{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,3]],"date-time":"2026-06-03T19:34:49Z","timestamp":1780515289300,"version":"3.54.1"},"reference-count":62,"publisher":"SAGE Publications","issue":"15-16","license":[{"start":{"date-parts":[[2025,8,1]],"date-time":"2025-08-01T00:00:00Z","timestamp":1754006400000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2025,8]]},"abstract":"<jats:p>\n                    There is growing concern about the long-term health consequences of concussion, stemming from its high incidence and evidence of post-injury sequelae. This has raised critical questions about clinical assessments of concussion recovery, and whether brain function has fully recovered at medical clearance. The major knowledge gap is only partly addressed by conventional cross-sectional neuroimaging studies, due to a lack of pre-injury baseline imaging. To address this gap, 187 university-level athletes had resting-state functional magnetic resonance imaging collected at pre-season baseline. Of this cohort, 25 were later concussed, with imaging at early symptomatic injury (SYM), medical clearance to return to play (RTP), and 1\u20133 months post-RTP (POST). An additional 27 uninjured athletes were reimaged as controls. Brain maps were parcellated, and functional connectivity was measured between regions. Mixed models assessed connectivity change at each post-concussion session, along with the moderating effect of time to medical clearance. Concussed athletes had a significantly altered connectome, with predominantly reduced frontotemporal connectivity. Effects were most extensive at SYM, with diminishing but significant effects at RTP and POST, all of which exceeded uninjured control variability (all\n                    <jats:italic toggle=\"yes\">z<\/jats:italic>\n                    \u2264 \u22123.71,\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    \u2264 0.001). For participants with a longer time to medical clearance, more extensive connectivity decreases were also seen at all post-concussion imaging sessions. These findings provide direct evidence that functional brain recovery lags beyond medical clearance, with more pronounced effects among individuals who have prolonged clinical recovery. Such prospective analyses provide a unique window into biological recovery processes, with major implications for the clinical management of concussion.\n                  <\/jats:p>","DOI":"10.1089\/neu.2024.0499","type":"journal-article","created":{"date-parts":[[2025,5,30]],"date-time":"2025-05-30T04:59:16Z","timestamp":1748581156000},"page":"1287-1301","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Post-Concussion Changes in the Functional Brain Connectome Relative to Pre-Injury Baseline: A Prospective Observational Study"],"prefix":"10.1177","volume":"42","author":[{"given":"Nathan W.","family":"Churchill","sequence":"first","affiliation":[{"name":"Brain Health and Wellness Research Program, St. Michael\u2019s Hospital, Unity Health Toronto, Toronto, Canada."},{"name":"Keenan Research Centre for Biomedical Science, St. Michael\u2019s Hospital, Unity Health Toronto, Toronto, Canada."},{"name":"Department of Physics, Toronto Metropolitan University, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael G.","family":"Hutchison","sequence":"additional","affiliation":[{"name":"Keenan Research Centre for Biomedical Science, St. Michael\u2019s Hospital, Unity Health Toronto, Toronto, Canada."},{"name":"Faculty of Kinesiology and Physical Education, University of Toronto, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9647-6569","authenticated-orcid":false,"given":"Simon J.","family":"Graham","sequence":"additional","affiliation":[{"name":"Department of Medical Biophysics, University of Toronto, Toronto, Canada."},{"name":"Hurvitz Brain Sciences Program, Sunnybrook Research Institute, Toronto, Canada."},{"name":"Physical Sciences Platform, Sunnybrook Research Institute, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tom A.","family":"Schweizer","sequence":"additional","affiliation":[{"name":"Brain Health and Wellness Research Program, St. Michael\u2019s Hospital, Unity Health Toronto, Toronto, Canada."},{"name":"Keenan Research Centre for Biomedical Science, St. Michael\u2019s Hospital, Unity Health Toronto, Toronto, Canada."