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Study links concussions to structural changes in the brain

Concussion in sport

A new study has found that concussions can have long-term effects on the structure of the brain. Even after clinical symptoms dissipate, structural changes can still be found, according to the study out of the Medical College of Wisconsin.

11 September 2017
By Shayna Goldman, Sports Illustrated

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A new study has found that concussions can have long-term effects on the structure of the brain. Even after clinical symptoms dissipate, structural changes can still be found, according to the study out of the Medical College of Wisconsin.

This study was presented at the American Academy of Neurology’s Sports Concussion Conference earlier this month. While the structural effects on the brain after suffering a concussion were known previously, this study’s focus was to give a clearer time frame for the duration of those effects. Researchers found that six months after the initial injury, an individual’s white matter still shows signs of microstructural brain damage.

Seventeen football players, both from high school and college, were studied after suffering an impact to the head. An additional eighteen athletes who did not suffer from a brain injury were also studied for comparison. All of the athletes were tested for clinical symptoms of concussions. In addition, researchers examined the athletes’ brains with advanced neuroimaging techniques—magnetic resonance imaging (MRI), diffusion tensor imaging (DTI), and diffusion kurtosis tensor imaging (DKTI). The athletes were scanned at certain points after the initial injury: 24 hours, eight days, and six months.

The purpose of the test used in this study is to detect how water molecules move in white matter. The study found that in an injured brain, the movement is restrained and does not move along the fibers as it would in a healthy brain. Additionally, these tests found microstructural changes in white matter of the injured brains.

Twenty-four hours after the brain injury, changes in white matter were observed. Researchers later noted the decreased movement of water in white matter six months after the initial injury. Researchers also recognized that the white matter appeared to show more signs of damage for those who suffered amplified clinical symptoms. Although these athletes did not see clinical symptoms after six months, the microstructural damage still appeared on the scans at that point.

Melissa Lancaster, PhD, of the Medical College of Wisconsin, discussed the findings of the study in a statement: “In other words, athletes may still experience long-term brain changes even after they feel they have recovered from the injury. These findings have important implications for managing concussions and determining recovery in athletes who have experienced a sports-related concussion.”

Thus far, there is no apparent link between structural changes to the brain and behavioral changes. Lancaster noted additional research is necessary to further explore that connection.

The long-term effects of concussions are a constant topic of discussion, and having a better understanding of the ramifications of these injuries can help lead toward proactive changes, such as not allowing players to return to playing for an extended period of time based on the microstructural damage, rather than only on clinical symptoms.

Concussion recovery is important for all who suffer from concussions, but even more so for young athletes. FAIR Health recently released data that showed that the rate of diagnosed concussions in children and young adults has increased 500% percent between 2010 and ‘14. According to this data, concussions were diagnosed often in September and October, which is football season. Although the increase in the data may be partly attributed to an increased participation in youth sports and more diagnostics for concussions available, it is still concerning. It has already been established how dangerous concussions in youths can be. With this increase in occurrence, further precautions need to be taken—especially since the brain suffers from structural damage for months after the injury, when children’s brains are still developing.

The results of this study affect more than just young athletes. Professional athletes are risking structural damage every time they play in a game. The NFL, for example, has noted the link between concussions and long-term implications on the brain—appearing to make strides in their viewpoints on concussions.

Unfortunately, many of those strides have been overshadowed by their other actions seemingly undermining the concussion research done thus far. The NFL has criticized many concussion studies and has paid for its own research, which has often led to different conclusions.

Hopefully, the NFL will finally utilize the data from studies already conducted—which may be likely since NFL medical advisor and former head of the NFL’s Mild Traumatic Brain Injury committee Dr. Elliot Pellman is retiring. The NFL has already announced that it will hire a full-time chief medical officer. Hopefully, the league will hire someone who is an expert on neurology and concussions and who will look at studies like the Medical College of Wisconsin’s and try to build off of that progress and make changes to concussion management practices in the NFL.

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