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
Neurologyjournal_title
Neurologyauthors
Churchill NW,Hutchison MG,Graham SJ,Schweizer TAdoi
10.1212/WNL.0000000000008523subject
Has Abstractpub_date
2019-11-19 00:00:00pages
e1980-e1992issue
21eissn
0028-3878issn
1526-632Xpii
WNL.0000000000008523journal_volume
93pub_type
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