Effects of a Concussion May Last Longer than Symptoms, Study Shows
March 01, 2012
A study recently published by the University of Kentucky's Scott Livingston shows that physiological problems stemming from a concussion may continue to present in the patient even after standard symptoms subside.
Currently, concussions are diagnosed and monitored through a patient's self-reported symptoms (including headache, confusion or disorientation, poor concentration, and memory loss) and through computerized neuropsychological testing programs, which measure cognitive abilities including attention and concentration, cognitive processing, learning and memory, and verbal fluency. Post-concussion abnormalities in either of these markers typically return to a normal level within five to 10 days following the injury.
Conducted while he was a graduate student at the University of Virginia, Livingston's study was just published in the February 2012 issue of the Journal of Clinical Neurophysiology. The study used motor-evoked potentials (MEPs) - an electrophysiological measurement that can provide hard evidence for changes in brain function - to determine if any physiological abnormalities followed a similar recovery pattern to self-reported symptoms and neuropsychological testing.
During an MEP test, subjects have electrodes placed on a limb - such as the hand or foot. A magnetic stimulating device is placed over the head, and they receive a brief pulse of magnetic stimulation to the brain. The "reaction time" - the amount of time it takes for the subject's limb to receive the response from the brain after the stimulation - is recorded.
Livingston's study enrolled 18 collegiate athletes - nine who had been concussed within the previous 24 hours, and nine who had not experienced a concussion. Each concussed subject was matched with a non-concussed subject using age, gender, sport, position played, prior concussion history, and history of learning disability or attention deficit-hyperactivity disorder as inclusion criteria.
Subjects were evaluated for evidence of concussion based on self-reported symptoms, computerized neurocognitive test performance, and MEPs for a period of 10 days. Post-concussion symptoms were more frequent and greater in severity in the immediate timeframe after the injury (24-72 hours) and decreased in the following days. Some subjects reported no symptoms by day 10, though others did not have complete symptoms resolution by that time. Neurocognitive deficits followed a similar pattern, proving greater just after the injury and returning to normal (or closer to normal) by day 10.
MEPs, however, showed delays in response time and smaller MEP size which continued up to day 10, with these physiological changes actually increasing as the concussed athletes' symptoms decreased and cognitive functioning improved.
Livingston, director of the UK Concussion Assessment Research Lab and assistant professor in the Department of Rehabilitation Sciences, says these findings are significant for both athletes and sports medicine clinicians.
"Further investigation of MEPs in concussed athletes is needed, especially to assess how long the disturbances in physiological functioning continue after those initial ten days post-injury," Livingston said. "But in the meantime, sports medicine personnel caring for concussed athletes should be cautious about relying solely on self-reported symptoms and neurocognitive test performances when making return-to-play decisions."
Livingston's research lab recently began a new program to further study MEPs in athletes pre- and post-concussion. At UK, all athletes who participate in a contact sport - including football, soccer, volleyball, diving, gymnastics, and basketball - are assessed preseason using MEP and neurocognitive testing to establish a baseline measure for each athlete.
If an athlete receives a concussion, he or she will come back to the lab as soon as possible after the injury for follow-up testing. This approach allows researchers to get a clearer idea of the extent of an athlete's injury, Livingston says.
Neurocognitive tests, such as the Immediate Post-Concussion Assessment and Testing (ImPACT)™, are a valuable component of concussion management. While major professional sports organizations like the NFL and NHL, as well as hundreds of colleges, universities, and high schools across the United States follow this standard, UK Athletics did not have a formal, standardized neurocognitive testing protocol in place until last year. The addition of the MEP assessment in the preseason testing and post-concussion management are unique - UK is the first and only collegiate athletics program to implement a baseline physiologic measure of brain function.
"No other college of university in the country is currently assessing physiologic brain responses and using this information to determine the extent of the functional brain injury," Livingston said. "This type of information enables us to closely track recovery, which may not correspond to the decrease in concussion symptoms or recovery of memory and other cognitive functions."
Learn more about concussion research at UK with Drs. James Jagger, Dan Han, and Scott Livingston in "UK at the Half," a radio interview broadcast at halftime of the Feb. 11 UK-Vanderbilt basketball game.
University of Kentucky
Related Concussion Current Events and Concussion News ArticlesTeenagers who have had a concussion also have higher rates of suicide attempts
Teenagers who have suffered a traumatic brain injury such as a concussion are at "significantly greater odds" of attempting suicide, being bullied and engaging in a variety of high risk behaviours, a new study has found. MRI pinpoints region of brain injury in some concussion patients
Researchers using information provided by a magnetic resonance imaging (MRI) technique have identified regional white matter damage in the brains of people who experience chronic dizziness and other symptoms after concussion. Rural versus urban causes of childhood concussion
Researchers at Western University (London, Canada) have found youth living in rural areas are more likely to sustain concussions from injuries involving motorized vehicles such as all-terrain vehicles and dirt bikes, whereas youth living in urban areas suffer concussions mostly as a result of sports.In rats, diffuse brain damage can occur with no signs of 'concussion,' reports study in Neurosurgery
A standard experimental model of concussion in rats causes substantial brain damage-but no behavioral changes comparable to those seen in patients with concussion, reports a study in the April issue of Neurosurgery, official journal of the Congress of Neurological Surgeons.Significant head, neck injury risk associated with extreme sports
A new study presented today at the 2014 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS) found that the thrill of extreme sports comes at a price: a higher risk for severe neck and head injuries.Penn Researchers Model a Key Breaking Point Involved in Traumatic Brain Injury
Even the mildest form of a traumatic brain injury, better known as a concussion, can deal permanent, irreparable damage.How well do football helmets protect players from concussions?
