Digital Commons Network^™

The Serotonin Transporter Promoter Polymorphism Moderates The Continuity Of Behavioral Inhibition In Early Childhood., Victoria C Johnson, Katie R Kryski, Haroon I Sheikh, Heather J Smith, Shiva M Singh, Elizabeth P Hayden

Brain and Mind Institute Researchers' Publications

Persistently elevated behavioral inhibition (BI) in children is a marker of vulnerability to psychopathology. However, little research has considered the joint influences of caregiver and child factors that may moderate the continuity of BI in early childhood, particularly genetic variants that may serve as markers of biological plasticity, such as the serotonin transporter linked polymorphic region (5-HTTLPR). We explored this issue in 371 preschoolers and their caregivers, examining whether parent characteristics (i.e., overinvolvement or anxiety disorder) and child 5-HTTLPR influenced the continuity of BI between ages 3 and 5. Measures were observational ratings of child BI, observational and questionnaire measures …

Quantifying And Comparing The Pattern Of Thalamic And Cortical Projections To The Posterior Auditory Field In Hearing And Deaf Cats., Blake E Butler, Nicole Chabot, Stephen G Lomber

Brain and Mind Institute Researchers' Publications

Following sensory loss, compensatory crossmodal reorganization occurs such that the remaining modalities are functionally enhanced. For example, behavioral evidence suggests that peripheral visual localization is better in deaf than in normal hearing animals, and that this enhancement is mediated by recruitment of the posterior auditory field (PAF), an area that is typically involved in localization of sounds in normal hearing animals. To characterize the anatomical changes that underlie this phenomenon, we identified the thalamic and cortical projections to the PAF in hearing cats and those with early- and late-onset deafness. The retrograde tracer biotinylated dextran amine was deposited in the …

Usage Of Swi (Susceptibility Weighted Imaging) Acquired At 7t For Qualitative Evaluation Of Temporal Lobe Epilepsy Patients With Histopathological And Clinical Correlation: An Initial Pilot Study., Benjamin Y M Kwan, Fateme Salehi, Pavlo Ohorodnyk, Donald H Lee, Jorge G Burneo, Seyed M Mirsattari, David Steven, Robert Hammond, Terry M Peters, Ali R Khan

Brain and Mind Institute Researchers' Publications

OBJECTIVES: Ultra high field MRI at 7T is able to provide much improved spatial and contrast resolution which may aid in the diagnosis of hippocampal abnormalities. This paper presents a preliminary experience on qualitative evaluation of 7T MRI in temporal lobe epilepsy patients with a focus on comparison to histopathology.

METHODS: 7T ultra high field MRI data, using T1-weighted, T2*-weighted and susceptibility-weighted images (SWI), were acquired for 13 patients with drug resistant temporal lobe epilepsy (TLE) during evaluation for potential epilepsy surgery. Qualitative evaluation of the imaging data for scan quality and presence of hippocampal and temporal lobe abnormalities were …

Neural Measures Reveal Implicit Learning During Language Processing., Laura J Batterink, Larry Y Cheng, Ken A Paller

Brain and Mind Institute Researchers' Publications

Language input is highly variable; phonological, lexical, and syntactic features vary systematically across different speakers, geographic regions, and social contexts. Previous evidence shows that language users are sensitive to these contextual changes and that they can rapidly adapt to local regularities. For example, listeners quickly adjust to accented speech, facilitating comprehension. It has been proposed that this type of adaptation is a form of implicit learning. This study examined a similar type of adaptation, syntactic adaptation, to address two issues: (1) whether language comprehenders are sensitive to a subtle probabilistic contingency between an extraneous feature (font color) and syntactic structure …

Probing The Nature Of Deficits In The ‘Approximate Number System’ In Children With Persistent Developmental Dyscalculia, S Bugden, Daniel Ansari

Brain and Mind Institute Researchers' Publications

In the present study we examined whether children with Developmental Dyscalculia (DD) exhibit a deficit in the so-called 'Approximate Number System' (ANS). To do so, we examined a group of elementary school children who demonstrated persistent low math achievement over 4 years and compared them to typically developing (TD), aged-matched controls. The integrity of the ANS was measured using the Panamath (www.panamath.org) non-symbolic numerical discrimination test. Children with DD demonstrated imprecise ANS acuity indexed by larger Weber fraction (w) compared to TD controls. Given recent findings showing that non-symbolic numerical discrimination is affected by visual parameters, we went further and …

