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   PID: hpt/lnx 1.9.0-cur 2019-01-08   
   TID: hpt/lnx 1.9.0-cur 2019-01-08   
    Almost half of people with concussion still show symptoms of brain   
   injury six months later    
      
     Date:   
         April 25, 2023   
     Source:   
         University of Cambridge   
     Summary:   
         Even mild concussion can cause long-lasting effects to the brain,   
         according to researchers. Using data from a Europe-wide study, the   
         team has shown that for almost a half of all people who receive a   
         knock to the head, there are changes in how regions of the brain   
         communicate with each other, potentially causing long term symptoms   
         such as fatigue and cognitive impairment.   
      
      
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   FULL STORY   
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   Even mild concussion can cause long-lasting effects to the brain,   
   according to researchers at the University of Cambridge. Using data from   
   a Europe-wide study, the team has shown that for almost a half of all   
   people who receive a knock to the head, there are changes in how regions   
   of the brain communicate with each other, potentially causing long term   
   symptoms such as fatigue and cognitive impairment.   
      
   Mild traumatic brain injury -- concussion -- results from a blow or jolt   
   to the head. It can occur as a result of a fall, a sports injury or from   
   a cycling accident or car crash, for example. But despite being labelled   
   'mild', it is commonly linked with persistent symptoms and incomplete   
   recovery. Such symptoms include depression, cognitive impairment,   
   headaches, and fatigue.   
      
   While some clinicians in recent studies predict that nine out of   
   10 individuals who experience concussion will have a full recovery   
   after six months, evidence is emerging that only a half achieve a full   
   recovery. This means that a significant proportion of patients may not   
   receive adequate post-injury care.   
      
   Predicting which patients will have a fast recovery and who will take   
   longer to recover is challenging, however. At present, patients with   
   suspected concussion will typically receive a brain scan -- either a CT   
   scan or an MRI scan, both of which look for structural problems, such   
   as inflammation or bruising -- yet even if these scans show no obvious   
   structural damage, a patient's symptoms may still persist.   
      
   Dr Emmanuel Stamatakis from the Department of Clinical Neurosciences and   
   Division of Anaesthesia at the University of Cambridge said: "Worldwide,   
   we're seeing an increase in the number of cases of mild traumatic brain   
   injury, particularly from falls in our ageing population and rising   
   numbers of road traffic collisions in low- and middle-income countries.   
      
   "At present, we have no clear way of working out which of these   
   patients will have a speedy recovery and which will take longer, and   
   the combination of over- optimistic and imprecise prognoses means that   
   some patients risk not receiving adequate care for their symptoms."   
   Dr Stamatakis and colleagues studied fMRI brain scans -- that is,   
   functional MRI scans, which look at how different areas of the brain   
   coordinate with each other -- taken from 108 patients with mild   
   traumatic brain injury and compared them with scans from 76 healthy   
   volunteers. Patients were also assessed for ongoing symptoms.   
      
   The patients and volunteers had been recruited to CENTER-TBI, a large   
   European research project which aims to improve the care for patients   
   with traumatic brain injury, co-chaired by Professor David Menon (head   
   of the division of Anaesthesia) and funded by the European Union.   
      
   In results published today in Brain, the team found that just under half   
   (45%) were still showing symptoms resulting from their brain injury,   
   with the most common being fatigue, poor concentration and headaches.   
      
   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   
   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 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."   
       * RELATED_TOPICS   
             o Mind_&_Brain   
                   # Brain_Injury # Intelligence # Neuroscience #   
                   Disorders_and_Syndromes # Brain-Computer_Interfaces #   
                   Dementia # Stroke # Mental_Health   
       * RELATED_TERMS   
             o Brain_damage o Social_cognition o Traumatic_brain_injury   
             o Psycholinguistics o Deep_brain_stimulation o Thalamus o   
             Aggression o Personality_disorder   
      
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   Story Source: Materials provided by University_of_Cambridge. The original   
   text of this story is licensed under a Creative_Commons_License. Note:   
   Content may be edited for style and length.   
      
      
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   Journal Reference:   
      1. 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, Krisztina Amrein, Nada Andelic, Lasse   
         Andreassen, Audny Anke, Philippe Azouvi, Bo-Michael Bellander,   
         Habib Benali, Andras Buki, Alessio Caccioppola, Emiliana Calappi,   
         Marco Carbonara, Giuseppe Citerio, Hans Clusmann, Mark Coburn,   
         Jonathan Coles, Marta Correia, Endre Czeiter, Ve'ronique De Keyser,   
         Vincent Degos, Bart Depreitere, Live Eikenes, Erzse'bet Ezer,   
         Kelly Foks, Shirin Frisvold, Alexandre Ghuysen, Damien Galanaud,   
         Ben Glocker, Asta Haberg, Iain Haitsma, Eirik Helseth, Peter J   
         Hutchinson, Evgenios Kornaropoulos, Noe'mi Kova'cs, Ana Kowark,   
         Steven Laureys, Didier Ledoux, Hester Lingsma, Andrew I R Maas,   
         Geoffrey Manley, David K Menon, Tomas Menovsky, Benoit Misset,   
         Visakh Muraleedharan, Ingeborg Nakken, Virginia Newcombe, Wibeke   
         Nordho/y, Jo'zsef Nyira'di, Fabrizio Ortolano, Paul M Parizel,   
         Vincent Perlbarg, Paolo Persona, Wilco Peul, Jussi P Posti, Louis   
         Puybasset, Sophie Richter, Cecilie Roe, Olav Roise, Rolf Rossaint,   
         Sandra Rossi, Daniel Rueckert, Toril Skandsen, Abayomi Sorinola,   
         Emmanuel Stamatakis, Ewout W Steyerberg, Nino Stocchetti, Riikka   
         Takala, Vikto'ria Tama's, Olli Tenovuo, Zolta'n Va'mos, Gregory   
         Van der Steen, Wim Van Hecke, Thijs Vande Vyvere, Jan Verheyden,   
         Anne Vik, Victor Volovici, Lars T Westlye, Guy Williams, Stefan   
         Winzeck, Peter Yle'n, Tommaso Zoerle, David K Menon, Emmanuel   
         A Stamatakis. Acute thalamic connectivity precedes chronic   
         post-concussive symptoms in mild traumatic brain injury. Brain,   
         2023; DOI: 10.1093/brain/ awad056   
   ==========================================================================   
      
   Link to news story:   
   https://www.sciencedaily.com/releases/2023/04/230425205339.htm   
      
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