New Brain-Imaging Technique Offers Clues for Concussions

Doctors still don't know a lot about how the brain reacts to concussions and why some patients fare better than others. New research could change that.

It’s always about this time of year when everyone starts talking about concussions. It’s no coincidence: Concussions are the most common type of brain injury. And with gobs of kids heading back to school for preseason and busy fall-sports schedules, concussions are on a lot of minds. (Pardon the pun.)

It’s certainly no coincidence that early last month, a new Pennsylvania state law went into effect, implementing new rules on schools, parents and coaches for how to handle athletes with suspected concussions. The law is an effort to curtail the rising rate of youth concussions; one national study found that ER visits for concussions doubled between 1997 and 2007.

Unfortunately, concussions can be difficult to treat, with symptoms and long-term neurological outcomes varying from person to person. If you’ve ever had a concussion or known anyone who has—I had a friend who had seven (7!!) when he was growing up—you know what I’m talking about: While some people may survive 10 concussions and come out hunky-dory, others might have one and suffer life-long consequences. The problem is, it’s hard for doctors to know from the get-go which patients are at risk for long-term consequences, and which are not.

Enter: New York researcher Michael Lipton. He’s done extensive research on the effects of concussions, using a brain-imaging technique called diffusion tensor imaging (DTI) to analyze the patterns of brain abnormalities that concussions can cause. It detects subtle damage by measuring the diffusion of water in the brain’s white matter.

In a recent study, Lipton examined 34 patients with mild concussions and 30 with no brain injuries. Each person was imaged at two weeks, three months and six months. Interestingly, concussion patients each had different outcomes, both from each other and from the non-injured patients, showing distinct spatial patterns of diffusion, which changed differently over time. Brain scans of the concussion group also indicated that the injured brains were trying to make up for the damage by increasing connections elsewhere in other regions.

At this point, it’s just a clue as to underlying causes in the Great Concussion Mystery. But as Fox News reports, “Lipton said he hopes the imaging technique will reveal certain symptom-related patterns among patients and ‘set the stage to use individualized information doctors can use to make a stab at making personalized predictions for [concussion] patients.’”

And that’s something every parent, coach, athlete and Pennsylvania state bureaucrat should hope for.