IMR Press / JIN / Volume 22 / Issue 2 / DOI: 10.31083/j.jin2202050
Open Access Original Research
Post-Concussion Symptoms, Cognition and Brain Connectivity in an Australian Undergraduate Population: A Quantitative Electroencephalography Study
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1 School of Psychological Science, University of Western Australia, 6009 Perth, WA, Australia
2 Curtin Health Innovation Research Institute, Curtin University, 6102 Bentley, WA, Australia
3 Perron Institute for Neurological and Translational Science, 6009 Nedlands, WA, Australia
*Correspondence: (Francesca Buhagiar)
These authors contributed equally.
J. Integr. Neurosci. 2023, 22(2), 50;
Submitted: 13 September 2022 | Revised: 2 December 2022 | Accepted: 7 December 2022 | Published: 8 March 2023
(This article belongs to the Special Issue Advances in Traumatic Brain Injury)
Copyright: © 2023 The Author(s). Published by IMR Press.
This is an open access article under the CC BY 4.0 license.

Background: An estimated 99 in 100,000 people experience a traumatic brain injury (TBI), with 85% being mild (mTBI) in nature. The Post-Concussion Symptom Scale (PCSS), is a reliable and valid measure of post-mTBI symptoms; however, diagnostic specificity is challenging due to high symptom rates in the general population. Understanding the neurobiological characteristics that distinguish high and low PCSS raters may provide further clarification on this phenomenon. Aim: To explore the neurobiological characteristics of post-concussion symptoms through the association between PCSS scores, brain network connectivity (using quantitative electroencephalography; qEEG) and cognition in undergraduates. Hypotheses: high PCSS scorers will have (1) more network dysregulation and (2) more cognitive dysfunction compared to the low PCSS scorers. Methods: A sample of 40 undergraduates were divided into high and low PCSS scorers. Brain connectivity was measured using qEEG, and cognition was measured via neuropsychological measures of sustained attention, inhibition, immediate attention, working memory, processing speed and inhibition/switching. Results: Contrary to expectations, greater frontoparietal network dysregulation was seen in the low PCSS score group (p = 0.003). No significant difference in cognitive dysfunction was detected between high and low PCSS scorers. Post-hoc analysis in participants who had experienced mTBI revealed greater network dysregulation in those reporting a more recent mTBI. Conclusions: Measuring post-concussion symptoms alone is not necessarily informative about changes in underlying neural mechanisms. In an exploratory subset analysis, brain network dysregulation appears to be greater in the early post-injury phase compared to later. Further analysis of underlying PCSS constructs and how to measure these in a non-athlete population and clinical samples is warranted.

post-concussion symptom scale
post-concussion symptoms
network connectivity
default mode network
salience network
frontoparietal network
Perron Institute for Neurological and Translational Science
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