Grant: Master's Award: Canada Graduate Scholarships

Pediatric concussions are a burden on the Canadian healthcare system, with rates increasing ~2.5-fold between 2010-2014. Most pediatric concussions resolve within 1 month, but over 30% of children will experience persistent post-concussive symptoms (PPCS) that are defined as three new or worsening symptoms beyond 1-month post-injury. PPCS is linked to decreased academic performance and quality of life. Effective post-concussion treatments exist and may prevent PPCS, but a lack of accurate prognostic tools makes it difficult to identify which children most need early intervention. The 5P Clinical Risk Score predicts children at high-risk of PPCS, but has moderate accuracy and relies on self-reported measures. Electroencephalography (EEG) is a feasible and widely available tool that can identify alterations in brain function post-concussion. EEG has potential to uncover a biomarker of PPCS, but is unexplored in children. Our objective is to determine if EEG markers will outperform clinical measures (5P Clinical Risk Score and physician judgment) in predicting PPCS in youth with concussion. Our hypothesis is EEG markers will have higher PPCS prediction accuracy than clinical measures. Youth aged 10-17 years will be recruited through the Montreal Children’s Hospital Pediatric Emergency Department (PED). In the PED, the 5P Clinical Risk Score will be calculated, the treating physician will rate the child’s likelihood of experiencing PPCS, and a resting-state EEG will be completed using a 19-channel EEG headset. A phone follow-up will occur at 1-month post-injury to determine if PPCS is present. An objective biomarker of PPCS will help identify children at high-risk of prolonged recovery, allowing clinicians to prioritize treatment to those needing early intervention.