Cerebrovascular Alterations After Sports-related Concussions (SRC)

Using MRI to examine brain blood flow in athletes during recovery from sports-related concussions

Full Project Name:Accessing Cerebrovascular Alterations During Recovery After Sports-related Concussions (SRC)Principal Investigator:Yang Wang, MD, RadiologyCo-Investigator:Michael McCrea, PhD, Neurosurgery; Lindsay D. Nelson, PhD, NeurosurgeryAward Amount:$200,000

Award Date

February2017

Project Duration:24 months

Project Description Narrative:

Sports-related concussion (SRC) is a significant public health problem. Despite tremendous efforts to increase awareness and education among team clinicians, trainers and others, there is no standardized, objective way to identify when an athlete has fully recovered from a concussion. Although return-to-play decisions are based on clinical markers of recovery (e.g., subjective symptoms, cognitive impairments), emerging research is finding that the brain may remain vulnerable even after athletes appear normal on clinical examinations. Consequently, there is a need to develop objective, brain-based markers of recovery from SRC and to use these markers to identify the period of time following clinical recovery when the brain may remain physiologically compromised.

Through this research, investigators will seek to use advanced neuroimaging techniques to examine longitudinal changes of cerebrovascular and cerebral blood flow in athletes at subacute and chronic stages of sports-related concussion, in comparison to control athletes, to determine neurophysiological recovery after traumatic brain injury.

Outcomes & Lessons Learned:

Generated data which suggests that cerebrovascular reactivity (CVR) and cerebral blood flow (CBF) as measured using advanced MRI can provide important information on the status of ongoing neurophysiological recovery, which can extend past the point of clinical symptom recovery
Integration of biomarkers developed as a result of this project will be useful in future investigations to guide targeted treatment and management approaches in sports-related concussion, as well as provide a foundation for further studies to assess rule-making efficacy and equipment or technique modifications aimed at athlete safety
Presented project findings at an international conference and developed one peer-reviewed paper, which is currently in press
Was awarded an NIH R01 grant using preliminary data from this project to continue investigation in this critical area

Project Updates:

Obtained IRB approval for the study
Established study protocol using team's newly developed techniques, applying on both SRC patients and matched controls
Completed data collection on SRC patients at 15 and 45 days after injury, as well on control subject at yoked period, making progress to follow up on all subjects in the second year at six months post-injury and complete all data analyses
Identified preliminary results showing changes in both CBF and CVR at the subacute stage of SRC
In accord with other research, findings supported team's hypothesis that abnormal CBF and CVR are associated with clinical deficits and injury recovery