White Matter Changes Persist After Concussion

Followup research needed to see if this would be similar for stroke and what can be done to correct it. But this won't occur since we have NO stroke leadership to go to or a stroke strategy to update. Your children and grandchildren will continue to be screwed.
http://www.medpagetoday.com/SportsMedicine/GeneralSportsMedicine/58986?
Even though they no longer had symptoms, young athletes who had a concussion still had changes in the white matter of their brains half a year after their injury, researchers found.
In a single-center case-control study, high school and college athletes with a concussion showed decreased mean diffusivity -- a marker of white matter changes -- on diffusion tensor imaging at 6 months compared with healthy matched controls, according to Melissa Lancaster, PhD, of the Medical College of Wisconsin in Milwaukee, and colleagues.
That could have implications for managing concussions and determining recovery in athletes who have experienced a sports-related concussion, they reported at the American Academy of Neurology's Sports Concussion Conference in Chicago.
"Athletes may still experience long-term brain changes even after they feel they have recovered from the injury," Lancaster said in a statement. "Additional research is needed to determine how these changes relate to long-term outcomes."
Recent neuroimaging studies have suggested that sports-related concussion is associated with acute neuroanatomical and neurophysiological changes, and that white matter tracts are especially vulnerable to concussion. Yet the duration of those effects is not clear.
Lancaster and colleagues therefore conducted diffusion tensor imaging (DTI) and diffusion kurtosis tensor imaging (DKTI) on 17 high school and college football players, mean age 17.4 years, who had a concussion, and compared the scans with those from 18 matched athlete controls, mean age of 17.7, who did not have a concussion.
The researchers also assessed concussion symptoms, balance, and cognition at three time points: 24 hours after concussion, 8 days later, and 6 months later.
Overall, they saw no differences between the two groups in terms of self-reported concussion symptoms, cognition, or balance 6 months after the injury.
But there was widespread decreased mean diffusivity in those with a concussion compared with controls at that time point -- which was similar to the acute findings at 24 hours and 8 days, the researchers said.
Also, those with more severe symptoms at the time of concussion were more likely to have alterations in white matter 6 months later.
"Despite normalization of clinical symptoms, concussed athletes showed significant white matter alterations 6 months post-injury that were related to initial symptom severity ratings," Lancaster and colleagues concluded. "These findings have implications for determination of recovery following sports-related concussion and concussion management."
There were no differences, however, on DKTI, which is an emerging technique for evaluating the microstructural environment of the brain. The reasons for that are not clear, the researchers said, and further study is needed.
Additional study is also needed as to what, exactly, the changes seen on DTI actually mean, and whether or not they have implications for long-term recovery from concussion, as well as its long-term impact.
The hunt is still on for biomarkers that could help determine recovery, as well as for biomarkers that can help better diagnose concussion.

The study was supported by the National Center for Advancing Translational Sciences at the NIH, the U.S. Army Medical Research and Materiel Command, and the NFL-GE Head Health Challenge.
The authors disclosed having no financial relationships with industry.

• Primary Source

  AAN Sports Concussion Conference

  Source Reference: Lancaster M, et al "Chronic white matter changes following sport-related concussion measured by diffusion tensor and diffusion kurtosis imaging" AAN SCC Meeting 2016.