A new study finds that football helmets currently used on the field may do little to protect against hits to the side of the head, or rotational force, an often dangerous source of brain injury and encephalopathy.New study finds differences in concussion risk between football helmets
Football helmets can be designed to reduce the risk of concussions, according to a new study by some of the nation's leading concussion researchers published today in the Journal of Neurosurgery.Middle-school girls continue to play soccer with concussion symptoms
Concussions are common among middle-school girls who play soccer, and most continue to play with symptoms, according to a study by John W. O' Kane, M.D., of the University of Washington Sports Medicine Clinic, Seattle, and colleagues.Dietary amino acids relieve sleep problems after traumatic brain injury in animals
Scientists who fed a cocktail of key amino acids to mice improved sleep disturbances caused by brain injuries in the animals.
More Concussion Current Events and Concussion News Articles
The Concussion Crisis: Anatomy of a Silent Epidemic|
by Linda Carroll (Author), David Rosner (Author)
THE CONCUSSION CRISIS brings an explosive but largely unseen epidemic out of the shadows. It puts a human face on a pressing public health crisis through poignant stories of athletes (from the peewees to the pros), soldiers, and others whose lives have been forever changed by jolts to the head and brain. Weaving their cautionary tales with a clear and accessible explanation of the advancing science and medicine, The Concussion Crisis is the definitive exploration of the invisible injury behind today’s alarming headlines. Journalists Linda Carroll and David Rosner sound an urgent wake-up call to every family and argue for changing a macho culture that refuses to treat concussion seriously as the traumatic brain injury it is.
Concussion Recovery: Rebuilding the Injured Brain|
by Colleen Butler (Author)
As stated by Harry Zarins, Executive Director of the Brain Injury Association of Canada, Concussion Recovery is an extremely practical guide, which is written from first-hand experience. The book is a compendium of information, techniques, and insight, which the author, Colleen Butler, has compiled from her own journey to understand brain injury and to find her path to recovery. Colleen's extensive experience in helping those who are coping with the challenges of brain injury has led her to develop innovative solutions to give hope and speed the recovery of survivors. Readers will greatly benefit from the empathetic, compassionate approach of the book, its humour and the information it offers. Uplifting, honest and straightforward, Concussion Recovery will empower survivors to take...
Concussions and Our Kids: America's Leading Expert on How to Protect Young Athletes and Keep Sports Safe|
by Dr. Robert Cantu (Author), Mark Hyman (Author)
“This is an important, cutting-edge work by the premier specialist in his field. If you watch sports, or if you have a young athlete in your family, you need to read this book.” —Dan Shaughnessy, author of The Curse of the Bambino
From Washington to Quebec, from offices at the NFL to the New York Times, from the NHL players’ union to the soccer fields of Anytown, U.S.A., people are talking about concussions. At the center of this crisis—and one of the key reasons for this increased awareness—is Dr. Robert Cantu, the country’s leading expert on athletic brain trauma and a pioneer in the study of the link between concussions and progressive brain disease in athletes.
Concussions and Our Kids is the first prescriptive book of its kind to address the...
League of Denial: The NFL, Concussions and the Battle for Truth|
by Mark Fainaru-Wada (Author), Steve Fainaru (Author)
“PROFESSIONAL FOOTBALL PLAYERS DO NOT SUSTAIN FREQUENT REPETITIVE BLOWS TO THE BRAIN ON A REGULAR BASIS.”
So concluded the National Football League in a December 2005 scientific paper on concussions in America’s most popular sport. That judgment, implausible even to a casual fan, also contradicted the opinion of a growing cadre of neuroscientists who worked in vain to convince the NFL that it was facing a deadly new scourge: A chronic brain disease that was driving an alarming number of players -- including some of the all-time greats -- to madness.
League of Denial reveals how the NFL, over a period of nearly two decades, sought to cover up and deny mounting evidence of the connection between football and brain damage.
Comprehensively, and for the first time, award-winning...
Coping with Concussion and Mild Traumatic Brain Injury: A Guide to Living with the Challenges Associated with Post Concussion Syndrome and Brain Trauma|
by Diane Roberts Stoler Ed.D. (Author), Barbara Albers Hill (Author)
A comprehensive guide for improving memory, focus, and quality of life in the aftermath of a concussion.
