Revealing the Relationship between Neurocognitive and Functional Neuroimaging Findings in Concussed Adolescents: An Investigation of Working Memory, Math Fluency, and Functional Near Infrared Spectroscopy

Date of Submission


Degree Type


Degree Name

Doctor of Psychology (PsyD)

Department Chair

Robert A DiTomasso, PhD, ABPP

First Advisor

Sarah Levin Allen, PhD, CBIS

Second Advisor

George McCloskey, PhD

Third Advisor

Hasan Ayaz, PhD

Fourth Advisor

Brian Balin, PhD


Methods used to make concussion diagnoses, namely neurocognitive testing and symptom reporting/observation, can be unreliable and lack sensitivity. For adolescents—an especially susceptible age group—decisions regarding returning to activities typically rely on these methods. The imprecision of these measures can, therefore, unnecessarily subject children to further injury and prolonged recovery trajectories. Although current methods can help inform some decisions, much of the underlying physiological changes attributed to concussion cannot be gleaned from these standard practices. The current study aimed to evaluate the relationship between behavioral functioning and underlying brain activation changes that occur in order to better understand the underlying physiological changes that occur in adolescents with concussions. Concussed adolescents (n = 10) ages 14 to 17 within 4 weeks of concussion were compared to matched controls (n = 10). Participants completed two tasks (n-back, math fluency) while wearing the functional near infrared spectroscopy (fNIRS). Each task consisted of three conditions (n-back: 1-back, 2-back, and 3-back; math fluency: addition, subtraction, and multiplication). Groups were compared across neurocognitive and neuroimaging dimensions. Correlational analyses revealed significant correlations within the response time (RT) and accuracy (ACC) measures of each task. There were significant main effects for the math (p

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