In the days and weeks following a concussion, it’s often tough to give patients a clear sense of their recovery time.
Now, a new study of college football players suggests that measuring blood flow in the brain might help.
“It provides support for using cerebral blood flow as an objective signal for the initial evaluation of a concussion, as well as measuring progress and recovery,” said one expert, Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York City. He was not involved in the new research.
Glatter explained that, as it stands now, it’s been tough for doctors to even confirm whether or not a person has sustained a concussion. Currently, physicians rely largely on standard neurologic exams or tests of balance or thinking/memory.
But recent advances in scanning technologies that track blood flow in the brain might change all that, Glatter added.
The new study was led by Timothy Meier of the Mind Research Network/Lovelace Biomedical and Environmental Research Institute in Albuquerque, N.M. According to the researchers, prior studies in animals have found that reduced blood flow in the brain is a marker of more severe concussion.
The new study included 17 college football players who had suffered concussions, and a comparison group of 27 football players without concussion.
The concussed players underwent scans to measure brain blood flow one day, one week and one month after their concussion. The players in the control group also had their brain blood flow checked.
Brain blood flow was compared against the concussed players’ symptoms, as well.
Reporting online March 2 in JAMA Neurology, Meier’s team found that players who had full recovery at either one week or one month after their concussions showed normal blood flow in the brain.
However, blood flow remained reduced in a key part of the brain one month after concussion in players who were slower to recover, as well as in those with the most severe initial psychiatric symptoms, the researchers said.
“To our knowledge, this study provides the first prospective evidence of reduced cerebral blood flow and subsequent recovery following concussion in a homogenous sample of collegiate football athletes,” Meier’s group wrote.
Glatter believes the scans may hold promise for post-concussion care. If the findings are replicated in a much larger trial, scans might someday be used “to make better decisions about monitoring athletes, as well as patients who suffer head trauma, and determining whether they can safely return to play or the work setting,” he said.
Glatter said the MRI technology used in the study isn’t portable, however, limiting its potential use. But he added that an alternate technology, called transcranial Doppler, is more portable and might work as well.
Dr. Kevin Curley is a sports medicine specialist at Winthrop-University Hospital in Mineola, N.Y. He said that while the new study “will not change the immediate management of concussions, it does help to possibly explain why some people recover more slowly.”
Curley added, “Any measure that provides objective data [for better diagnosis/prognosis] is something that should be studied further.”
SOURCES: Robert Glatter, M.D., emergency physician, Lenox Hill Hospital, New York City; Kevin Curley, M.D., Winthrop-University Hospital, Mineola, N.Y.; JAMA Neurology, news release, March 2, 2015: HealthDay
The findings mesh with other recent research that has linked chronic fatigue syndrome to a faulty immune system, said Dr. Jacob Teitelbaum, director of the Fatigue & Fibromyalgia Practitioners Network.
“What we see is an initial overdrive of the immune system, suggesting that one or several infections have become chronic, with the immune system being unable to turn itself off,” Teitelbaum said. “So in the early phases of the illness, we see the immune system being on overdrive. As this goes on, the immune system exhausts itself, resulting in widespread, yet ineffective, attacks against many infections.”
People with long-term chronic fatigue syndrome, then, are saddled with worn-out immune systems that struggle to combat even the mild infections that healthy immune system would shrug off quickly, he said.
SOURCES: Mady Hornig, M.D., associate professor and director, Translational Research, Jerome L. and Dawn Greene Infectious Disease Laboratory, Columbia University’s Mailman School of Public Health, New York City; Jacob Teitelbaum, M.D., director, Fatigue & Fibromyalgia Practitioners Network; Feb. 27, 2015, Science Advances