Altered resting state EEG microstate dynamics in acute-phase pediatric mild traumatic brain injury.

Objective: Sport-related concussion presents significant diagnostic and monitoring challenges, especially in youth populations. This study investigates the potential of EEG microstate analysis as a tool for assessing acute-phase brain activity changes in adolescent male athletes following a concussion. We analyzed resting-state EEG data from 32 participants in a between-subjects design, comparing participants with acute concussion (within two weeks of injury) to an age- and sex- matched sample with no reported history of concussion. Methodology: We applied a modified k-means clustering algorithm to group resting-state EEG topographical maps into seven clusters, with each cluster represented by one of the canonical microstate classes (A-G). Average duration, occurrence rate, and time coverage for each microstate were extracted.  Results: Statistically significant differences in mean duration, occurrence rate, and time coverage of microstates B and E were observed. Specifically, the mean duration, occurrence and time coverage of microstate E showed a significant decrease in the concussed cohort in comparision to the controls (p < 0.001). In addition, the mean duration, occurrence rate and time coverage was higher in the concussed cohort in comparision with the healthy cohort (p = 0.003). A significant negative linear relationship was found between microstate E and symptom severity (p = 0.006, F = 15.72). Discussion: These results suggest that mild traumatic brain injury may disrupt the dynamic interaction of large-scale brain networks, hinting at potential biomarkers of injury. This study may help to inform future work on objective, brain-based tools for diagnosis and recovery assessment in concussed adolescents. Further research in larger, more diverse populations is necessary to validate these potential biomarkers.