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To date, studies have largely focused on changes in pairwise connectivity strength between brain regions. Less is known about how concussion affects whole-brain network topology, particularly the \u201csmall-world\u201d organization which facilitates efficient communication at both local and global scales. The present study addressed this knowledge gap by measuring local and global efficiency of 26 concussed athletes at acute injury, return to play (RTP) and one year post-RTP, along with a cohort of 167 athletic controls. On average, concussed athletes showed no alterations in local efficiency but had elevated global efficiency at acute injury, which had resolved by RTP. Athletes with atypically long recovery, however, had reduced global efficiency at 1\u00a0year post-RTP, suggesting long-term functional abnormalities for this subgroup. Analyses of nodal efficiency further indicated that global network changes were driven by high-efficiency visual and sensorimotor regions and low-efficiency frontal and subcortical regions. This study provides evidence that concussion causes\u00a0subtle acute and long-term changes in the small-world organization of the brain, with effects that are related to the clinical profile of recovery.<\/jats:p>","DOI":"10.1038\/s41598-021-85811-4","type":"journal-article","created":{"date-parts":[[2021,3,25]],"date-time":"2021-03-25T11:06:58Z","timestamp":1616670418000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":26,"title":["Long-term changes in the small-world organization of brain networks after concussion"],"prefix":"10.1038","volume":"11","author":[{"given":"N. W.","family":"Churchill","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"M. 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