TY  - JOUR
AU  - Pearce, Alan J
PY  - 2019
DA  - 2019/09/27
TI  - Transcranial Magnetic Stimulation: A Tool for Quantifying Neurophysiological Changes in the Brain Following Concussion Injury in Sports
JO  - OBM Neurobiology
SP  - 042
VL  - 03
IS  - 03
AB  - Background: Sport-related concussion is a growing public health concern. Defined as a injury that disturbs neurological functions, concussion is characterised by a constellation of signs and symptoms. However, clinical imaging methods do not reveal any structural damage. Recently, neurophysiological techniques such as single and paired-pulse transcranial magnetic stimulation (TMS) are being applied to quantify neurophysiological changes (specifically corticospinal and intracortical excitation and intracortical inhibition) following concussion; both from an acute perspective, but also to investigate chronic changes associated with concussion injuries. The aim of this review paper is to present a systematic review and qualitative review on studies using TMS to assess concussion. Specifically, questions addressed refer to the efficacy of single and paired-pulse TMS on quantifying changes in neurophysiology following acute concussion and long-term changes in those with a history of repeated head trauma.
Methods: Systematic searching of relevant databases for peer-reviewed literature between 1985 to present day. A qualitative synthesis of studies attaining the inclusion criteria was conducted.
Results: Twenty-two studies met the inclusion criteria. TMS study checklist rated studies of moderate to high methodological quality, with all but five studies being observational between-group design. Nine studies reported short-term data following concussion, with seven of the nine studies reporting alterations in intracortical inhibition. Thirteen studies reported long-term changes in those with persistent symptoms or chronic changes with history of head trauma. Six of 11 studies presented changes in intracortical inhibition with single pulse. Eleven studies presented paired-pulse data; intracortical facilitation was reported in two studies, while one study reporting short-interval intracotrical facilitation. All but one study reported intracortical inhibition measures, with the majority of these studies showing differences in long-interval intracortical inhibition differences between older individuals with a history of head trauma compared to age-matched controls.
Conclusions: This review demonstrates that TMS is a reliable and sophisticated technique to measure the neurophysiology of concussion. While further studies are required to establish effectiveness TMS as a clinical tool for mild brain injury, the potential of TMS to reliably quantify cortical activity offers exciting opportunities to provide objective measures for concussion diagnosis and prognosis.
SN  - 2573-4407
UR  - https://doi.org/10.21926/obm.neurobiol.1903042
DO  - 10.21926/obm.neurobiol.1903042
ID  - Pearce2019
ER  -