A Quantitative Comparison Of The Hemispheric, Areal, And Laminar Origins Of Sensory And Motor Cortical Projections To The Superior Colliculus Of The Cat., Blake E Butler, Nicole Chabot, Stephen G Lomber

Brain and Mind Institute Researchers' Publications

The superior colliculus (SC) is a midbrain structure central to orienting behaviors. The organization of descending projections from sensory cortices to the SC has garnered much attention; however, rarely have projections from multiple modalities been quantified and contrasted, allowing for meaningful conclusions within a single species. Here, we examine corticotectal projections from visual, auditory, somatosensory, motor, and limbic cortices via retrograde pathway tracers injected throughout the superficial and deep layers of the cat SC. As anticipated, the majority of cortical inputs to the SC originate in the visual cortex. In fact, each field implicated in visual orienting behavior makes a …

A Trial-By-Trial Window Into Sensorimotor Transformations In The Human Motor Periphery., Chao Gu, Daniel K Wood, Paul L Gribble, Brian D Corneil

Brain and Mind Institute Researchers' Publications

UNLABELLED: The appearance of a novel visual stimulus generates a rapid stimulus-locked response (SLR) in the motor periphery within 100 ms of stimulus onset. Here, we recorded SLRs from an upper limb muscle while humans reached toward (pro-reach) or away (anti-reach) from a visual stimulus. The SLR on anti-reaches encoded the location of the visual stimulus rather than the movement goal. Further, SLR magnitude was attenuated when subjects reached away from rather than toward the visual stimulus. Remarkably, SLR magnitudes also correlated with reaction times on both pro-reaches and anti-reaches, but did so in opposite ways: larger SLRs preceded shorter …

Why Numerical Symbols Count In The Development Of Mathematical Skills: Evidence From Brain And Behaviour, Rebecca Merkley, Daniel Ansari

Brain and Mind Institute Researchers' Publications

Numerical skills measured prior to school entry are predictive of mathematics achievement longitudinally. It is therefore important that young children start school with strong mathematical foundations. Here we review evidence from behavior and neuroimaging that highlights numerical symbol knowledge as a key mediator between informal and formal mathematical competencies. We argue that future research should aim to elucidate cognitive and neuronal mechanisms underpinning the acquisition of symbolic knowledge. Furthermore, multiple aspects of numerical symbol knowledge, such as identification, cardinality, and ordinality, should be emphasized in preschool childcare environments

Rapid Decrement In The Effects Of The Ponzo Display Dissociates Action And Perception., Robert L Whitwell, Gavin Buckingham, James T Enns, Philippe A Chouinard, Melvyn A Goodale

Brain and Mind Institute Researchers' Publications

It has been demonstrated that pictorial illusions have a smaller influence on grasping than they do on perceptual judgments. Yet to date this work has not considered the reduced influence of an illusion as it is measured repeatedly. Here we studied this decrement in the context of a Ponzo illusion to further characterize the dissociation between vision for perception and for action. Participants first manually estimated the lengths of single targets in a Ponzo display with their thumb and index finger, then actually grasped these targets in another series of trials, and then manually estimated the target lengths again in …

Effects Of Material Properties And Object Orientation On Precision Grip Kinematics., Vivian C Paulun, Karl R Gegenfurtner, Melvyn A Goodale, Roland W Fleming

Brain and Mind Institute Researchers' Publications

Successfully picking up and handling objects requires taking into account their physical properties (e.g., material) and position relative to the body. Such features are often inferred by sight, but it remains unclear to what extent observers vary their actions depending on the perceived properties. To investigate this, we asked participants to grasp, lift and carry cylinders to a goal location with a precision grip. The cylinders were made of four different materials (Styrofoam, wood, brass and an additional brass cylinder covered with Vaseline) and were presented at six different orientations with respect to the participant (0°, 30°, 60°, 90°, 120°, …

A Longitudinal Investigation Of Predictors Of The Association Between Age 3 And Age 6 Behavioural Inhibition., Victoria C Johnson, Thomas M Olino, Daniel N Klein, Margaret W Dyson, Sara J Bufferd, C Emily Durbin, Lea R Dougherty, Elizabeth P Hayden

