title: Cerebral Blood Flow Alterations in Acute Sport-Related Concussion.
abstract: Sport-related concussion (SRC) is a major health problem, affecting millions of athletes each year. While the clinical effects of SRC (e.g., symptoms and functional impairments) typically resolve within several days, increasing evidence suggests persistent neurophysiological abnormalities beyond the point of clinical recovery after injury. This study aimed to evaluate cerebral blood flow (CBF) changes in acute SRC, as measured using advanced arterial spin labeling (ASL) magnetic resonance imaging (MRI). We compared CBF maps assessed in 18 concussed football players (age, 17.8 ± 1.5 years) obtained within 24 h and at 8 days after injury with a control group of 19 matched non-concussed football players. While the control group did not show any changes in CBF between the two time-points, concussed athletes demonstrated a significant decrease in CBF at 8 days relative to within 24 h. Scores on the clinical symptom (Sport Concussion Assessment Tool 3, SCAT3) and cognitive measures (Standardized Assessment of Concussion [SAC]) demonstrated significant impairment (vs. pre-season baseline levels) at 24 h (SCAT, p < 0.0001; SAC, p < 0.01) but returned to baseline levels at 8 days. Two additional computerized neurocognitive tests, the Automated Neuropsychological Assessment Metrics and Immediate Post-Concussion and Cognitive Testing, showed a similar pattern of changes. These data support the hypothesis that physiological changes persist beyond the point of clinical recovery after SRC. Our results also indicate that advanced ASL MRI methods might be useful for detecting and tracking the longitudinal course of underlying neurophysiological recovery from concussion.
authors.affiliation: 1 Department of Radiology, Medical College of Wisconsin , Milwaukee, Wisconsin.|2 Department of Biophysics, Medical College of Wisconsin , Milwaukee, Wisconsin.
authors.forename: Yang
authors.initials: Y
authors.lastname: Wang
authors.affiliation: 3 Department of Neurosurgery, Medical College of Wisconsin , Milwaukee, Wisconsin.|4 Department of Neurology, Medical College of Wisconsin , Milwaukee, Wisconsin.
authors.forename: Lindsay D
authors.initials: LD
authors.lastname: Nelson
authors.affiliation: 3 Department of Neurosurgery, Medical College of Wisconsin , Milwaukee, Wisconsin.
authors.forename: Ashley A
authors.initials: AA
authors.lastname: LaRoche
authors.affiliation: 3 Department of Neurosurgery, Medical College of Wisconsin , Milwaukee, Wisconsin.
authors.forename: Adam Y
authors.initials: AY
authors.lastname: Pfaller
authors.affiliation: 1 Department of Radiology, Medical College of Wisconsin , Milwaukee, Wisconsin.|2 Department of Biophysics, Medical College of Wisconsin , Milwaukee, Wisconsin.
authors.forename: Andrew S
authors.initials: AS
authors.lastname: Nencka
authors.affiliation: 1 Department of Radiology, Medical College of Wisconsin , Milwaukee, Wisconsin.|2 Department of Biophysics, Medical College of Wisconsin , Milwaukee, Wisconsin.
authors.forename: Kevin M
authors.initials: KM
authors.lastname: Koch
authors.affiliation: 3 Department of Neurosurgery, Medical College of Wisconsin , Milwaukee, Wisconsin.|4 Department of Neurology, Medical College of Wisconsin , Milwaukee, Wisconsin.
authors.forename: Michael A
authors.initials: MA
authors.lastname: McCrea
mesh_terms: D000293:Adolescent; D000328:Adult; D001265:Athletic Injuries / Q000000981:diagnostic imaging / Q000503:physiopathology*; D001924:Brain Concussion / Q000000981:diagnostic imaging / Q000503:physiopathology*; D002560:Cerebrovascular Circulation / Q000502:physiology*; D005538:Football; D006801:Humans; D008279:Magnetic Resonance Imaging / Q000379:methods*; D008297:Male; D009483:Neuropsychological Tests; D013113:Spin Labels; D055815:Young Adult
chemical_list: D013113:Spin Labels
keywords: MRI; arterial spin labeling; cerebral blood flow; concussion; recovery