Article

PURPOSE: To compare functional magnetic resonance imaging (fMRI) activation
patterns during a cognitive task, exercise capacity, and symptoms in
postconcussion syndrome (PCS) patients who received exercise treatment (n = 4)
with a PCS placebo stretching group (n = 4) and a healthy control group (n = 4).
METHODS: Subjects completed a math processing task during fMRI and an exercise
treadmill test before (time 1) and after approximately 12 weeks (time 2).
Exercise subjects performed aerobic exercise at 80% of the heart rate (HR)
attained on the treadmill test, 20 minutes per day with an HR monitor at home, 6
days per week. The program was modified as the HR for symptom exacerbation
increased. RESULTS: At time 1, there was no difference in fMRI activation between
the 2 PCS groups but healthy controls had significantly greater activation in the
posterior cingulate gyrus, lingual gyrus, and cerebellum versus all PCS subjects
(P < .05, corrected for multiple comparisons). At time 2, exercise PCS did not
differ from healthy controls whereas placebo stretching PCS had significantly
less activity in the cerebellum (P < .05 corrected) and in the anterior cingulate
gyrus and thalamus (P < .001, uncorrected) versus healthy controls. At time 2,
exercise PCS achieved a significantly greater exercise HR (P < .001) and had
fewer symptoms (P < .0004) than placebo stretching PCS. Cognitive performance did
not differ by group or time. CONCLUSIONS: Controlled aerobic exercise
rehabilitation may help restore normal cerebral blood flow regulation, as
indicated by fMRI activation, in PCS patients. The PCS symptoms may be related to
abnormal cerebral blood flow regulation.

Langue : ANGLAIS