Cerebral Blood Flow Alterations in Acute Sport-Related Concussion

Yang Wang, Lindsay D. Nelson, Ashley A. Laroche, Adam Y. Pfaller, Andrew S. Nencka, Kevin M. Koch, Michael A. McCrea

Research output: Contribution to journalArticle

66 Scopus citations

Abstract

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 h and at 8 days after injury with 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 within 24 h. Scores on the clinical symptom (Sport Concussion Assessment Tool 3, SCAT3) and cognitive measures (Standardized Assessment of Concussion [SAC]) demonstrated significant impairment (vs. pre-season baseline levels) at 24 h (SCAT, p < 0.0001; SAC, p < 0.01) but returned to baseline levels at 8 days. Two additional computerized neurocognitive tests, the Automated Neuropsychological Assessment Metrics and Immediate Post-Concussion and Cognitive Testing, 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.

Original languageEnglish (US)
Pages (from-to)1227-1236
Number of pages10
JournalJournal of Neurotrauma
Volume33
Issue number13
DOIs
StatePublished - Jul 1 2016
Externally publishedYes

Keywords

  • arterial spin labeling
  • cerebral blood flow
  • concussion
  • MRI
  • recovery

ASJC Scopus subject areas

  • Clinical Neurology

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    Wang, Y., Nelson, L. D., Laroche, A. A., Pfaller, A. Y., Nencka, A. S., Koch, K. M., & McCrea, M. A. (2016). Cerebral Blood Flow Alterations in Acute Sport-Related Concussion. Journal of Neurotrauma, 33(13), 1227-1236. https://doi.org/10.1089/neu.2015.4072