Research Reports - Cerebral blood flow alterations in acute sport-related concussion

J Neurotrauma. 2015 Sep 28. [Epub ahead of print]

Wang Y(1), Nelson LD(2,)(3), LaRoche AA(4), Pfaller AY(5), Nencka AS(6), Koch
KM(7), McCrea M(8).

Sport-related concussion (SRC) is a major health problem, affecting millions of
athletes each year. While the clinical effects of SRC (e.g., symptoms and
functional impairments) typically resolve within several days, increasing
evidence suggests persistent neurophysiological abnormalities beyond the point of
clinical recovery after injury. This study aimed to evaluate cerebral blood flow
(CBF) changes in acute SRC, as measured using advanced arterial spin labeling
(ASL) magnetic resonance imaging (MRI). We compared CBF maps assessed in 18
concussed football players (age 17.8 ± 1.5 years) obtained within 24 hours and at
8 days after injury, in comparison to a control group of 19 matched non-concussed
football players. While the control group did not show any changes in CBF between
the two time points, concussed athletes demonstrated a significant decrease in
CBF at 8 days relative to 24 hours. Scores on the clinical symptom (Sport
Concussion Assessment Tool 3, SCAT3) and cognitive (Standardized Assessment of
Concussion, SAC) measures demonstrated significant impairment (versus pre-season
baseline levels) at 24 hours (SCAT p < 0.0001, SAC p < 0.01) but returned to
baseline levels at 8 days. Two additional computerized neurocognitive tests,
Automated Neuropsychological Assessment Metrics (ANAM) and Immediate
Post-Concussion and Cognitive Testing (ImPACT), showed a similar pattern of
changes. These data support the hypothesis that physiological changes persist
beyond the point of clinical recovery after SRC. Our results also indicate that
advanced ASL MRI methods might be useful for detecting and tracking the
longitudinal course of underlying neurophysiological recovery from concussion. 

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