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CARE Consortium: White matter abnormalities after concussion

Concussed athletes demonstrate connective tissue damage within the brain

As concussion symptoms abate, is the brain recovering at the same pace at the cellular level? Sourajit Mustafi, a postdoctoral fellow working with Dr. Yu-Chien Wu in radiology and imaging sciences at the Indiana University School of Medicine, and a team of researchers used diffusion tensor imaging — an advanced MRI technique — to examine the brains of 30 concussed college football players and 28 matched controls taking part in the Concussion Assessment, Research and Education Consortium study to begin unraveling that complicated, and essential, question. They published their findings in October 2017 in the Journal of Neurotrauma.

What did the study find?

The athletes underwent clinical testing and advanced MRI within 48 hours after sustaining a concussion. On average, white matter regions in the brain — in essence, the connective tissue between brain cells — was more damaged than that of the control group. Those temporary changes to the axons correlated strongly with clinical symptoms of concussion.

“These findings provide additional evidence of acute changes in brain microstructures that correlate with clinically meaningful signs and symptoms after (concussion),” the paper noted.

What are the implications?

The road to clear recovery guidelines that take not only symptom recovery into account, but how the brain itself is healing, will be a long one. But this is an important step toward that goal.

“This line of research is not only valuable to our understanding of the underlying pathophysiology of concussion, but also has the potential for major translational impact in informing evidence-based guidelines for injury management and return to play after (concussion),” the authors added. 

What’s next?

Researchers will build on these findings by continuing to rely on advanced imaging techniques to chart the intricacies and the timeline of the brain’s recovery after injury.