},{"name":"Faculty of Medicine (Neurosurgery), University of Toronto, Toronto, Canada."}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2025,8,14]]},"reference":[{"key":"e_1_3_6_2_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2015.4126"},{"key":"e_1_3_6_3_2","doi-asserted-by":"publisher","DOI":"10.1017\/cjn.2016.290"},{"key":"e_1_3_6_4_2","doi-asserted-by":"publisher","DOI":"10.1080\/02699050310001617352"},{"issue":"3","key":"e_1_3_6_5_2","first-page":"303","article-title":"Multiple concussions and neuropsychological functioning in collegiate football players","volume":"36","author":"Macciocchi SN","year":"2001","unstructured":"Macciocchi SN, , Barth JT, , Littlefield L, et al. Multiple concussions and neuropsychological functioning in collegiate football players. J Athl Train, 2001; 36(3):303\u2013306.","journal-title":"J Athl Train"},{"key":"e_1_3_6_6_2","doi-asserted-by":"publisher","DOI":"10.1097\/01.PHM.0000083666.74494.BA"},{"key":"e_1_3_6_7_2","doi-asserted-by":"publisher","DOI":"10.1249\/mss.0b013e3180383da5"},{"key":"e_1_3_6_8_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0b013e318204db50"},{"key":"e_1_3_6_9_2","doi-asserted-by":"publisher","DOI":"10.1080\/09540260310001606692"},{"key":"e_1_3_6_10_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2016-097464"},{"key":"e_1_3_6_11_2","doi-asserted-by":"publisher","DOI":"10.1162\/jocn_a_00077"},{"key":"e_1_3_6_12_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.0905267106"},{"key":"e_1_3_6_13_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008523"},{"key":"e_1_3_6_14_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2019.6471"},{"key":"e_1_3_6_15_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2013.2983"},{"key":"e_1_3_6_16_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2014.3413"},{"key":"e_1_3_6_17_2","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhu012"},{"key":"e_1_3_6_18_2","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhz129"},{"key":"e_1_3_6_19_2","doi-asserted-by":"publisher","DOI":"10.1038\/nn.4135"},{"key":"e_1_3_6_20_2","doi-asserted-by":"publisher","DOI":"10.3171\/2013.12.JNS132090"},{"key":"e_1_3_6_21_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0150215"},{"key":"e_1_3_6_22_2","doi-asserted-by":"publisher","DOI":"10.3389\/fneur.2016.00011"},{"issue":"5","key":"e_1_3_6_23_2","first-page":"738","article-title":"A prospective functional MR imaging study of mild traumatic brain injury in college football players","volume":"25","author":"Jantzen KJ","year":"2004","unstructured":"Jantzen KJ, , Anderson B, , Steinberg FL, et al. A prospective functional MR imaging study of mild traumatic brain injury in college football players. American Journal of Neuroradiology, 2004; 25(5):738\u2013745.","journal-title":"American Journal of Neuroradiology"},{"key":"e_1_3_6_24_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2013-092313"},{"key":"e_1_3_6_25_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097699"},{"key":"e_1_3_6_26_2","doi-asserted-by":"publisher","DOI":"10.3389\/fphys.2021.653603"},{"key":"e_1_3_6_27_2","doi-asserted-by":"publisher","DOI":"10.1093\/cercor\/bhw157"},{"key":"e_1_3_6_28_2","doi-asserted-by":"publisher","DOI":"10.1038\/s41598-021-85811-4"},{"key":"e_1_3_6_29_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2017-097506"},{"key":"e_1_3_6_30_2","first-page":"1","article-title":"Assessing the effects of concussion using the C3Logix Test Battery: An exploratory study","author":"Bernstein JP","year":"2018","unstructured":"Bernstein JP, , Calamia M, , Pratt J, et al. Assessing the effects of concussion using the C3Logix Test Battery: An exploratory study. Applied Neuropsychology: Adult, 2018:1\u20138.","journal-title":"Applied Neuropsychology: Adult"},{"key":"e_1_3_6_31_2","doi-asserted-by":"publisher","DOI":"10.1080\/87565641.2017.1383994"},{"key":"e_1_3_6_32_2","doi-asserted-by":"publisher","DOI":"10.1002\/sim.7654"},{"key":"e_1_3_6_33_2","volume-title":"Greenfield\u2019s Neuropathology","author":"Graham D","year":"2002","unstructured":"Graham D, , Gennarelli T, , McIntosh T. Trauma. In: Greenfield\u2019s Neuropathology. Oxford University Press: New York; 2002."