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Review
.2010 Oct;1208(1):58-66.
doi: 10.1111/j.1749-6632.2010.05695.x.

A unified science of concussion

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Free PMC article
Review

A unified science of concussion

Jun Maruta et al. Ann N Y Acad Sci.2010 Oct.
Free PMC article

Abstract

The etiology, imaging, and behavioral assessment of mild traumatic brain injury (mTBI) are daunting fields, given the lack of a cohesive neurobiological explanation for the observed cognitive deficits seen following mTBI. Although subjective patient self-report is the leading method of diagnosing mTBI, current scientific evidence suggests that quantitative measures of predictive timing, such as visual tracking, could be a useful adjunct to guide the assessment of attention and to screen for advanced brain imaging. Magnetic resonance diffusion tensor imaging (DTI) has demonstrated that mTBI is associated with widespread microstructural changes that include those in the frontal white matter tracts. Deficits observed during predictive visual tracking correlate with DTI findings that show lesions localized in neural pathways subserving the cognitive functions often disrupted in mTBI. Unifying the anatomical and behavioral approaches, the emerging evidence supports an explanation for mTBI that the observed cognitive impairments are a result of predictive timing deficits caused by shearing injuries in the frontal white matter tracts.

© 2010 Association for Research in Nervous and Mental Disease.

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Figures

Figure 1
Figure 1
Visual tracking of a target moving in a circular trajectory of 8.5° radius at 0.4 Hz. (A) Example of a good performance by a normal subject. (B) Example of a poor performance by a subject with chronic postconcussive symptoms. Right panel: Two-dimensional trajectory of the gaze superimposed over nine cycles. Left panel: Scattergram of gaze positions relative to the target fixed at the 12 o'clock position. The white circle indicates the average gaze position. The dot–dashed curve indicates the circular path.
Figure 2
Figure 2
Relationships between FA values and visual tracking performance variability in the tangential direction of the target trajectory. (A) Right ACR. (B) Genu of the corpus callosum (CC). The regression lines were determined from the combined subject population. (C) Cross-factorization of A and B (multiplication of respective abscissa and ordinates). Circles, normal subjects; Diamonds, subjects with chronic postconcussive symptoms; SD, standard deviation; VAR, variance.
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