Mapping brain recovery after concussion: From acute injury to 1 year after medical clearance.

Abstract:

OBJECTIVE:To test the hypothesis that concussion-related brain alterations seen at symptomatic injury and medical clearance to return to play (RTP) will have dissipated by 1 year after RTP. METHODS:For this observational study, 24 athletes with concussion were scanned longitudinally within 1 week after injury, at RTP, and 1 year after RTP. A large control cohort of 122 athletes were also scanned before the season. Each imaging session assessed global functional connectivity (Gconn) and cerebral blood flow (CBF), along with white matter fractional anisotropy (FA) and mean diffusivity (MD). The main effects of concussion on MRI parameters were evaluated at each postinjury time point. In addition, covariation was assessed between MRI parameters and clinical measures of acute symptom severity and time to RTP. RESULTS:Different aspects of brain physiology showed different patterns of recovery over time. Both Gconn and FA displayed no significant effects at 1 year after RTP, whereas CBF and MD exhibited persistent long-term effects. The effects of concussion on MRI parameters were also dependent on acute symptom severity and time to RTP for all postinjury time points. CONCLUSION:This study provides the first longitudinal evaluation of concussion focused on time of RTP and 1 year after medical clearance, using multiple different MRI measures to assess brain structure and function. These findings significantly enhance our understanding of the natural course of brain recovery after a concussion.

journal_name

Neurology

journal_title

Neurology

authors

Churchill NW,Hutchison MG,Graham SJ,Schweizer TA

doi

10.1212/WNL.0000000000008523

subject

Has Abstract

pub_date

2019-11-19 00:00:00

pages

e1980-e1992

issue

21

eissn

0028-3878

issn

1526-632X

pii

WNL.0000000000008523

journal_volume

93

pub_type

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