Dual mediating effects of learning motivation and hope on the relationship between generative AI acceptance and learning engagement among Chinese college students: moderated mediation effect of self-d

Concussion, a form of mild traumatic brain injury (mTBI), is caused by a primary biomechanical force to the head and involves secondary physiological processes that produce rapid neurological dysfunction, including sensory disturbances, with or without loss of consciousness and typically without overt structural tissue damage (). Globally, millions of cases occur annually (–), and individuals who sustain repeat concussions face heightened cumulative risk for chronic neurological consequences (–). While most patients recover from concussion injury within weeks, approximately 10%−20% experience persistent symptoms beyond the expected recovery window, a condition known as post-concussion syndrome (PCS) (, –) and repeat concussion is known to contribute to a prolonged recovery from injury (–). PCS frequently includes heightened sensitivity to light and noise, cognitive dysfunction, headache, and fatigue (–) that can persist beyond the acute period after injury and substantially impair daily functioning and quality of life [for reviews see (–)]. Clinical evaluation after TBI often emphasizes losses of sensory function, particularly when primary sensory cortices are injured. In contrast, increases in sensory sensitivity are typically monitored only in the acute post-injury period, where they are attributed to headache-associated visual and auditory discomfort. However, emerging evidence indicates that sensory hypersensitivity can persist for months or even years in a substantial subset of PCS cases (, ). These chronic sensory disturbances remain under-recognized despite the likelihood that they could potentially contribute to long-term cognitive complaints. Abnormal sensory perception and salience (attention/gating) is an under-studied but potentially important functional disturbance in PCS because it could play a significant role in PCS-related cognitive difficulties. Sensory gating is a complex cognitive function that allows the brain to modulate its sensitivity to incoming sensory stimuli to protect higher cortical centers from being flooded with irrelevant sensory stimuli, while focusing conscious attention on significant or novel sensory input, regulating sensory salience (, ). To date, the neurobiological basis of sensory hypersensitivity after repeat concussion injuries and its effects on cognitive function and mental exhaustion is not well understood. Single or repeat concussion injuries are implicated in the development of both long-term sensory dysregulation and cognitive deficits both clinically () and pre-clinically (), but a causal relationship between them has not been established. Non-injury disorders with sensory hyper-sensitivity are known to contribute to issues with attention, memory, and mental exhaustion (–). Therefore, we hypothesized that sensory dysfunction after mTBI may also underpin more cognitively complex PCS symptomology.