Often presenting itself after a head trauma, concussion— or mild traumatic brain injury (mTBI)— can cause chronic migraines, depression, memory, and sleep problems that can last for years, referred to as post concussion syndrome (PCS).
Neuropsychologist and concussion survivor Dr. Diane Roberts Stoler is the authority on all aspects of the recovery process. Coping with Concussion and Mild Traumatic Brain Injury is a lifeline for patients, parents, and other caregivers.
Concussion and Brain Injuries: Cerebral and Cranial Trauma, Skull Fractures, Contusions, Hemorrhage, Loss of Consciousness, Coma, Sports and War|
by University Press Publishers
CONCUSSION AND BRAIN INJURIES: Cerebral and Cranial Trauma, Skull Fractures, Contusions, Hemorrhage, Loss of Consciousness, Coma, Sports and War
1. CONCUSSION AND TRAUMATIC BRAIN INJURIES
2. CONCUSSION AND MILD HEAD INJURIES: NEURODYNAMICS
3. TEAM SPORTS, CONCUSSION & MILD HEAD INJURIES
4. WAR, CONCUSSION, BRAIN INJURY AND BLAST INJURIES
5. HYPOXIA, CONCUSSION & BLOOD FLOW
6. POST CONCUSSION SYNDROME
7. CONTUSIONS, BRAIN LESIONS, & HEAD INJURIES
8. DEPRESSED SKULL FACTURES: CRANIAL NEURODYNAMICS
9. LINEAR SKULL FRACTURES: SEEING, HEARING, OLFACTION
10. BASILAR FRACTURES AND CRANIAL NERVE INJURIES: DIZZYNESS, VERTIGO, FACIAL PARALYSIS
11. COMA & HEAD INJURIES
It's All In Your Head: Everyone's Guide to Managing Concussions|
by Ann Engelland (Author)
Dad fell off the ladder and struck his head. Your son took a hard hit in the soccer game and probably has a concussion. What do you do now? It’s All in Your Head: Everyone’s Guide to Managing Concussions will walk you through the steps of evaluating a head injury and will assist in diagnosing, managing, and recovering from a concussion. Based on the simple principle of The Four Rs: Recognize, Respond, Rest, and Reassess, It’s All in Your Head will empower you to support the injured and advocate for the best possible treatment and outcome, whether the injured person is you or someone you care about. Following the Four Rs will guide the injured through what they need in order to recover successfully and return to work, school, play, and other everyday activities as quickly and safely...
Nourish Your Noggin: Brain-Building Foods & Easy-to-Make Recipes to Hasten Your Healing From Mild Traumatic Brain Injury (Concussion & Post Concussion Syndrome)|
by Tina M. Sullivan (Author)
In May of 2010, my 13 yr. old son suffered a very severe concussion. He fell backwards and slammed the back of his head on a wood floor. A MONTH & A HALF LATER, while playing, he fell to his knees. This seemingly innocent fall was enough to shake his brain and disrupt his brain tissue and brain function. Within the hour, he had lines in his vision, echoed hearing, anxiety, cognitive fatigue, sensory issues, etc. Thus, began my son's journey into the scary world of "Mild Traumatic Brain Injury" and "Post Concussion Syndrome." Our lives STOPPED. Along with having him evaluated by three Pediatric Neurologists, I continued to do the things I could do-- pray and become his advocate by researching proactive steps to help him to heal as quickly and fully as his brain would allow.
Understanding Mild Traumatic Brain Injury (MTBI): An Insightful Guide to Symptoms, Treatments, and Redefining Recovery|
by Mary Ann Keatley (Editor), Laura L. Whittemore (Editor)
Understanding Mild Traumatic Brain Injury (MTBI) is a clearly written guide for anyone who has sustained a head injury, concussion or MTBI caused by a fall, automobile or sports related accident or a blast injury. It describes the signs and symptoms as they show up in everyday life. There are helpful tips for family, friends and loved ones, as well as, "brain-saving" decisions to prevent sports-related concussions, and a list of medical professionals who treat this "invisible" injury. Since MTBI is often unidentified and misunderstood, this book is also an essential reference for health care professionals, teachers, athletic coaches and employers to expand their knowledge of the physical and behavioral symptoms. The intention of the authors is to create a greater awareness of this injury...
Mild Traumatic Brain Injury and Postconcussion Syndrome: The New Evidence Base for Diagnosis and Treatment (Oxford Workshop Series: American Academy of Clinical Neuropsychology)|
by Michael A. McCrea (Author)
This is the first neuropsychology book to translate exciting findings from the recent explosion of research on sport-related concussion to the broader context of mild traumatic brain injury (MTBI) and post-concussive syndrome (PCS) in the general population. In addition, it includes a Continuing Education (CE) component administered by the American Academy of Clinical Neuropsychology.
Traumatic brain injuries constitute a major global public health problem, but until now, MTBIs, which constitute up to 90 percent of all treated TBIs, have been difficult to evaluate and manage clinically because of the absence of a viable model. Dr. McCrea's book thus provides a welcome evidence base for all clinicians - including psychologists, neuropsychologists, neurologists, neurosurgeons,...