Skip to main content
    • Aa
    • Aa

Acute and Subacute Changes in Neural Activation during the Recovery from Sport-Related Concussion

  • Thomas A. Hammeke (a1), Michael McCrea (a2), Sarah M. Coats (a3), Matthew D. Verber (a4), Sally Durgerian (a5), Kristin Flora (a6), Gary S. Olsen (a7), Peter D. Leo (a5), Thomas A. Gennarelli (a2) and Stephen M. Rao (a8)...

To study the natural recovery from sports concussion, 12 concussed high school football athletes and 12 matched uninjured teammates were evaluated with symptom rating scales, tests of postural balance and cognition, and an event-related fMRI study during performance of a load-dependent working memory task at 13 h and 7 weeks following injury. Injured athletes showed the expected postconcussive symptoms and cognitive decline with decreased reaction time (RT) and increased RT variability on a working memory task during the acute period and an apparent full recovery 7 weeks later. Brain activation patterns showed decreased activation of right hemisphere attentional networks in injured athletes relative to controls during the acute period with a reversed pattern of activation (injured > controls) in the same networks at 7 weeks following injury. These changes coincided with a decrease in self-reported postconcussive symptoms and improved cognitive test performance in the injured athletes. Results from this exploratory study suggest that decreased activation of right hemisphere attentional networks mediate the cognitive changes and postconcussion symptoms observed during the acute period following concussion. Conversely, improvement in cognitive functioning and postconcussive symptoms during the subacute period may be mediated by compensatory increases in activation of this same attentional network. (JINS, 2013, 19, 1–10)

Corresponding author
Correspondence and reprint requests to: Thomas A. Hammeke, Clement J. Zablocki VA Medical Center, Acute Mental Health—Neuropsychology, Bldg 111, Room 3301, 5000 W. National Avenue, Milwaukee, WI 53295. E-mail:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

C.M. Arrington , T.H. Carr , A.R. Mayer , S.M. Rao (2000). Neural mechanisms of visual attention: Object-based selection of a region in space. Journal of Cognitive Neuroscience, 12, 106117.

S.P. Broglio , T.W. Puetz (2008). The effect of sport concussion on neurocognitive function, self-report symptoms and postural control: A meta-analysis. Sports Medicine, 38, 5367.

J.-K. Chen , K.M. Johnston , S. Frey , M. Petrides , K. Worsley , A. Ptito (2004). Functional abnormalities in symptomatic concussed athletes: An fMRI study. Neuroimage, 22, 6882.

J.-K. Chen , K.M. Johnston , M. Petrides , A. Ptito (2008a). Neural substrates of symptoms of depression following concussion in male athletes with persisting postconcussion symptoms. Archive of General Psychiatry, 65, 8189.

J.-K. Chen , K.M. Johnston , M. Petrides , A. Ptito (2008b). Recovery from mild head injury in sports: Evidence from serial functional magnetic resonance imaging studies in male athletes. Clinical Journal of Sports Medicine, 18, 241247.

S.H.A. Chen , D.A. Kareken , P.S. Fastenau , L.E. Trexler , G.D. Hutchins (2003). A study of persistent post-concussion symptoms in mild head trauma using positron emission tomography. Journal of Neurology, Neurosurgery, & Psychiatry, 74, 326332.

M.W. Collins , S.H. Grindel , M.R. Lovell , D.E. Dede , D.J. Moser , B.R. Phalin , D.B. McKeag (1999). Relationship between concussion and neuropsychological performance in college football players. Journal of American Medical Association, 282, 964970.

M. Corbetta , G.L. Shulman (2011). Spatial neglect and attention networks. Annual Review of Neuroscience, 34, 569599.

K.M. Guskiewicz , M. McCrea , S.W. Marshall , R.C. Cantu , C. Randolph , W. Barr , J.P. Kelly (2003). Cumulative effects associated with recurrent concussion in collegiate football players: The NCAA Concussion Study. Journal of American Medical Association, 290, 25492555.

