Effects of persistent post-concussion symptoms on neurocognitive, motor, and neurophysiological outcomes

Objective To determine the effects of persistent post-concussion symptoms (PPCS) on neurocognitive, motor, and neurophysiological outcomes compared to healthy controls. Sex-related differences were also examined.Methods A cross-sectional design was employed. Fifteen individuals with PPCS (24.3 ± 25.2 months post-injury, 25.7 ± 5.0 years; 9 F) and 15 age- and sex-matched controls (24.4 ± 3.8 years; 9 F) participated in the study. Outcome measures included i) symptom reporting, ii) neurocognitive status, iii) static and dynamic balance, iv) gait, and v) neurophysiology measures of corticospinal excitability and inhibition via transcranial magnetic stimulation.Results The PPCS group reported significantly greater number and severity of symptoms compared to the control group (p < 0.001). Overall neurocognitive performance and within the attention domain was worse in the PPCS group (p ≤ 0.04), and females performed worse than males (p ≤ 0.03). Individuals with PPCS had worse performance on gait (p = 0.01), with females in the PPCS group performing the worst (p ≤ 0.04). The PPCS group demonstrated greater corticospinal inhibition compared to controls, but it did not reach statistical significance (p = 0.07, ηp2 = 0.22).Conclusion The PPCS group demonstrated greater symptom reporting and severity, worse neurocognitive performance, worse balance and gait performance, and altered neurophysiology. Further, females with PPCS demonstrated worse balance and gait performance compared to all other groups.