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Preliminary study finds altered cortical activity during balance recovery in symptomatic mTBISmall study finds brain activity differences during balance recovery after mild concussion

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Key Takeaway
Consider these preliminary findings on altered cortical balance activity in mTBI as hypothesis-generating only.

This preliminary investigation compared cortical activity during balance recovery in 5 people with symptomatic mild traumatic brain injury (mTBI, 27±13 days post-injury) and 5 age-matched controls (21-35 years). Participants underwent instrumented push & release tests of reactive balance while researchers measured preparatory sensorimotor cortical beta-burst power and duration before perturbation, and cortical N1 response amplitude and latency during recovery.

People with mTBI showed lower preparatory beta-burst power compared to controls (effect size g=1.18, p=0.044) and earlier cortical N1 response latency during balance recovery (g=3.28, p=0.045). The relationship between preparatory and evoked cortical activity was also altered after mTBI, with greater beta-burst power and longer duration associated with shorter N1 latencies (rs>-0.77, ps<0.010). Safety and tolerability data were not reported.

Key limitations include the preliminary, hypothesis-generating nature of the observations and the very small sample size (n=5 per group), which severely limits generalizability. The study design cannot establish causality, only associations. The authors suggest the preparatory brain state before reactive balance recovery should be explored as a potential target for post-mTBI rehabilitation, but this remains speculative given the early stage of evidence.

Researchers conducted a small, preliminary study to understand how the brain controls balance after mild traumatic brain injury (mTBI), commonly called concussion. They looked at brain activity in 5 people with recent symptomatic concussions and 5 healthy people of similar age (21-35 years old). All participants performed balance tests where they had to recover from being gently pushed.

The study measured brain signals before and during these balance challenges. They found that people with concussion had lower power in certain brain signals (called beta-bursts) in the second before a balance challenge began. During the recovery itself, their brains showed an earlier response (called the N1 response) compared to healthy people. The relationship between these two types of brain activity also appeared different after concussion.

This research is very early and exploratory. With only 5 people in each group, the findings cannot be generalized to everyone with concussion. The study shows there may be measurable differences in how the brain prepares for and reacts to balance threats after injury, but it does not prove these differences cause balance problems. More research with many more people is needed to see if these brain signals could one day help guide rehabilitation.

What this means for you:
A very small study found brain activity differences during balance tasks in people with concussion, but much more research is needed.

Study Details

Sample sizen = 5
EvidenceLevel 5
PublishedMar 2026
View Original Abstract ↓
Background and purposePeople after mild traumatic brain injury (mTBI) show persistent deficits in reactive balance. Cortical processes engaged during preparation and execution of balance reactions are reflected in distinct cortical activity signatures that can be measured with electroencephalography (EEG). The purpose of this study was to 1) compare preparatory cortical beta activity and evoked cortical N1 responses during balance recovery in people with mTBI and controls, and 2) explore relationships between preparatory and evoked cortical activity. MethodsParticipants (age 21-35 years) with symptomatic mTBI (n=5, 27{+/-}13 days post-injury) and controls (n=5) completed the instrumented and modified push & release tests of reactive balance. Cortical activity was recorded using encephalography (EEG). Main outcome measures were 1) preparatory sensorimotor cortical beta-bust power and duration prior to balance perturbation onset (-1s - 0s), and 2) cortical N1 response amplitude and latency during the post-perturbation balance recovery (50-250ms). ResultsPeople with mTBI exhibited lower preparatory beta-burst power compared to controls (p=0.044, g=1.18). During balance recovery, cortical N1 responses occurred earlier in people with mTBI compared to controls (p=0.045, g=3.28). Relationships between preparatory and evoked cortical activity were altered after mTBI compared to controls; people after mTBI with greater beta-burst power and longer duration elicited shorter N1 latencies (rs>-0.77, ps<0.010). Discussion and conclusionThe results serve as preliminary, hypothesis-generating observations to guide future research directions investigating neural signatures of reactive balance deficits in people after mTBI. The preparatory brain state before reactive balance recovery should be explored as a potential target for post-mTBI balance rehabilitation.
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