Altered resting state EEG microstate dynamics in acute-phase pediatric mild traumatic brain injury.

Objective Sport-related concussion presents significant diagnostic and monitoring challenges, especially in youth populations. This study investigates the potential of EEG microstate analysis as a tool for assessing acute-phase brain activity changes in adolescent male athletes following a concussion. We analyzed resting-state EEG data from 32 participants in a between-subjects design, comparing participants with acute concussion (within two weeks of injury) to an age- and sex-matched sample with no reported history of concussion. Methodology We applied a modified k-means clustering algorithm to group resting-state EEG topographical maps into seven clusters, with each cluster represented by one of the canonical microstate classes (A-G). Average duration, occurrence rate, and time coverage for each microstate were extracted.

Statistically significant differences in mean duration, occurrence rate, and time coverage of microstates B and E were observed. Specifically, the mean duration, occurrence and time coverage of microstate E showed a significant decrease in the concussed cohort in comparision to the controls (p < 0.001). In addition, the mean duration, occurrence rate and time coverage was higher in the concussed cohort in comparision with the healthy cohort (p = 0.003). A significant negative linear relationship was found between microstate E and symptom severity (p = 0.006, F = 15.72).

These results suggest that mild traumatic brain injury may disrupt the dynamic interaction of large-scale brain networks, hinting at potential biomarkers of injury. This study may help to inform future work on objective, brain-based tools for diagnosis and recovery assessment in concussed adolescents. Further research in larger, more diverse populations is necessary to validate these potential biomarkers. Competing Interest Statement The authors have declared no competing interest. Funding Statement Yes Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was approved by the University of British Columbia Clinical Research Ethics Board (Approval number: H17-02973). All participants provided assent and their parents gave written informed consent as per the guidelines of the Human Ethics Review Board of the University of British Columbia. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable. Yes Data Availability Data cannot be shared publicly because the data has been obtained from children. Data may be available for researchers who meet the criteria for access to confidential data by contacting the senior author (NVB - nvb31{at}mail.ubc.ca).