Time Course of Clinical and Electrophysiological Recovery After Sport-Related Concussion

Background and Purpose: Recent neuroimaging studies suggest that abnormalities in brain function after concussion exist beyond the point of observed clinical recovery. This study investigated the relationship between an index of brain dysfunction (traumatic brain injury [TBI] Index), concussion severity, and outcome. Methods: EEG was collected from forehead locations in 65 male athletes with concussion within 24 hours of concussion, with follow-up at 8 and 45 days postinjury. Neurocognitive and symptom assessments were also performed and used to classify subjects in mild or moderate concussion categories. Time to return to play was recorded. Results: The TBI Index was higher in the moderate than mild concussion group at injury, day 8, and day 45. The moderate group had increased symptoms and decreased cognitive performance only at the time of injury. At the time of injury, only the TBI Index was significantly associated with the length of time to return to play. Conclusions: Recovery of brain function after sport-related concussion may extend well beyond the time course of clinical recovery and be related to clinical severity. An index of brain dysfunction may be an objective indicator of injury, recovery, and readiness to return to play. The relatively small sample indicates the need for further study on the time course of physiological recovery.