TY - JOUR
T1 - Residual brain dysfunction observed one year post-mild traumatic brain injury
T2 - Combined EEG and balance study
AU - Slobounov, Semyon
AU - Sebastianelli, Wayne
AU - Hallett, Mark
N1 - Funding Information:
This work was supported by National Institutes of Health Grant RO1 NS056227-01A2 “Identification of Athletes at Risk for Traumatic Brain Injury”.
PY - 2012/9
Y1 - 2012/9
N2 - Objectives: There is still considerable debate and controversy about whether EEG can be used as a robust clinical tool for assessment of mild traumatic brain injury (MTBI). Nonhomogeneous subject populations, inaccurate assessment of severity of brain injury, time since injury when EEG testing was performed, the lack of EEG research conducted serially and in conjunction with other behavioral measures as injury evolves over time may contribute to the existing controversies. In this study, we implemented a concussion assessment protocol combining a series of EEG and balance measures throughout one year post-injury to document the efficacy of EEG and balance measures as relate to differential recovery of patients suffering from MTBI. Methods: Three hundred and eighty subjects at risk for MTBI were initially recruited for baseline testing. Forty nine from this initial subjects pool subsequently suffered a single episode of concussive blow and were tested on day 7, 15, 30. days, 6. months and 12. months post-injury. EEGs were recorded while sitting, standing on the force plate and then on a foam base of support with eyes open/closed conditions. EEG alpha power (8-12. Hz) and its percent suppression from sitting to standing postures were computed. The center of pressure (COP) measures were obtained from the force platform and analyzed for eyes open and eyes closed conditions. Results: Percent alpha power suppression from sitting to standing postural conditions significantly increased in MTBI subjects shortly after the injury (p<0.01). Percent alpha power suppression significantly correlated with increased area of COP during standing posture with eye closed (r 2=0.53, p<0.01). The magnitude of alpha power suppression predicted the rate of recovery of this measure in sub-acute and chronic phases of injury (r 2=0.609, p<0.01). Finally, 85% of MTBI subjects who showed more than 20% of alpha power suppression in the acute phase of injury did not return to pre-injury status up to 12months post-injury. Conclusions: The efficacy of serially implemented EEG measures in conjunction with balance assessment over the course of MTBI evolution to document residual cerebral dysfunction was demonstrated. Specifically, alteration of EEG alpha power dynamics in conjunction with balance data in the acute phase of injury with respect to baseline measures may predict the rate of recovery from a single concussive blow. Significance: Neurophysiological measures are excellent tools to assess the status and prognosis of patients with MTBI.
AB - Objectives: There is still considerable debate and controversy about whether EEG can be used as a robust clinical tool for assessment of mild traumatic brain injury (MTBI). Nonhomogeneous subject populations, inaccurate assessment of severity of brain injury, time since injury when EEG testing was performed, the lack of EEG research conducted serially and in conjunction with other behavioral measures as injury evolves over time may contribute to the existing controversies. In this study, we implemented a concussion assessment protocol combining a series of EEG and balance measures throughout one year post-injury to document the efficacy of EEG and balance measures as relate to differential recovery of patients suffering from MTBI. Methods: Three hundred and eighty subjects at risk for MTBI were initially recruited for baseline testing. Forty nine from this initial subjects pool subsequently suffered a single episode of concussive blow and were tested on day 7, 15, 30. days, 6. months and 12. months post-injury. EEGs were recorded while sitting, standing on the force plate and then on a foam base of support with eyes open/closed conditions. EEG alpha power (8-12. Hz) and its percent suppression from sitting to standing postures were computed. The center of pressure (COP) measures were obtained from the force platform and analyzed for eyes open and eyes closed conditions. Results: Percent alpha power suppression from sitting to standing postural conditions significantly increased in MTBI subjects shortly after the injury (p<0.01). Percent alpha power suppression significantly correlated with increased area of COP during standing posture with eye closed (r 2=0.53, p<0.01). The magnitude of alpha power suppression predicted the rate of recovery of this measure in sub-acute and chronic phases of injury (r 2=0.609, p<0.01). Finally, 85% of MTBI subjects who showed more than 20% of alpha power suppression in the acute phase of injury did not return to pre-injury status up to 12months post-injury. Conclusions: The efficacy of serially implemented EEG measures in conjunction with balance assessment over the course of MTBI evolution to document residual cerebral dysfunction was demonstrated. Specifically, alteration of EEG alpha power dynamics in conjunction with balance data in the acute phase of injury with respect to baseline measures may predict the rate of recovery from a single concussive blow. Significance: Neurophysiological measures are excellent tools to assess the status and prognosis of patients with MTBI.
UR - http://www.scopus.com/inward/record.url?scp=84864403493&partnerID=8YFLogxK
UR - http://www.scopus.com/inward/citedby.url?scp=84864403493&partnerID=8YFLogxK
U2 - 10.1016/j.clinph.2011.12.022
DO - 10.1016/j.clinph.2011.12.022
M3 - Article
C2 - 22361265
AN - SCOPUS:84864403493
SN - 1388-2457
VL - 123
SP - 1755
EP - 1761
JO - Clinical Neurophysiology
JF - Clinical Neurophysiology
IS - 9
ER -