During the acute recovery phase of concussion injury and mild TBI, injured individuals commonly demonstrate increased symptom reports (eg headache, dizziness, nausea, etc), impaired motor control (eg gait and balance), and slowed cognitive functioning. In the majority of instances, concussed individuals return to a pre-injury level of clinical functioning within 10 days of injury. Our research laboratory however, has demonstrated that subtle differences in balance, gait, brain electrophysiology and upper extremity visuomotor control remain undetectable by standard clinical tests and persist for years after injury. These subtle differences documented in young adults (18-29 years) may be the beginnings of chronic traumatic encephalopathy (CTE) reported in older adults with a concussion history. As such, we are proposing the application of repetitive transcranial magnetic stimulation (TMS) as a novel marker of persistent injury and potential intervention to decrease subtle declines in cerebral functioning.
