Working memory recovery in adolescents with concussion: Longitudinal fMRI study

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Abstract
Background Understanding behavioral and neural underpinnings of post-concussion recovery of working memory function is critically important for improving clinical outcomes and adequately planning return-to-activity decisions. Previous studies provided inconsistent results due to small sample sizes and the use of a mixed population of participants who were at different post-injury time points. Methods To better understand behavioral and neural correlates of working memory recover during the first 6 months post-concussion, we used functional magnetic resonance imaging (fMRI) to scan 45 concussed adolescents [CONC] at baseline (Results By the 6-month follow-up, all affected adolescents were asymptomatic and cleared to return-to-activity. Working memory function recovery was reflected by faster and more accurate performance at 6 months vs. baseline (p-valuesConclusion Post-concussion recovery is associated with significant performance improvements in speed and accuracy, as well as normalization of brain responses in the LIFG and LOFC during the n-back task. The observed patterns of LOFC activation might reflect compensatory strategies to distribute neural processing and reduce neural fatigue post-concussion.
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