Persistent Postconcussion Changes Seen in Cerebral Blood Flow
THURSDAY, March 13, 2025 -- For athletes with concussion, persistent postconcussion changes are seen in cerebral blood flow (CBF) and white matter at return-to-play (RTP) and up to one year later, according to a study published online March 12 in Neurology.
Nathan W. Churchill, Ph.D., from Unity Health Toronto, and colleagues conducted a prospective observational study involving healthy athletes without a history of psychiatric, neurologic, or sensory-motor conditions to examine whether individuals with concussion show functional and structural magnetic resonance imaging (MRI) brain changes relative to preinjury levels. Clinical and MRI data were collected at preseason baseline; those who were concussed were reassessed at one to seven days after injury, at RTP, and at one to three months and one year after RTP. At their subsequent preseason baseline, a matched control cohort of uninjured athletes was also reassessed.
The study included 25 athletes with concussion and follow-up imaging and 27 controls. The researchers observed statistically significant changes from baseline among adults with concussion, including decreased frontoinsular CBF, increased white matter mean diffusivity, and reduced fractional anisotropy in the corona radiata and internal capsule. The effects persisted beyond RTP; only the changes in CBF exceeded longitudinal variability in controls. Significantly greater changes in medial temporal CBF were also seen for participants with longer recovery periods.
"The presence of significant, long-lasting brain changes after injury reinforces concerns about the consequences of repeated concussions and to what extent these effects accumulate over time," the authors write.
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