# identifying Concussed Adolescents at Risk for Emotional dysregulation 2 (iCARE2)

> **NIH NIH R01** · UNIVERSITY OF PITTSBURGH AT PITTSBURGH · 2024 · $787,947

## Abstract

ABSTRACT
 Adolescent concussion is a major public health concern, affecting nearly 2 million children and adolescents in the
U.S. each year. These injuries result from biomechanical forces acting on the brain. Primarily invovled in emotion
processing and regulation, midline brain regions −including the fronto-limbic system and hypothalamus/pituitary− are
particularly vulnerable to these forces. The reporting of transient psychological symptoms is common following a
concussion; h
owever,
adolescent g persistent psychological problems (e.g., anxiety)
irls are at a greater risk for
after injury. It is important to note that adolescence is a period marked by hormone-dependent mechanisms of brain
plasticity that open a window of heightened sensitivity to the influences of endogenous and exogenous factors on the
brain. Thus, it is conceivable that a concussion during this period may increase risk for psychiatric morbidity, especially
in girls who, having a more rapid transition through puberty, may have a limited time to heal. If puberty has an effect
on concussion, concussion is also likely to affect puberty. Intriguing evidence of post-concussion hypopituitarism are
emerging; yet the underlying mechanisms are unknown. Filling this knowledge gap is important because a better
understanding of the pathophysiologic mechanisms of adolescent concussion can aid in early identification of risk
and provides new targets for the development of future interventions. The objective of this application is to investigate
the pathophysiologic mechanisms of persistent psychological symptoms in adolescent concussion and to further un-
derstand the role of pubertal hormones across sexes and pubertal stages, when neurodevelopmental changes with
potential downstream consequences for psychiatric vulnerability may occur. By prospectively characterizing 6-month
trajectories of psychological symptoms in 10- to 18-year-olds with and without concussion, this proposal aims to ex-
amine if a) hormonal changes and/or b) concussion-related lesions in midline brain regions can help explain the
persistence of these symptoms across different pubertal stages and sexes and to further determine c) the contribution
of pubertal maturity and sex on these relationships. To this end, we will use a combination of hormonal profiles,
capturing changes in pubertal hormones for up to 3 months after injury, state-of-the-art neuroimaging methods, al-
lowing to detect indirect indices of brain injury in subacute and chronic phases of concussion, and statistical methods
designed to model different effects of complex developmental processes during adolescence. This is innovative be-
cause no study has used such a highly integrative approach to examine the influence of hormones and MRI abnor-
malities in adolescent concussion and how these relate to pathophysiologic mechanisms underlying the persistence
of psychological symptoms in 10- to 18-year-olds. This contribution is anticipated to be significant ...

## Key facts

- **NIH application ID:** 10977903
- **Project number:** 2R01MH114881-06
- **Recipient organization:** UNIVERSITY OF PITTSBURGH AT PITTSBURGH
- **Principal Investigator:** Anthony P Kontos
- **Activity code:** R01 (R01, R21, SBIR, etc.)
- **Funding institute:** NIH
- **Fiscal year:** 2024
- **Award amount:** $787,947
- **Award type:** 2
- **Project period:** 2017-12-19 → 2029-05-31

## Primary source

NIH RePORTER: https://reporter.nih.gov/project-details/10977903

## Citation

> US National Institutes of Health, RePORTER application 10977903, identifying Concussed Adolescents at Risk for Emotional dysregulation 2 (iCARE2) (2R01MH114881-06). Retrieved via AI Analytics 2026-05-25 from https://api.ai-analytics.org/grant/nih/10977903. Licensed CC0.

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