. (2012). Introducing a novel approach of network oriented analysis of ERPs, demonstrated on adult attention deficit hyperactivity disorder. Clinical Neurophysiology, 123(8), 1568–1580. doi: 10.1016/j.clinph.2011.12.010.CrossRefPubMedGoogle Scholar
- Slobounov, S. M., Gay, M., Zhang, K., Johnson, B., Pennell, D., Sebastianelli, W., et al. (2011). Alteration of brain functional network at rest and in response to YMCA physical stress test in concussed athletes: RsFMRI study. NeuroImage, 55(4), 1716–1727. doi: 10.1016/j.neuroimage.2011.01.024.CrossRefPubMedPubMedCentralGoogle Scholar