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. 2016 Jul 1;33(13):1227-36.
doi: 10.1089/neu.2015.4072. Epub 2015 Nov 12.

Cerebral Blood Flow Alterations in Acute Sport-Related Concussion

Yang Wang  1   2 , Lindsay D Nelson  3   4 , Ashley A LaRoche  3 , Adam Y Pfaller  3 , Andrew S Nencka  1   2 , Kevin M Koch  1   2 , Michael A McCrea  3   4
Affiliations

Cerebral Blood Flow Alterations in Acute Sport-Related Concussion

Yang Wang et al. J Neurotrauma. .

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.

Keywords: MRI; arterial spin labeling; cerebral blood flow; concussion; recovery.

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Figures

<b>FIG. 1.</b>
FIG. 1.
Regions (in blue color) show significantly less cerebral blood flow (CBF) in concussion group at 24 h after injury, compared with the control group. No region shows significantly more CBF in the concussion group compared to the control group. Images reflect family-wise error correction at p < 0.05. Color bar indicates the t score. Color image is available online at www.liebertpub.com/neu
<b>FIG. 2.</b>
FIG. 2.
Diffuse cortical and subcortical regions (in blue color) show significantly less cerebral blood flow (CBF) in concussion group at 8 days after injury, compared with the control group. No region shows significant more CBF in the concussion group compared to the control group. Images reflect family-wise error correction at p < 0.05. Color bar indicates the t scores. Color image is available online at www.liebertpub.com/neu
<b>FIG. 3.</b>
FIG. 3.
Spread cortical and subcortical regions (in blue color) show significantly decreased cerebral blood flow (CBF) in concussion group at 8 days compared to 24 h after injury. No region shows significantly increased CBF in the concussion group at 8 days. Images reflect family-wise error correction at p < 0.05. Color bar indicates the t scores. Color image is available online at www.liebertpub.com/neu
<b>FIG. 4.</b>
FIG. 4.
Significant group-by-time interaction of cerebral blood flow changes is found mainly in bilateral frontal and temporal regions (in hot color). Images reflect family-wise error correction at p < 0.05. Color bar indicates the t scores. Color image is available online at www.liebertpub.com/neu
See this image and copyright information in PMC

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