Lingering Brain Injury Symptoms Haunt Concussion Patients

Six Top Brain Scan MRI Images

Researchers at the University of Cambridge have identified that mild concussions can cause long-lasting consequences on the mind, altering how mind areas talk with every single other and possibly foremost to extensive-time period indications this kind of as tiredness and cognitive impairment. Despite a deficiency of clear structural destruction in schedule brain scans, the research exposed that the thalamus, the brain’s relay procedure, turns into hyperconnected following a concussion. This overcompensation may be the induce of persistent indicators professional by clients. By examining PET scans, scientists recognized associations involving neurotransmitters and lengthy-time period signs and symptoms, boosting the possibility of establishing targeted therapies in the foreseeable future.

Even delicate concussion can induce extended-lasting outcomes to the mind, according to researchers at the College of Cambridge. Working with data from a Europe-broad study, the group has shown that for just about a half of all folks who get a knock to the head, there are changes in how regions of the mind talk with every other, possibly producing very long time period indicators this kind of as tiredness and cognitive impairment.

Gentle traumatic mind injury – concussion – success from a blow or jolt to the head. It can arise as a outcome of a fall, a athletics injuries or from a biking accident or vehicle crash, for instance. But regardless of being labelled ‘mild’, it is usually connected with persistent indicators and incomplete recovery. This sort of indications include things like melancholy, cognitive impairment, headaches, and fatigue.

“The blend of around-optimistic and imprecise prognoses signifies that some individuals hazard not acquiring satisfactory care for their indications.” — Emmanuel Stamatakis

Even though some clinicians in recent scientific tests forecast that nine out of 10 individuals who encounter concussion will have a comprehensive restoration following 6 months, proof is emerging that only 50 percent attain a full restoration. This implies that a significant proportion of individuals may not acquire ample post-personal injury care.

Predicting which patients will have a fast recovery and who will just take longer to get better is challenging, having said that. At current, people with suspected concussion will usually obtain a mind scan – both a CT scan or an MRI scan, each of which look for structural difficulties, these kinds of as inflammation or bruising – nevertheless even if these scans present no noticeable structural damage, a patient’s signs and symptoms might still persist.

Dr Emmanuel Stamatakis from the Section of Clinical Neurosciences and Division of Anaesthesia at the University of Cambridge mentioned: “Worldwide, we’re seeing an boost in the amount of cases of moderate traumatic mind harm, specifically from falls in our ageing population and rising figures of road site visitors collisions in low- and middle-revenue countries.

“At existing, we have no distinct way of operating out which of these patients will have a speedy restoration and which will acquire lengthier, and the mixture of in excess of-optimistic and imprecise prognoses indicates that some individuals danger not obtaining adequate care for their signs.”

Dr Stamatakis and colleagues examined

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 the 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 are 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.”

Reference: “Acute thalamic connectivity precedes chronic post-concussive symptoms in mild traumatic brain injury” by 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, CENTER-TBI MRI Substudy Participants and Investigators, David K Menon and Emmanuel A Stamatakis, 22 February 2023, Brain.
DOI: 10.1093/brain/awad056