Brain and Mind Institute Researchers' Publications

Children who exhibit elevated levels of the temperament trait behavioural inhibition (BI) across time may be at greatest risk for anxiety. However, little research has investigated the influence of other temperamental traits, particularly positive emotionality (PE), on the continuity of BI in childhood, nor whether parental overprotection influences associations between early and later child BI. To explore whether PE and overprotection shape associations between early and later BI, this longitudinal study of three-year-olds (

Communication Intervention For Individuals With Down Syndrome: Systematic Review And Meta-Analysis, Nicole Neil, Emily A. Jones

Education Publications

A systematic review was conducted to identify effective intervention strategies for communication in individuals with Down syndrome. We updated and extended previous reviews by examining: (1) participant characteristics; (2) study characteristics; (3) characteristics of effective interventions (e.g., strategies and intensity); (4) whether interventions are tailored to the Down syndrome behavior phenotype; and (5) the effectiveness (i.e., percentage non-overlapping data and Cohen’s d) of interventions. Thirty-seven studies met inclusion criteria. The majority of studies used behaviour analytic strategies and produced moderate gains in communication targets. Few interventions were tailored to the needs of the Down syndrome behaviour phenotype. The results …

Disentangling Representations Of Object And Grasp Properties In The Human Brain, Sara Fabbri, Kevin M. Stubbs, Rhodri Cusack, Jody C. Culham

Brain and Mind Institute Researchers' Publications

No abstract provided.

Health System Support And Health System Strengthening: Two Key Facilitators To The Implementation Of Ambulatory Tuberculosis Treatment In Uzbekistan, Stefan Köhler

Brain and Mind Institute Researchers' Publications

Uzbekistan inherited a hospital-based health system from the Soviet Union. We explore the health system-related challenges faced during the scale-up of ambulatory (outpatient) treatment for drug-susceptible and drug-resistant tuberculosis (TB) in Karakalpakstan in Uzbekistan. Semi-structured interviews were conducted with key informants of the TB services, the ministries of health and finance, and their TB control partners. Structural challenges and resource needs were both discussed as obstacles to the expansion of ambulatory TB treatment. Respondents stated need for revising the financing mechanisms of the TB services to incentivize referral to ambulatory TB treatment. An increased workload and need for transportation in …

Cerebral Functional Connectivity Periodically (De)Synchronizes With Anatomical Constraints., Raphaël Liégeois, Erik Ziegler, Christophe Phillips, Pierre Geurts, Francisco Gómez, Mohamed Ali Bahri, B T Thomas Yeo, Andrea Soddu, Audrey Vanhaudenhuyse, Steven Laureys, Rodolphe Sepulchre

Brain and Mind Institute Researchers' Publications

This paper studies the link between resting-state functional connectivity (FC), measured by the correlations of fMRI BOLD time courses, and structural connectivity (SC), estimated through fiber tractography. Instead of a static analysis based on the correlation between SC and FC averaged over the entire fMRI time series, we propose a dynamic analysis, based on the time evolution of the correlation between SC and a suitably windowed FC. Assessing the statistical significance of the time series against random phase permutations, our data show a pronounced peak of significance for time window widths around 20-30 TR (40-60 s). Using the appropriate window …

Catalise: A Multinational And Multidisciplinary Delphi Consensus Study. Identifying Language Impairments In Children, D. V.M. Bishop, Margaret J. Snowling, Paul A. Thompson, Trisha Greenhalgh, Catherine Adams, Lisa Archibald, Gillian Baird, Ann Bauer, Jude Bellair, Christopher Boyle, Elizabeth Brownlie, Glenn Carter, Becky Clark, Judy Clegg, Nancy Cohen, Gina Conti-Ramsden, Julie Dockrell, Janet Dunn, Susan Ebbels, Aoife Gallagher, Simon Gibbs, Emma Gore-Langton, Mandy Grist, Mary Hartshorne, Alison Hüneke, Marc Joanisse, Sally Kedge, Thomas Klee, Saloni Krishnan, Linda Lascelles, James Law, Laurence Leonard

Communication Sciences and Disorders Publications

© 2016 Bishop et al. This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. Delayed or impaired language development is a common developmental concern, yet there is little agreement about the criteria used to identify and classify language impairments in children. Children's language difficulties are at the interface between education, medicine and the allied professions, who may all adopt different approaches to conceptualising them. Our goal in this study was to use an online Delphi …

Insights Into Quasar Uv Spectra Using Unsupervised Clustering Analysis, A Tammour, S.C. Gallagher, M Daley, G.T. Richards

