How the Brain Fixes a Concussion

Imaging of traumatic brain injury patients shows differences in water movement along axons

(RxWiki News) A bump on the head is sometimes more than just an ouch. Symptoms from a concussion or other mild traumatic brain injury (TBI) can last for months or even years.

A recent study used images of the brain to determine a patient’s outcome one year after a mild TBI. The researchers concluded that by looking at water movement in the brain they could tell whether the patient was likely to improve.

The results also help scientists understand the changes a brain may go through to work around an injury.

"Seek care immediately following a head concussion"

Michael Lipton, MD, PhD, of Albert Einstein College of Medicine at Yeshiva University and Montefiore Medical Center and colleagues studied 17 emergency room patients with mild TBI. Patients underwent diffusion tensor imaging (DTI) within two weeks of their injury. DTI is used to measure the patterns of water movement in the brain and identify areas of high and low flow in the area of white matter nerve fibers.

After one year, the patients were given two questionnaires to understand the lingering effects of the concussion. Particular attention was paid to post-concussion symptoms and how they affect the patient’s quality of life. The data from the TBI patients was compared to data from 40 healthy controls.

Nerve fibers that make up a brain’s white matter, or axons, connect different parts of the brain. In a patient with TBI, multiple portions of the brain may be affected by the injury. Low water movement, also known as fractional anisotropy (FA), occurs where there is an injury along the axons. Low FA within white matter has been linked to cognitive impairment in patients with TBI.

The results of this study showed that patients with high FA had fewer symptoms after the concussion and better overall functioning.

Areas of high FA can indicate that changes have occurred in that area of the brain. The researchers believe that these changes are the brain’s way of compensating for an injury to enhance recovery.

Dr. Daniel Clearfield, DO, is a sports medicine and concussion specialist who told dailyRx that he was not surprised by the DTI results that showed a brain’s ability to heal or self-regulate after an injury.

“One of the principles of osteopathic medicine is that the body is capable of self-healing, self-regulation, and health maintenance,” said Dr. Clearfield.

“That said, this was a small population studied and more data needs to be used before definitive conclusions can be drawn between the link of post-concussive syndrome and neuroimaging such as DTI,” adds Dr. Clearfield.

With more research and better understanding, medical professionals may be able to create treatments that help the brain’s ability to compensate and aid in faster healing with fewer cognitive difficulties.

The research was presented at the annual Radiological Society of North America conference. The researchers report no conflicts of interest. Research presented at academic conferences should be considered preliminary until published in a peer reviewed journal.

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Review Date: 
December 10, 2012