1. Results
Somatosensory Processing and Neurocognitive Performance
During Recovery From Concussion
J. Beck1, S. Folger2DPT, W. Bixby1 PhD, E. E. Hall1 PhD, FACSM, C.J. Ketcham1 PhD, K. Patel3 MD
1Department of Exercise Science, 2 Department of Physical Therapy Education, 3 Department of Sports Medicine, Elon University, Elon, NC
Background
Research suggests that cortical metrics—a set of
sensory-based assessment tools—can differentiate a
concussed individual from a non-concussed individual.
Synchronization is a cortical metric that describes the
connectivity between neighboring cortical areas in the
brain. Research shows that when a concussion
causes neurological impairment it can be recorded as
it changes somatosensory processing, which are
controlled by neighboring cortical areas. This
processing speed may be related to deficits incurred
from a concussion.
Purpose
To determine the impact of concussions on
somatosensory processing and assess the relationship
between somatosensory processing and neurocognitive
performance.
Measures
In order to determine temporal order judgment (TOJ), two
sequential taps were delivered, one to each tip of digits 2
and 3, with an initial inter- stimulus interval (ISI) of
150ms. The ISI was subsequently reduced as a result of
subject response as defined by a two alternative forced
choice protocol. The stimulus location that received the
first of the two taps was randomized on a trial by trial
basis. Subjects were asked which stimulus came first.
ImPACT assesses neurocognitive function and gives 5
index scores:
Conclusions
This data suggests that deficits in somatosensory
processing and the relationship between visual motor
speed may have implications in concussion recovery
and return-to-play.
Participants
This study consisted of fifty NCAA Division I collegiate
student-athletes. 38 were tested at baseline, 6 were
tested within 10 days of a concussion and 6 were tested
greater than 10 days following a concussion.
Procedure
Participants took the Immediate Post-Concussion
Assessment and Cognitive Testing (ImPACTTM) test and
completed a somatosensory processing protocol
(Tommerdahl et al., 2007) using a vibrotactile stimulator
(Cortical Metrics, LLC) that delivered stimuli to the second
and third digits. Temporal order judgment (TOJ) involved
the ability to differentiate the timing between two
sequential taps on the digits in the presence and absence
of a conditioning stimulus. Participants were grouped as
not concussed, within 10 days of a concussion, or
beyond10 days of a concussion.
0
5
10
15
20
25
30
Baseline Within 10 days of
a concussion
Beyond 10 days
post-concussion
Meanvalueoftimedifference
Time to Temporal Order Judgement
TOJ Verbal
Memory
Visual
Memory
Visual
Motor
Speed
Reaction
Time
Impulse
Pearson
Correlation
-0.011 -0.088 -0.33 0.066 0.186
Sig.(1-tail) 0.469 0.272 0.100 0.326 0.098
• Verbal Memory
• Visual Memory
• Visual Motor
Processing Speed
• Reaction Time
• Impulse Control