Emotional Regulation and Adolescent Concussion: Overview and Role of Neuroimaging

João Paulo Lima Santos (), Meilin Jia-Richards, Anthony P. Kontos, Michael W. Collins and Amelia Versace
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João Paulo Lima Santos: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
Meilin Jia-Richards: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA
Anthony P. Kontos: Department of Orthopaedic Surgery, UPMC Sports Concussion Program, University of Pittsburgh, Pittsburgh, PA 15213, USA
Michael W. Collins: Department of Orthopaedic Surgery, UPMC Sports Concussion Program, University of Pittsburgh, Pittsburgh, PA 15213, USA
Amelia Versace: Department of Psychiatry, University of Pittsburgh School of Medicine, Pittsburgh, PA 15213, USA

IJERPH, 2023, vol. 20, issue 13, 1-21

Abstract: Emotional dysregulation symptoms following a concussion are associated with an increased risk for emotional dysregulation disorders (e.g., depression and anxiety), especially in adolescents. However, predicting the emergence or worsening of emotional dysregulation symptoms after concussion and the extent to which this predates the onset of subsequent psychiatric morbidity after injury remains challenging. Although advanced neuroimaging techniques, such as functional magnetic resonance imaging and diffusion magnetic resonance imaging, have been used to detect and monitor concussion-related brain abnormalities in research settings, their clinical utility remains limited. In this narrative review, we have performed a comprehensive search of the available literature regarding emotional regulation, adolescent concussion, and advanced neuroimaging techniques in electronic databases (PubMed, Scopus, and Google Scholar). We highlight clinical evidence showing the heightened susceptibility of adolescents to experiencing emotional dysregulation symptoms following a concussion. Furthermore, we describe and provide empirical support for widely used magnetic resonance imaging modalities (i.e., functional and diffusion imaging), which are utilized to detect abnormalities in circuits responsible for emotional regulation. Additionally, we assess how these abnormalities relate to the emotional dysregulation symptoms often reported by adolescents post-injury. Yet, it remains to be determined if a progression of concussion-related abnormalities exists, especially in brain regions that undergo significant developmental changes during adolescence. We conclude that neuroimaging techniques hold potential as clinically useful tools for predicting and, ultimately, monitoring the treatment response to emotional dysregulation in adolescents following a concussion.

Keywords: concussion; adolescence; post-concussion symptoms; emotion dysregulation; functional MRI; resting state MRI; diffusion MRI (search for similar items in EconPapers)
JEL-codes: I I1 I3 Q Q5 (search for similar items in EconPapers)
Date: 2023
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