ARTICLE
Concussion recovery patterns varied for different aspects of brain physiology, with some effects persisting a year after college athletes returned to play, a longitudinal imaging study showed. Brain activity and communication between brain regions appeared normal 1 year after athletes received medical clearance to return to play, but cerebral blood flow and white matter diffusivity showed persistent effects, a new report states. “Brain recovery after concussion may be a more complex and longer-lasting process than we originally thought,” said a co-author. "There is growing concern for the long-term health risks associated with concussion. However, we still know relatively little about how the brain recovers from concussion over the long-term, which is needed to understand the potential cause of these health concerns,” he said. “At the moment, safe return-to-play is largely based on the resolution of symptoms, but this is an indirect measure of brain recovery." At medical clearance, "concussed athletes showed differences in brain structure and function compared to uninjured athletes, suggesting incomplete recovery. More importantly, 1 year later, some aspects of the brain looked normal, but others still showed signs of ongoing recovery.” These findings are consistent with smaller studies that have used various imaging and electrical measurement tools to assess post-concussion effects. Many of the measurement tools — such as evoked potentials, diffusion tensor MRI, and functional MRI — are not recognized by the American Board of Radiology, are not clinical tools that a doctor in his office will order up and use as a stop-go criteria. By the end of the study, the concussed athletes were determined to be fully recovered based on clinical assessment, and had otherwise fully returned to normal work and school activities, but this study suggests that there are long-lasting brain changes even with full clinical recovery. It raises new questions about when — if ever -- the brain returns to 'normal,' and whether the long-lasting brain changes we see are related to worse outcomes if the athletes sustain another concussion before recovery is completed. Source: https://www.medpagetoday.com/neurology/headtrauma/82776