Recent evidence suggests that concussion- related impairments can persist well beyond six months. This is revealed when patients are assessed: (1) by more complex cognitive tasks; (2) under circumstances of stress such as depression, pain, sleep deprivation, or high altitude; (3) by functional neuroimaging; and (4) by electrophysiological measures. With regard to the last: a small number of studies have also provided support for long-term changes in functional brain activity aft er concussion by recording electroencephalograms and measuring the classic P300 eventrelated potential component. The P300 is thought to refl ect a basic cognitive process by which incoming information is categorized and has also been linked to processes involved in updating the context of working memory. This study showed that, long after a concussion, more sensitive electrophysiological measures can reveal subtle changes in brain activity during cognitive processing, including inefficient information-processing capacity during a working- memory task, and it would be of great interest to couple these data with metabolic measurements. One of the biggest challenges of the next ten years will be to improve the applicability of advanced neuroimaging to concussion by determining its validity for reliably identifying biological changes that have clinical significance. Ultimately, the changes of greatest importance may occur at an ultrastructural level beyond the resolution of current non- invasive technologies. Yet the pace of progress in imaging is such that we may soon have a much fi ner- grained picture of post-CBI neurobiology. Advances in this domain will tremendously improve our comprehension of what happens to the neuronal architecture after a concussion. Coupling such data with those related to brain metabolism and neuro- behavior would enable a far more accurate and sophisticated analysis of the short- and long- term consequences of CBI. At the experimental level, new animal models are needed that more accurately replicate typical human concussion. That step is essential to accelerating our progress in understanding and developing effective interventions for CBI and chronic encephalopathy.
The Pathophysiology of concussive crain injury
Tavazzi B;
2019-01-01
Abstract
Recent evidence suggests that concussion- related impairments can persist well beyond six months. This is revealed when patients are assessed: (1) by more complex cognitive tasks; (2) under circumstances of stress such as depression, pain, sleep deprivation, or high altitude; (3) by functional neuroimaging; and (4) by electrophysiological measures. With regard to the last: a small number of studies have also provided support for long-term changes in functional brain activity aft er concussion by recording electroencephalograms and measuring the classic P300 eventrelated potential component. The P300 is thought to refl ect a basic cognitive process by which incoming information is categorized and has also been linked to processes involved in updating the context of working memory. This study showed that, long after a concussion, more sensitive electrophysiological measures can reveal subtle changes in brain activity during cognitive processing, including inefficient information-processing capacity during a working- memory task, and it would be of great interest to couple these data with metabolic measurements. One of the biggest challenges of the next ten years will be to improve the applicability of advanced neuroimaging to concussion by determining its validity for reliably identifying biological changes that have clinical significance. Ultimately, the changes of greatest importance may occur at an ultrastructural level beyond the resolution of current non- invasive technologies. Yet the pace of progress in imaging is such that we may soon have a much fi ner- grained picture of post-CBI neurobiology. Advances in this domain will tremendously improve our comprehension of what happens to the neuronal architecture after a concussion. Coupling such data with those related to brain metabolism and neuro- behavior would enable a far more accurate and sophisticated analysis of the short- and long- term consequences of CBI. At the experimental level, new animal models are needed that more accurately replicate typical human concussion. That step is essential to accelerating our progress in understanding and developing effective interventions for CBI and chronic encephalopathy.I documenti in IRIS sono protetti da copyright e tutti i diritti sono riservati, salvo diversa indicazione.