},{"key":"e_1_3_6_34_2","doi-asserted-by":"publisher","DOI":"10.1037\/neu0000110"},{"key":"e_1_3_6_35_2","doi-asserted-by":"publisher","DOI":"10.1227\/01.NEU.0000186950.54075.3B"},{"issue":"7","key":"e_1_3_6_36_2","first-page":"17","article-title":"Finite Element (FE) human head models\/literature review","volume":"2","author":"Tarlochan F","year":"2013","unstructured":"Tarlochan F. Finite Element (FE) human head models\/literature review. Int J Sci Technol Res, 2013; 2(7):17\u201331. Available from: https:\/\/www.ijstr.org\/","journal-title":"Int J Sci Technol Res"},{"key":"e_1_3_6_37_2","doi-asserted-by":"publisher","DOI":"10.1038\/jcbfm.1990.115"},{"key":"e_1_3_6_38_2","doi-asserted-by":"publisher","DOI":"10.1007\/s13311-014-0319-5"},{"key":"e_1_3_6_39_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroscience.2005.01.052"},{"key":"e_1_3_6_40_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0006-8993(97)01418-2"},{"key":"e_1_3_6_41_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.1995.12.555"},{"key":"e_1_3_6_42_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.expneurol.2015.02.011"},{"key":"e_1_3_6_43_2","doi-asserted-by":"publisher","DOI":"10.3389\/fncel.2012.00058"},{"key":"e_1_3_6_44_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0056805"},{"key":"e_1_3_6_45_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.tics.2017.03.003"},{"key":"e_1_3_6_46_2","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.24962"},{"key":"e_1_3_6_47_2","doi-asserted-by":"publisher","DOI":"10.1148\/radiol.12120748"},{"key":"e_1_3_6_48_2","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.21151"},{"key":"e_1_3_6_49_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.nicl.2018.02.011"},{"key":"e_1_3_6_50_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.0000000000008523"},{"key":"e_1_3_6_51_2","doi-asserted-by":"publisher","DOI":"10.1089\/neu.2015.3905"},{"key":"e_1_3_6_52_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0065470"},{"key":"e_1_3_6_53_2","doi-asserted-by":"publisher","DOI":"10.1002\/(SICI)1522-2586(199907)10:1<33::AID-JMRI5>3.0.CO;2-N"},{"key":"e_1_3_6_54_2","doi-asserted-by":"publisher","DOI":"10.1002\/hbm.23843"},{"key":"e_1_3_6_55_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2015.07.010"},{"key":"e_1_3_6_56_2","doi-asserted-by":"publisher","DOI":"10.1152\/jn.00783.2009"},{"key":"e_1_3_6_57_2","doi-asserted-by":"publisher","DOI":"10.1136\/bjsports-2023-106849"},{"key":"e_1_3_6_58_2","doi-asserted-by":"publisher","DOI":"10.1212\/WNL.44.5.837"},{"key":"e_1_3_6_59_2","doi-asserted-by":"publisher","DOI":"10.1001\/archinte.166.10.1092"},{"issue":"3","key":"e_1_3_6_60_2","article-title":"The state-trait anxiety inventory","volume":"5","author":"Spielberger CD","year":"1971","unstructured":"Spielberger CD, , Gonzalez-Reigosa F, , Martinez-Urrutia A, et al. The state-trait anxiety inventory. Revista Interamericana de Psicologia\/Interamerican Journal of Psychology, 1971; 5(3 & 4).","journal-title":"Revista Interamericana de Psicologia\/Interamerican Journal of Psychology"},{"key":"e_1_3_6_61_2","doi-asserted-by":"publisher","DOI":"10.1093\/occmed\/kqu168"},{"key":"e_1_3_6_62_2","doi-asserted-by":"publisher","DOI":"10.1073\/pnas.1001414107"},{"key":"e_1_3_6_63_2","doi-asserted-by":"publisher","DOI":"10.1016\/j.neuroimage.2003.12.030"}],"container-title":["Journal of Neurotrauma"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/journals.sagepub.com\/doi\/full-xml\/10.1089\/neu.2024.0499","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2024.0499","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/journals.sagepub.com\/doi\/pdf\/10.1089\/neu.2024.0499","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,5,1]],"date-time":"2026-05-01T22:46:03Z","timestamp":1777675563000},"score":1,"resource":{"primary":{"URL":"https:\/\/journals.sagepub.com\/doi\/10.1089\/neu.2024.0499"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2025,8]]},"references-count":62,"journal-issue":{"issue":"15-16","published-print":{"date-parts":[[2025,8]]}},"alternative-id":["10.1089\/neu.2024.0499"],"URL":"https:\/\/doi.org\/10.1089\/neu.2024.0499","relation":{},"ISSN":["0897-7151","1557-9042"],"issn-type":[{"value":"0897-7151","type":"print"},{"value":"1557-9042","type":"electronic"}],"subject":[],"published":{"date-parts":[[2025,8]]}}}