Almost half of people with concussion still show symptoms of brain
injury six months later

Date:
April 25, 2023
Source:
University of Cambridge
Summary:
Even mild concussion can cause long-lasting effects to the brain,
according to researchers. Using data from a Europe-wide study, the
team has shown that for almost a half of all people who receive a
knock to the head, there are changes in how regions of the brain
communicate with each other, potentially causing long term symptoms
such as fatigue and cognitive impairment.


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FULL STORY ==========================================================================
Even mild concussion can cause long-lasting effects to the brain,
according to researchers at the University of Cambridge. Using data from
a Europe-wide study, the team has shown that for almost a half of all
people who receive a knock to the head, there are changes in how regions
of the brain communicate with each other, potentially causing long term symptoms such as fatigue and cognitive impairment.

Mild traumatic brain injury -- concussion -- results from a blow or jolt
to the head. It can occur as a result of a fall, a sports injury or from
a cycling accident or car crash, for example. But despite being labelled 'mild', it is commonly linked with persistent symptoms and incomplete
recovery. Such symptoms include depression, cognitive impairment,
headaches, and fatigue.

While some clinicians in recent studies predict that nine out of
10 individuals who experience concussion will have a full recovery
after six months, evidence is emerging that only a half achieve a full recovery. This means that a significant proportion of patients may not
receive adequate post-injury care.

Predicting which patients will have a fast recovery and who will take
longer to recover is challenging, however. At present, patients with
suspected concussion will typically receive a brain scan -- either a CT
scan or an MRI scan, both of which look for structural problems, such
as inflammation or bruising -- yet even if these scans show no obvious structural damage, a patient's symptoms may still persist.

Dr Emmanuel Stamatakis from the Department of Clinical Neurosciences and Division of Anaesthesia at the University of Cambridge said: "Worldwide,
we're seeing an increase in the number of cases of mild traumatic brain
injury, particularly from falls in our ageing population and rising
numbers of road traffic collisions in low- and middle-income countries.

"At present, we have no clear way of working out which of these
patients will have a speedy recovery and which will take longer, and
the combination of over- optimistic and imprecise prognoses means that
some patients risk not receiving adequate care for their symptoms."
Dr Stamatakis and colleagues studied fMRI brain scans -- that is,
functional MRI scans, which look at how different areas of the brain
coordinate with each other -- taken from 108 patients with mild
traumatic brain injury and compared them with scans from 76 healthy
volunteers. Patients were also assessed for ongoing symptoms.

The patients and volunteers had been recruited to CENTER-TBI, a large
European research project which aims to improve the care for patients
with traumatic brain injury, co-chaired by Professor David Menon (head
of the division of Anaesthesia) and funded by the European Union.

In results published today in Brain, the team found that just under half
(45%) were still showing symptoms resulting from their brain injury,
with the most common being fatigue, poor concentration and headaches.

The researchers found that these patients had abnormalities in a region of
the brain known as the thalamus, which integrates all sensory information
and relays this information around the brain. Counter-intuitively,
concussion was associated with increased connectivity between the
thalamus and the rest of the brain -- in other words, the thalamus was
trying to communicate more as a result of the injury -- and the greater
this connectivity, the poorer the prognosis for the patient.

Rebecca Woodrow, a PhD student in the Department of Clinical Neuroscience
and Hughes Hall, Cambridge, said: "Despite there being no obvious
structural damage to the brain in routine scans, we saw clear evidence
that the thalamus -- the brain's relay system -- was hyperconnected. We
might interpret this as the thalamus trying to over-compensate for any anticipated damage, and this appears to be at the root of some of the long-lasting symptoms that patients experience." By studying additional
data from positron emission tomography (PET) scans, which can measure
regional chemical composition of body tissues, the researchers were
able to make associations with key neurotransmitters depending on
which long-term symptoms a patient displayed. For example, patients experiencing cognitive problems such as memory difficulties showed
increased connectivity between the thalamus and areas of the brain rich
in the neurotransmitter noradrenaline; patients experiencing emotional symptoms, such as depression or irritability, showed greater connectivity
with areas of the brain rich in serotonin.

Dr Stamatakis, who is also Stephen Erskine Fellow at Queens' College, Cambridge, added: "We know that there already drugs that target these
brain chemicals so our findings offer hope that in future, not only
might we be able to predict a patient's prognosis, but we may also be
able to offer a treatment targeting their particular symptoms."
* RELATED_TOPICS
o Mind_&_Brain
# Brain_Injury # Intelligence # Neuroscience #
Disorders_and_Syndromes # Brain-Computer_Interfaces #
Dementia # Stroke # Mental_Health
* RELATED_TERMS
o Brain_damage o Social_cognition o Traumatic_brain_injury
o Psycholinguistics o Deep_brain_stimulation o Thalamus o
Aggression o Personality_disorder

========================================================================== Story Source: Materials provided by University_of_Cambridge. The original
text of this story is licensed under a Creative_Commons_License. Note:
Content may be edited for style and length.


========================================================================== Journal Reference:
1. Rebecca E Woodrow, Stefan Winzeck, Andrea I Luppi, Isaac R Kelleher-
Unger, Lennart R B Spindler, J T Lindsay Wilson, Virginia F J
Newcombe, Jonathan P Coles, Krisztina Amrein, Nada Andelic, Lasse
Andreassen, Audny Anke, Philippe Azouvi, Bo-Michael Bellander,
Habib Benali, Andras Buki, Alessio Caccioppola, Emiliana Calappi,
Marco Carbonara, Giuseppe Citerio, Hans Clusmann, Mark Coburn,
Jonathan Coles, Marta Correia, Endre Czeiter, Ve'ronique De Keyser,
Vincent Degos, Bart Depreitere, Live Eikenes, Erzse'bet Ezer,
Kelly Foks, Shirin Frisvold, Alexandre Ghuysen, Damien Galanaud,
Ben Glocker, Asta Haberg, Iain Haitsma, Eirik Helseth, Peter J
Hutchinson, Evgenios Kornaropoulos, Noe'mi Kova'cs, Ana Kowark,
Steven Laureys, Didier Ledoux, Hester Lingsma, Andrew I R Maas,
Geoffrey Manley, David K Menon, Tomas Menovsky, Benoit Misset,
Visakh Muraleedharan, Ingeborg Nakken, Virginia Newcombe, Wibeke
Nordho/y, Jo'zsef Nyira'di, Fabrizio Ortolano, Paul M Parizel,
Vincent Perlbarg, Paolo Persona, Wilco Peul, Jussi P Posti, Louis
Puybasset, Sophie Richter, Cecilie Roe, Olav Roise, Rolf Rossaint,
Sandra Rossi, Daniel Rueckert, Toril Skandsen, Abayomi Sorinola,
Emmanuel Stamatakis, Ewout W Steyerberg, Nino Stocchetti, Riikka
Takala, Vikto'ria Tama's, Olli Tenovuo, Zolta'n Va'mos, Gregory
Van der Steen, Wim Van Hecke, Thijs Vande Vyvere, Jan Verheyden,
Anne Vik, Victor Volovici, Lars T Westlye, Guy Williams, Stefan
Winzeck, Peter Yle'n, Tommaso Zoerle, David K Menon, Emmanuel
A Stamatakis. Acute thalamic connectivity precedes chronic
post-concussive symptoms in mild traumatic brain injury. Brain,
2023; DOI: 10.1093/brain/ awad056 ==========================================================================

Link to news story: https://www.sciencedaily.com/releases/2023/04/230425205339.htm

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