Brain and Mind Institute Researchers' Publications

Machine learning techniques can provide powerful tools to detect patterns in multidimensional parameter space. We use K-means - a simple yet powerful unsupervised clustering algorithm which picks out structure in unlabelled data - to study a sample of quasar UV spectra from the Quasar Catalog of the 10th Data Release of the Sloan Digital Sky Survey (SDSS-DR10) of Paris et al. Detecting patterns in large data sets helps us gain insights into the physical conditions and processes giving rise to the observed properties of quasars. We use K-means to find clusters in the parameter space of the equivalent width (EW), …

The Contributions Of Anatol Rapoport To Game Theory, Erika Simpson

Political Science Publications

Game theory is used to rationally and dispassionately examine the strategic behaviour of nations, especially superpower behaviour. This article explains how basic game theory - at its simplest level - was used by Anatol Rapoport to generate ideas about how to enhance world peace. Rapoport was at the forefront of the game theoreticians who sought to conceptualize strategies that could promote international cooperation. Accordingly, the basic logic of game theory is explained using the game models of ‘Chicken’ and ‘Prisoner’s Dilemma’. These models were used by Rapoport in his books and lectures in simple and complex ways. Then Rapoport’s revolutionary …

Exposure-Based Interventions For The Management Of Individuals With High Levels Of Needle Fear Across The Lifespan: A Clinical Practice Guideline And Call For Further Research, C. Meghan Mcmurtry, Anna Taddio, Melanie Noel, Martin M. Antony, Christine T. Chambers, Gordon J.G. Asmundson, Rebecca Pillai Riddell, Vibhuti Shah, Noni E. Macdonald, Jess Rogers, Lucie M. Bucci, Patricia Mousmanis, Eddy Lang, Scott Halperin, Susan Bowles, Christine Halpert, Moshe Ipp, Michael J. Rieder, Kate Robson, Elizabeth Uleryk, Elizabeth Votta Bleeker, Vinita Dubey, Anita Hanrahan, Donna Lockett, Jeffrey Scott

Paediatrics Publications

Needle fear typically begins in childhood and represents an important health-related issue across the lifespan. Individuals who are highly fearful of needles frequently avoid health care. Although guidance exists for managing needle pain and fear during procedures, the most highly fearful may refuse or abstain from such procedures. The purpose of a clinical practice guideline (CPG) is to provide actionable instruction on the management of a particular health concern; this guidance emerges from a systematic process. Using evidence from a rigorous systematic review interpreted by an expert panel, this CPG provides recommendations on exposure-based interventions for high levels of needle …

The Neural Roots Of Mathematical Expertise, Daniel Ansari

Brain and Mind Institute Researchers' Publications

No abstract provided.

Music Therapy In Patients With Dementia And Behavioral Disturbance On An Inpatient Psychiatry Unit: Results From A Pilot Randomized Controlled Study., Joanna Thornley, Hussein Hirjee, Akshya Vasudev

Psychiatry Publications

The prevalence of dementia continues to grow worldwide due to an aging population and is projected to affect 65.7 million people by 2030 (World Health Organization, 2012). Behavioral and psychological symptoms of dementia (BPSD), including agitation, anxiety, aggression, depression, and psychosis, can occur in as much as 80% of the affected population, frequently necessitating psychiatric admission. Traditionally BPSD have been treated using pharmacological approaches. However, such medications could have serious adverse effects and additionally have limited efficacy in reducing such symptoms (Ballard et al., 2009).

Challenges In Mathematical Cognition: A Collaboratively-Derived Research Agenda, Lara Alcock, Daniel Ansari, Sophie Batchelor, Marie-Josee Bisson, Bert De Smedt, Camilla Gilmore, Silke M. Gobel, Minna Hannula-Sormunen, Jeremy Hodgen, Matthew Inglis, Ian Jones, Michele Mazzocco, Nicole Mcneil, Michael Schneider, Victoria Simms, Keith Weber

Brain and Mind Institute Researchers' Publications

This paper reports on a collaborative exercise designed to generate a coherent agenda for research on mathematical cognition. Following an established method, the exercise brought together 16 mathematical cognition researchers from across the fields of mathematics education, psychology and neuroscience. These participants engaged in a process in which they generated an initial list of research questions with the potential to significantly advance understanding of mathematical cognition, winnowed this list to a smaller set of priority questions, and refined the eventual questions to meet criteria related to clarity, specificity and practicability. The resulting list comprises 26 questions divided into six broad …