C.I. Halterman , J. Langan , A. Drew , E. Rodriguez , L.R. Osternig , L.-S. Chou , P.l. van Donkelaar (2006). Tracking the recovery of visuospatial attention deficits in mild traumatic brain injury. Brain, 129, 747753.

B. Johnson , K. Zhang , M. Gay , S. Horovitz , M. Hallett , W. Sebastianelli , S. Slobounov (2012). Alteration of brain default network in subacute phase of injury in concussed individuals: Resting-state fMRI study. Neuroimage, 59, 511518.

S. Kumar , S.L. Rao , B.A. Chandramouli , S.V. Pillai (2009). Reduction of functional brain connectivity in mild traumatic brain injury during working memory. Journal of Neurotrauma, 26, 665675.

M.R. Lovell , M.W. Collins (1998). Neuropsychological assessment of the college football player. Journal of Head Trauma Rehabilitation, 13, 926.

M.R. Lovell , J.E. Pardini , J. Welling , M.W. Collins , J. Bakal , N. Lazar , J.T. Becker (2007). Functional brain abnormalities are related to recovery and time return-to-play in athletes. Neurosurgery, 61, 352359.

S.N. Macciocchi , J.T. Barth , W. Alves , R.W. Rimel , J.A. Jane (1996). Neuropsychological functioning and recovery after mild head injury in collegiate athletes. Neurosurgery, 39, 510514.

B. Malojcic , Z. Mubrin , B. Coric , M. Susnic , G.J. Spilich (2008). Consequences of mild traumatic brain injury on information processing assessed with attention and short-term memory tasks. Journal of Neurotrauma, 25, 3037.

A.R. Mayer , M.V. Mannell , J. Ling , R. Elgie , C. Gasparovic , J.P. Phillips , R.A. Yeo (2009). Auditory orienting and inhibition of return in mild traumatic brain injury: A fMRI study. Human Brain Mapping, 30, 41524166.

M. McCrea , K.M. Guskiewicz , S.W. Marshall , W. Barr , C. Randolph , R.C. Cantu , J.P. Kelly (2003). Acute effects and recovery time following concussion in collegiate football players: The NCAA Concussion Study. Journal of American Medical Association, 290, 25562563.

M. McCrea , T.A. Hammeke , G. Olsen , P. Leo , K. Guskiewicz (2004). Unreported concussion in high school football players: Implications for prevention. Clinical Journal of Sports Medicine, 14, 1317.

N.S. Narayanan , V. Prabhakaran , S.A. Bunge , K. Christoff , E.M. Fine , J.D. Gabrieli (2005). The role of the prefrontal cortex in the maintenance of verbal working memory: An event-related fMRI analysis. Neuropsychology, 19(2), 223232.

M.R. Newsome , J.L. Steinberg , R.S. Scheibel , M. Troyanskaya , Z. Chu , G. Hanten , H.S. Levin (2008). Effects of traumatic brain injury on working memory-related brain activation in adolescents. Neuropsychology, 22, 419425.

J.E. Pardini , D.A. Pardini , J.T. Becker , K.L. Dunfee , W.F. Eddy , M.R. Lovell , J.S. Welling (2010). Postconcussive symptoms are associated with compensatory cortical recruitment during a working memory task. Neurosurgery, 67, 10201027.

S.M. Slobounov , K. Zhang , D. Pennell , W. Ray , B. Johnson , W. Sebastianelli (2010). Functional abnormalities in normally appearing athletes following mild traumatic brain injury: A functional MRI study. Experimental Brain Research, 202, 341354.

S. Sternberg (1966). High-speed scanning in human memory. Science, 153, 652654.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Journal of the International Neuropsychological Society
  • ISSN: 1355-6177
  • EISSN: 1469-7661
  • URL: /core/journals/journal-of-the-international-neuropsychological-society
Please enter your name
Please enter a valid email address
Who would you like to send this to? *



Altmetric attention score

Full text views

Total number of HTML views: 7
Total number of PDF views: 72 *
Loading metrics...

Abstract views

Total abstract views: 264 *
Loading metrics...

* Views captured on Cambridge Core between September 2016 - 22nd May 2017. This data will be updated every 24 hours.