By Brian Pickering: Sports Health
Lake Region Healthcare Sports Medicine
A recent study in the Journal of Neurotrauma reported that concussion injuries may show up in the brain years after the initial diagnosis. The study looked at 43 student athletes (22 with a history of concussion, 21 without) and found that the brains of those student athletes with a history of concussion showed changes in size, blood flow, and neuro connections in the brain months after injury. Some of these changes appeared years after the concussions were diagnosed. Athletes without a history of concussions did not have any differences. Although a small sample size, this study reinforces the beliefs of many that concussions have long-term effects if not handled correctly and should lead to additional research looking at effects of concussions years after the injury has occurred.
Medical professionals know that there are changes to the brain after injury. This is the reason we now have athletes return to a “baseline” level of cognitive, psychological, and motor function.While these can sometimes be hard to identify and interpret, there are a number of tools available that allow the medical professional to test for impairment and monitor improvement. There are still many subjective things that need to be evaluated, but these tests that are computer based or verbally administered on the sidelines are an excellent tool that can be used as part of the larger evaluation. The concern in this study is that many of these athletes had physical differences in the brain years after the last concussion.
In the research, MRI studies showed a 10-20 percent reduction in brain volume in the frontal lobe. This area of the brain is involved in speech, problem solving, and decision making. Shrinkage of the brain has been linked to emotional challenges, difficulty in communicating and trouble walking and putting together cognizant thoughts. Many of these same issues are found in patients with Alzheimer’s disease. We know from past studies and reports that the rate of Alzheimer’s and other similar diseases is higher in professional football players than in the general population.
As someone who has dealt with athletic concussions on a professional level and as a parent, I know we have a long way to go. Concussion is still viewed by many in the athletic community as a short-term problem. The problem with this is that athletes are put back into situations where further damage can take place before appropriate healing can occur. This can lead to long-term health issues such as depression and decreased cognitive function. The research will continue to get better and better direct our efforts to diagnose, treat and ultimately safely return the athlete to competition without an increased risk of further injury. As I talk professionally with others that manage concussions in athletes, the real problem becomes that we are relying on the athlete to report the symptoms and tell us how they are feeling. We can test clinically for balance, memory, concentration and other measurable values, but some kids will appear normal even with a concussion. With fall sports underway at high schools and colleges, the real take away should be that sports are a positive impact on the lives of kids. Athletes should not be scared away from participating in football, soccer or any other sport they enjoy because of concussions. The health benefits (including social benefits) outweigh any risk of injury in the majority of athletes.
Interested in further discussion on concussions? Mark your calendar for Monday, Sept. 19 at 5:30 p.m. Lake Region Healthcare will kick off the 2016 “Live Well” Education Series with this topic featuring student athlete Taylor Zatocha and LRH Pediatrician, Dr. Al Magnuson. Watch www.lrhc.org for more details.
Do you have a question regarding sports medicine that you would like to see addressed in this space in the future? Send your questions to SportsMed@lrhc.org, and it may be featured in an upcoming article.