Functional Plasticity In Somatosensory Cortex Supports Motor Learning By Observing., Heather R Mcgregor, Joshua G A Cashaback, Paul L Gribble

Brain and Mind Institute Researchers' Publications

An influential idea in neuroscience is that the sensory-motor system is activated when observing the actions of others [1, 2]. This idea has recently been extended to motor learning, in which observation results in sensory-motor plasticity and behavioral changes in both motor and somatosensory domains [3-9]. However, it is unclear how the brain maps visual information onto motor circuits for learning. Here we test the idea that the somatosensory system, and specifically primary somatosensory cortex (S1), plays a role in motor learning by observing. In experiment 1, we applied stimulation to the median nerve to occupy the somatosensory system with …

It’S A Matter Of Time: Reframing The Development Of Cognitive Control As A Modification Of The Brain’S Temporal Dynamics, R. Matthew Hutchison, J. Bruce Morton

Psychology Publications

Cognitive control is a process that unfolds over time and regulates thought and action in the service of achieving goals and managing unanticipated challenges. Prevailing accounts attribute the protracted development of this mental process to incremental changes in the functional organization of a cognitive control network. Here, we challenge the notion that cognitive control is linked to a topologically static network, and argue that the capacity to manage unanticipated challenges and its development should instead be characterized in terms of inter-regional functional coupling dynamics. Ongoing changes in temporal coupling have long represented a fundamental pillar in both empirical and theoretical-based …

Propofol-Induced Frontal Cortex Disconnection: A Study Of Resting-State Networks, Total Brain Connectivity, And Mean Bold Signal Oscillation Frequencies., Pieter Guldenmund, Ithabi S Gantner, Katherine Baquero, Tushar Das, Athena Demertzi, Pierre Boveroux, Vincent Bonhomme, Audrey Vanhaudenhuyse, Marie-Aurélie Bruno, Olivia Gosseries, Quentin Noirhomme, Muriëlle Kirsch, Mélanie Boly, Adrian M Owen, Steven Laureys, Francisco Gómez, Andrea Soddu

Brain and Mind Institute Researchers' Publications

Propofol is one of the most commonly used anesthetics in the world, but much remains unknown about the mechanisms by which it induces loss of consciousness. In this resting-state functional magnetic resonance imaging study, we examined qualitative and quantitative changes of resting-state networks (RSNs), total brain connectivity, and mean oscillation frequencies of the regional blood oxygenation level-dependent (BOLD) signal, associated with propofol-induced mild sedation and loss of responsiveness in healthy subjects. We found that detectability of RSNs diminished significantly with loss of responsiveness, and total brain connectivity decreased strongly in the frontal cortex, which was associated with increased mean oscillation …

Revising The Bis/Bas Scale To Study Development: Measurement Invariance And Normative Effects Of Age And Sex From Childhood Through Adulthood., David Pagliaccio, Katherine R Luking, Andrey P Anokhin, Ian H Gotlib, Elizabeth P Hayden, Thomas M Olino, Chun-Zi Peng, Greg Hajcak, Deanna M Barch

Brain and Mind Institute Researchers' Publications

Carver and White's (1994) Behavioral Inhibition System/Behavioral Activation System (BIS/BAS) Scales have been useful tools for studying individual differences in reward-punishment sensitivity; however, their factor structure and invariance across development have not been well tested. In the current study, we examined the factor structure of the BIS/BAS Scales across 5 age groups: 6- to 10-year-old children (N = 229), 11- to 13-year-old early adolescents (N = 311), 14- to 16-year-old late adolescents (N = 353), 18- to 22-year-old young adults (N = 844), and 30- to 45-year-old adults (N = 471). Given poor fit of the standard 4-factor model (BIS, …

The Role Of Executive Processes In Working Memory Deficits In Parkinson's Disease, Aleksandra Gruszka, Daniel Bor, Roger R. Barker, Edward Necka, Adrian M. Owen

BrainsCAN Publications

© Polish Academy of Sciences, Committee for Psychological Sciences 2016. Idiopathic Parkinson's disease (PD) impairs working memory, but the exact nature of this deficit in terms of the underlying cognitive mechanisms is not well understood. In this study patients with mild clinical symptoms of PD were compared with matched healthy control subjects on a computerized battery of tests designed to assess spatial working memory and verbal working memory. In the spatial working memory task, subjects were required to recall a sequence of four locations. The verbal working memory task was methodologically identical except for the modality of the stimuli used, …

