Concussion-Related Injuries May Remain Even 1 Year After Return to Play

Concussion-caused brain injuries may remain even 1 year after an athlete has been medically cleared to return to play, according to a new study.¹

To assess whether concussion-related brain alterations remain in the long term, the researchers conducted 3 magnetic resonance imaging (MRI) scans on 24 athletes with concussion. These scans occurred within 1 week after injury, when the athlete was cleared to return to play, and 1 year after return to play. 

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The researchers also performed an MRI scan on 122 athletes without concussion before the start of their sport season and compared these imaging findings to those of the athletes with concussion.

With each imaging session, the researchers evaluated the athletes’ global functional connectivity, cerebral blood flow, white matter fractional anisotropy, and mean diffusivity.

Among athletes with concussion, signs of brain injury showed on the MRI scan at the return to play timepoint and also on the MRI scan a year after return to play.

“Different aspects of brain physiology showed different patterns of recovery over time,” the study authors wrote.

For example, while both global functional connectivity and white matter fractional anisotropy showed no significant effects at 1 year after return to play, cerebral blood flow and mean diffusivity did show persistent long-term effects.

“Specifically, concussed athletes had an average decrease in blood flow of 10 milliliters per 100 grams of blood per minute compared to healthy athletes,” the study authors said in a press release.²

At each postinjury timepoint, the researchers also evaluated the main effects of concussion on MRI parameters and found that the effects were dependent on acute symptom severity and time to return to play for all postinjury timepoints.

“The principal finding of this study was that different aspects of brain physiology have different patterns of long-term recovery,” said study co-author Nathan W. Churchill, PhD, in a press release.² “These findings significantly enhance our understanding of the natural course of brain recovery after a concussion. Future studies are needed to look beyond one year after return to play to see if these longer-term brain injuries eventually heal or remain permanent.”

—Colleen Murphy

References:

1. 1. Churchill NW, Hutchison MG, Graham SJ, Schweizer TA. Mapping brain recovery after concussion: from acute injury to 1 year after medical clearance [published online October 16, 2019]. Neurology. doi:10.1212/WNL.0000000000008523.
2. 2. Brain injury from concussion may linger longer than one year after return to play [press release]. Minneapolis, MN: American Academy of Neurology; October 16, 2019. https://www.aan.com/PressRoom/Home/PressRelease/2752. Accessed October 18, 2019.