{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,26]],"date-time":"2026-06-26T07:28:46Z","timestamp":1782458926755,"version":"3.54.5"},"reference-count":52,"publisher":"MDPI AG","issue":"12","license":[{"start":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T00:00:00Z","timestamp":1718755200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"National Institute of Health","award":["R01MH11488101"],"award-info":[{"award-number":["R01MH11488101"]}]},{"name":"National Institute of Health","award":["FP00004146"],"award-info":[{"award-number":["FP00004146"]}]},{"name":"Chuck Noll Foundation for Brain Injury Research","award":["R01MH11488101"],"award-info":[{"award-number":["R01MH11488101"]}]},{"name":"Chuck Noll Foundation for Brain Injury Research","award":["FP00004146"],"award-info":[{"award-number":["FP00004146"]}]}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["JCM"],"abstract":"<jats:p>Background: Understanding the behavioral and neural underpinnings of the post-concussion recovery of working memory function is critically important for improving clinical outcomes and adequately planning return-to-activity decisions. Previous studies provided inconsistent results due to small sample sizes and the use of a mixed population of participants who were at different post-injury time points. We aimed to examine working memory recovery during the first 6 months post-concussion in adolescents. Methods: We used functional magnetic resonance imaging (fMRI) to scan 45 concussed adolescents [CONCs] at baseline (&lt;10 days post-concussion) and at 6 months post-concussion. Healthy control adolescents [HCs; n = 32] without a history of concussion were scanned once. During the scans, participants performed one-back and two-back working memory tasks with letters as the stimuli and angry, happy, neutral, and sad faces as distractors. Results: All affected adolescents were asymptomatic and cleared to return to activity 6 months after concussion. Working memory recovery was associated with faster and more accurate responses at 6 months vs. baseline (p-values &lt; 0.05). It was also characterized by significant difficulty-related activation increases in the left inferior frontal gyrus (LIFG) and the left orbitofrontal cortex (LOFC) at 6 months vs. baseline. Although the activation differences between one-back and two-back were comparable between HCs and CONCs at 6 months, HCs had more pronounced activation in the LIFG than concussed adolescents. Conclusions: Post-concussion recovery is associated with significant performance improvements in speed and accuracy, as well as the normalization of brain responses in the LIFG and LOFC during the n-back task. The observed patterns of LOFC activation might reflect compensatory strategies to distribute neural processing and reduce neural fatigue post-concussion.<\/jats:p>","DOI":"10.3390\/jcm13123585","type":"journal-article","created":{"date-parts":[[2024,6,19]],"date-time":"2024-06-19T08:06:06Z","timestamp":1718784366000},"page":"3585","update-policy":"https:\/\/doi.org\/10.3390\/mdpi_crossmark_policy","source":"Crossref","is-referenced-by-count":4,"title":["Working Memory Recovery in Adolescents with Concussion: Longitudinal fMRI Study"],"prefix":"10.3390","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-6605-5130","authenticated-orcid":false,"given":"Anna","family":"Manelis","sequence":"first","affiliation":[{"name":"Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jo\u00e3o P.","family":"Lima Santos","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stephen J.","family":"Suss","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cynthia L.","family":"Holland","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery\/UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Courtney A.","family":"Perry","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery\/UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert W.","family":"Hickey","sequence":"additional","affiliation":[{"name":"Department of Pediatric Emergency Medicine, Children\u2019s Hospital of Pittsburgh, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA 15224, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael W.","family":"Collins","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery\/UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anthony P.","family":"Kontos","sequence":"additional","affiliation":[{"name":"Department of Orthopaedic Surgery\/UPMC Sports Medicine Concussion Program, University of Pittsburgh, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9925-5203","authenticated-orcid":false,"given":"Amelia","family":"Versace","sequence":"additional","affiliation":[{"name":"Department of Psychiatry, University of Pittsburgh, Pittsburgh, PA 15213, USA"},{"name":"Department of Radiology, Magnetic Resonance Research Center, University of Pittsburgh Medical Center, University of Pittsburgh, Pittsburgh, PA 15213, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1968","published-online":{"date-parts":[[2024,6,19]]},"reference":[{"key":"ref_1","doi-asserted-by":"crossref","first-page":"1789","DOI":"10.1001\/jama.2021.1538","article-title":"Trends in the Prevalence of Concussion Reported by US Adolescents, 2016\u20132020","volume":"325","author":"Veliz","year":"2021","journal-title":"JAMA J. 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