Transient Pupil Dilation After Subsaccadic Microstimulation Of Primate Frontal Eye Fields., Sebastian J Lehmann, Brian D Corneil

Brain and Mind Institute Researchers' Publications

UNLABELLED: Pupillometry provides a simple and noninvasive index for a variety of cognitive processes, including perception, attention, task consolidation, learning, and memory. The neural substrates by which such cognitive processes influence pupil diameter remain somewhat unclear, although cortical inputs to the locus coeruleus mediating arousal are likely involved. Changes in pupil diameter also accompany covert orienting; hence the oculomotor system may provide an alternative substrate for cognitive influences on pupil diameter. Here, we show that low-level electrical microstimulation of the primate frontal eye fields (FEFs), a cortical component of the oculomotor system strongly connected to the intermediate layers of the …

The Identity Capital Model: A Handbook Of Theory, Methods, And Findings, James Côté

Sociology Publications

No abstract provided.

Clinical Risk Score For Persistent Postconcussion Symptomsamong Children With Acute Concussion In The Ed, Roger Zemek, Nick Barrowman, Stephen B. Freedman, Jocelyn Gravel, Isabelle Gagnon, Candice Mcgahern, Mary Aglipay, Gurinder Sangha, Kathy Boutis, Darcy Beer, William Craig, Emma Burns, Ken J. Farion, Angelo Mikrogianakis, Karen Barlow, Alexander S. Dubrovsky, Willem Meeuwisse, Gerard Gioia, William P. Meehan, Miriam H. Beauchamp, Yael Kamil, Anne M. Grool, Blaine Hoshizaki, Peter Anderson, Brian L. Brooks, Keith Owen Yeates

Paediatrics Publications

IMPORTANCE Approximately one-third of children experiencing acute concussion experience ongoing somatic, cognitive, and psychological or behavioral symptoms, referred to as persistent postconcussion symptoms (PPCS). However, validated and pragmatic tools enabling clinicians to identify patients at risk for PPCS do not exist. OBJECTIVE To derive and validate a clinical risk score for PPCS among children presenting to the emergency department. DESIGN, SETTING, AND PARTICIPANTS Prospective, multicenter cohort study (Predicting and Preventing Postconcussive Problems in Pediatrics [5P]) enrolled young patients (aged 5-<18 years) who presented within 48 hours of an acute head injury at 1 of 9 pediatric emergency departments within the Pediatric Emergency Research Canada (PERC) network from August 2013 through September 2014 (derivation cohort) and from October 2014 through June 2015 (validation cohort). Participants completed follow-up 28 days after the injury. EXPOSURES All eligible patients had concussions consistent with the Zurich consensus diagnostic criteria. MAIN OUTCOMES AND MEASURES The primary outcomewas PPCS risk score at 28 days, which was defined as 3 or more new or worsening symptoms using the patient-reported Postconcussion Symptom Inventory compared with recalled state of being prior to the injury. RESULTS In total, 3063 patients (median age, 12.0 years [interquartile range, 9.2-14.6 years]; 1205 [39.3%] girls) were enrolled (n = 2006 in the derivation cohort; n = 1057 in the validation cohort) and 2584 of whom (n = 1701 [85%] in the derivation cohort; n = 883 [84%] in the validation cohort) completed follow-up at 28 days after the injury. Persistent postconcussion symptoms were present in 801 patients (31.0%) (n = 510 [30.0%] in the derivation cohort and n = 291 [33.0%] in the validation cohort). The 12-point PPCS risk score model for the derivation cohort included the variables of female sex, age of 13 years or older, physician-diagnosed migraine history, prior concussion with symptoms lasting longer than 1 week, headache, sensitivity to noise, fatigue, answering questions slowly, and 4 or more errors on the Balance Error Scoring System tandem stance. The area under the curve was 0.71 (95%CI, 0.69-0.74) for the derivation cohort and 0.68 (95%CI, 0.65-0.72) for the validation cohort. CONCLUSIONS AND RELEVANCE A clinical risk score developed among children presenting to the emergency department with concussion and head injury within the previous 48 hours had modest discrimination to stratify PPCS risk at 28 days. Before this score is adopted in clinical practice, further research is needed for external validation, assessment of accuracy in an office setting, and determination of clinical utility.