A preliminary investigation of cognitive intolerance and neuroimaging among adolescents returning to school after concussion.
John G Baker, Barry S Willer, Michael G Dwyer and 1 others
PMID 32324445WHAT IT FOUND
In adolescents recovering from concussion, higher reported cognitive symptoms were linked to lower white matter integrity on brain scans.
This pilot suggests a link between symptom burden and brain structure, but does not prove a test can diagnose cognitive intolerance yet.
Key findings
01Higher scores for cognitive intolerance symptoms were significantly associated with lower fractional anisotropy values in white matter tracts connecting frontal and parietal regions.
02These associations were found only at the follow-up imaging time point (average 22.4 days post-injury) and not at the initial time point.
03When the analysis included a mixture of patients and healthy controls, the associations did not reach statistical significance.
STILL TO COME
How it was doneWhat they foundWhat it means for SLPs
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What it does not show
The sample size was very small (26 patients). The measures of cognitive intolerance were subjective, relying on patient reports and chart notes rather than a standardized objective test. The study design was compromised by the need to preserve blinding for a larger study, resulting in mixed groups of patients and controls for some analyses. The associations were only seen at one time point and did not hold up when controls were included in the analysis. This is a pilot study aimed at introducing a concept, not at proving clinical utility.
Declared interests
The authors report no conflict of interest.
The easy way to misread this
Do not interpret the association between symptom scores and brain scan values as a diagnostic test. The findings were only significant in the small patient-only group and disappeared when controls were mixed in, meaning this does not yet offer a way to identify cognitive intolerance in individual patients.