29 November 2016

Three Radiology Research Projects to Better Understand Concussions

A recent article in Radiology Today illustrates how radiological imaging is becoming an increasingly important tool in studying and diagnosing concussions.

The Centers for Disease Control and Prevention estimate that 248,000 children and teens visit the emergency department each year to evaluate concussions suffered during physical activity. Concussions, also known as mild traumatic brain injuries, have serious short- and long- term effects on thinking, sensation, language and emotion. In the short run, repeated concussions can potentially cause dramatic, fatal brain swelling. In the long run, they have increasingly been linked to Chronic Traumatic Encephalopathy (CTE), Alzheimer’s, Parkinson’s disease and other brain disorders.

Public awareness of the alarming short- and long-term effects of concussions is growing quickly, but timely diagnosis remains difficult. Most diagnostic methods for concussions – particularly on athletic fields – are dependent on evaluation of symptoms that are often understated by athletes. Although radiological imaging is not yet a practical sideline solution, researchers have used it to better understand the physiological effects of concussions and track the brain’s recovery. The September 2016 issue of Radiology Today presented three current projects demonstrating how researchers are using imaging to better diagnose concussions, understand their severity and determine how they impact athletes’ brains. 

  • MRI Blood Flow Examination – Researchers at the Medical College of Wisconsin presented a study at the American Academy of Neurology’s Sports Concussion Conference in July on cerebral blood flow in football players. The study found that while concussed players’ symptoms would often improve to baseline levels by the eighth day following the injury, MRIs indicated ongoing low blood flow after the same amount of time. Decreased blood flow is often used as an indicator of cerebral microbleeds. Microbleeds are most commonly found in people over 60, and should not be present in high school students. Youth athletes demonstrating signs of microbleeds could potentially be at risk for CTE, which is associated with memory loss, confusion, impaired judgment, impulse control problems, aggression, depression and progressive dementia, according to Boston University’s CTE Center.  
  • Combining TechniquesResearchers at the University of Texas Southwestern Medical Center, Wake Forest School of Medicine and Children’s National Medical Center published a study in the May Journal of Neurotrauma finding that a single season of football can result in brain changes. The techniques they used include:
  1. Equipping helmets with sensors that detect impacts players received.
  2. MRI diffusion kurtosis imaging that detects both normal development and pathological changes in the white matter that allows the brain to make proper neurological connections.
  3. PET scans to detect tau proteins that are believed to cause cognitive impairment in Alzheimer’s patients.

The researchers are next looking to conduct longitudinal studies to observe long-term brain development. They are also planning to study non-helmeted athletes through alternative techniques such as equipping mouth guards with sensors.

  • Ultrasound Examination – In May, the American Association of Neurology presented a study that used ultrasound to map changes in blood flow after an injury. Although traditional ultrasound could only differentiate between concussed and control groups 60 percent of the time, the advanced software improved diagnostic accuracy to 83 percent. 

How Sheridan Healthcare, Jupiter Medical Center and Joe Namath Developed a Groundbreaking Treatment Protocol for Traumatic Brain Injuries

In 2014, Sheridan began a partnership with Jupiter Medical Center and legendary Jets quarterback Joe Namath to study the effectiveness of hyperbaric oxygen therapy to treat traumatic brain injuries. The FDA-approved clinical trial led by co-directors of the Joe Namath Neurological Research Center, Barry Miskin, MD, FACS and Sheridan Healthcare Radiology Medical Director Lee A. Fox, MD, MA, investigates how breathing pure oxygen in a pressurized chamber can stimulate the growth of new blood vessels to help the brain recover. After seeing improvements in Namath’s cognition and memory as a result of his continued hyperbaric oxygen therapy, the team hopes the study will provide valuable insights into how to combat the degenerating effects of concussions. While research and development of treatment options for concussions are in their early stages, the future applications could literally be game-changing.

For more information, see our blog post on hyperbaric oxygen therapy research.