BOLD Alterations in Working Memory after Mild Traumatic Brain Injury versus Concussion: A fMRI Study
Bibliographic record
Abstract
Mild traumatic brain injury (mTBI) and concussion are terms that are often used interchangeably.A lack of uniformity between their definitions, however, has created controversies across disciplines.With the concussion definition, developed by the Concussion in Sport Group (CISG), patients do not need to present with one of the objective clinical signs after head injury (e.g., loss of consciousness), but instead only post-concussive symptoms (PCS), whereas they are essential for the mTBI definition created by the World Health Organization (WHO).The discrepancy between the definitions has generated diagnostic challenges when PCS are present and patients lack the hallmark features of mTBI.Through use of task-based functional magnetic resonance imaging (fMRI), this study aimed to determine if mTBI and concussion are distinct diagnostic entities, or if they should be considered synonymous.We recruited patients who fit the WHO criteria of mTBI, patients who fit the CISG definition of concussion without the mTBI criteria, and healthy controls.Using a verbal working memory task, we compared task performance and fMRI blood-oxygen-level-dependent (BOLD) signal changes between groups.Whole-brain analysis of fMRI activations revealed differences in altered activations patterns between the concussion and mTBI groups, despite performing as well as the control group on the task.Specifically, the mTBI group showed significantly reduced BOLD signal changes in prefrontal, insular, and parietal brain regions when compared to the concussion and control groups.Furthermore, the concussion group had additional increases in activity outside the regions of interest, in the left medial frontal gyrus, left frontal eye fields, right globus pallidus, right caudate, and left fusiform gyrus, which was not seen in the control group.Both patient groups also presented with abnormal activations in our regions of interest, but these atypical activation patterns could not be attributed to post-concussion symptom scale
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.000 | 0.000 |
| Science and technology studies | 0.000 | 0.000 |
| Scholarly communication | 0.000 | 0.000 |
| Open science | 0.000 | 0.000 |
| Research integrity | 0.001 | 0.000 |
| Insufficient payload (model declined to judge) | 0.005 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".