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ObjectiveAs opposed to postconcussion physical activity, the potential influence of cognitive activity on concussion recovery is not well characterised. This study evaluated the intensity and duration of daily cognitive activity reported by adolescents following concussion and examined the associations between these daily cognitive activities and postconcussion symptom duration. MethodsThis study prospectively enrolled adolescents aged 11–17 years with a physician-confirmed concussion diagnosis within 72 hours of injury from the emergency department and affiliated concussion clinics. Participants were followed daily until symptom resolution or a maximum of 45 days postinjury to record their daily cognitive activity (intensity and duration) and postconcussion symptom scores. ResultsParticipants (n=83) sustained their concussion mostly during sports (84%), had a mean age of 14.2 years, and were primarily male (65%) and white (72%). Participants reported an average of 191 (SD=148), 166 (SD=151) and 38 (SD=61) minutes of low-intensity, moderate-intensity and high-intensity daily cognitive activity postconcussion while still being symptomatic. Every 10 standardised minutes per hour increase in moderate-intensity or high-intensity cognitive activities postconcussion was associated with a 22% greater rate of symptom resolution (adjusted hazard ratio (aHR) 1.22, 95% CI 1.01 to 1.47). Additionally, each extra day’s delay in returning to school postconcussion was associated with an 8% lower rate of symptom resolution (aHR 0.92, 95% CI 0.85 to 0.99). ConclusionIn adolescents with concussion, more moderate-high intensity cognitive activity is associated with faster symptom resolution, and a delayed return to school is associated with slower symptom resolution. However, these relationships may be bidirectional and do not necessarily imply causality. Randomised controlled trials are needed to determine if exposure to early cognitive activity can promote concussion recovery in adolescents. 

Despite cognitive workload (CW) being a critical metric in several applications, no technology exists to seamlessly and reliably quantify CW. Previously, we demonstrated the feasibility of a wearable MagnetoCardioGraphy (MCG) sensor to classify high vs. low CW based on MCG-derived heart rate variability (mHRV). However, our sensor was unable to address certain critical operational requirements, resulting in noisy signals, often to the point of being unusable. In addition, test conditions for the participants were not decoupled from motion (i.e., physical activity (PA)), raising questions as to whether the noted changes in mHRV were attributed to CW, PA, or both. This study reports software and hardware advancements to optimize the MCG data quality, and investigates whether changes in CW (in the absence of PA) can be reliably detected. Performance is validated for healthy adults (n = 10) performing three types of CW tasks (one for low CW and two for high CW to eliminate the memory effect). Results demonstrate the ability to retrieve MCG R-peaks throughout the recordings, as well as the ability to differentiate high vs. low CW in all cases, confirming that CW does modulate the mHRV. A paired Bonferroni t-test with significance 𝛼=0.01 confirms the hypothesis that an increase in CW decreases mHRV. Our findings lay the groundwork toward a seamless, practical, and low-cost sensor for monitoring CW. 

We have recently demonstrated a wearable MagnetoCardioGraphy (MCG) sensor capable of classifying high vs. low cognitive work, i.e., the amount of mental effort a person is exerting when performing a task during a given period of time. However, a major limitation of our previous work was the requirement to eliminate any type of motion for the participants. Here, we explore the effect of motion by employing three (3) different experimental setups, each with a different amount of physical motion and cognitive load exerted. To better understand the effect of motion, an inertial measurement unit (IMU) and a breathing rate sensor are employed in addition to the MCG sensor. Our results show that heart rate variability (HRV), demonstrated through the mean difference in duration between consecutive heartbeats, is at its highest when neither cognitive workload nor motion are exerted. HRV drops when the subject involves cognitive workload and motion. Our results pave the way for additional research in the field, with an utmost goal of catering to specific clinical applications.