Although several mechanisms have been proposed to underlie observed neuropsychological deficits and subsequent recovery of function following Mild Traumatic Brain Injury (MTBI), to date the link between alterations in axonal morphology, large scale neural functioning and behavioral recovery has not been established. This proposal represents an integrated approach to establishing a connection between structural damage resulting from MTBI, consequent deficits in neural functioning and the outward manifestations of cognitive and behavioral symptoms. The approach is both discovery-based and hypothesis driven, in which animal models of neural reorganization and regeneration, as well as possible cognitive compensatory processes are subject to empirical test. The accessibility to pre-injury baseline measures in athletes makes concussion an ideal entry point into the prospective study of MTBI and recovery of function. Over five consecutive years, pre-season baseline measures will be collected from FAU football players (N=80/year) on a Comprehensive Imaging Protocol for the Assessment of Concussion (CIPAC). The CIPAC will employ a combination of: a) functional magnetic resonance imaging (fMRI) and diffusion tensor imaging (DTI), b) a Web-based neurocognitive assessment battery designed specifically for prospective testing (Concussion Resolution Index, Headminder Inc.), c) the NeuroCom(R) sensory organization test and d) self reported symptoms. Players identified as suffering a concussion during the course of the season will enter a post-concussion recording schedule in which they will be tested within 24 hours following injury and at regular intervals during recovery and during follow-up at 1 and 3 months. In this prospective approach, pre-injury levels of behavioral and neural functioning acquired during baseline testing will be used to evaluate post-concussion deficits independently for each individual. Particular focus will be on questions concerning: 1) the morphological, physiological and behavioral consequences of (multiple) concussions; 2) mechanisms of plasticity and recovery of function following MTBI; 3) the relationship between deficits in neural functioning and standardized behavioral measures of concussion; and 4) the implications for current assessment techniques and return to play guidelines. This individualized approach should provide important insights into the structural and dynamic mechanisms underlying recovery of function in the human brain.
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