Concussions, whether from an accident, sporting event, or combat, can lead to permanent loss of higher level mental processes.
Scientists have debated for centuries whether concussions involve structural damage to brain tissue or whether physiological changes that merely impair the way brain cells function, explain this loss. Now, for the first time, researchers at Albert Einstein College of Medicine of Yeshiva University have linked areas of brain injury to specific altered mental processes caused by concussions.
The research, described in the August 26 edition of Radiology, provides compelling evidence that concussions involve brain damage. The findings suggest that diffusion tensor imaging (DTI), the brain scanning method used by the Einstein scientists, could help in diagnosing concussions and in assessing the effectiveness of treatments.
"DTI has been used to look at other brain disorders, but this is the first study to focus on concussions," said Michael Lipton, M.D., Ph.D., associate director of the Gruss Magnetic Resonance Research Center (MRRC) and associate professor of radiology, of psychiatry and behavioral sciences, and of neuroscience at Einstein and lead author of the study. "It proved to be a powerful tool for detecting the subtle brain damage that we found to be associated with concussions."Each year, more than one million Americans sustain a concussion (technically referred to as mild traumatic brain injury). Concussions in adults result mainly from motor vehicle accidents or falls. While most people recover from concussions with no lasting ill effects, as many as 30 percent suffer permanent impairment — undergoing a personality change or being unable to plan an event. A 2003 federal study called concussions "a serious public health problem" that costs the U.S. an estimated $80 billion a year.
The Einstein research involved 20 people known to have suffered concussions (18 from motor vehicle accidents and two from falls) and 20 healthy control subjects. The patients were recruited from one hospital emergency room; two of them had lost consciousness, but only for a few minutes. Both the patients and control subjects underwent conventional brain imaging with magnetic resonance (MR) and computed tomography (CT) scanning, plus a battery of neuropsychological tests to assess executive function, which is often impaired after a concussion. All concussion patients underwent brain imaging and testing within two weeks of their accidents.
Experienced reviewers who evaluated the conventional MR and CT images of patients and controls found no abnormalities in either group. However, the neuropsychological results showed that the patients performed significantly worse than the controls on tests of executive function.
Patients and controls also underwent diffusion tensor imaging (DTI), a recently developed MRI-based imaging technique that can detect subtle changes in the brain by measuring the diffusion of water in the brain's white matter. DTI revealed abnormal brain regions in 15 of the concussion patients, while no abnormal regions were found in controls. Most importantly, the presence of major areas of structural damage in concussion patients (as shown by large alterations in normal water diffusion using DTI) predicted low scores on their executive-function tests. These damaged areas were located mainly in the brain's prefrontal cortex, which is essential for normal executive function and is susceptible to injury in concussion.
Dr. Lipton notes that use of DTI could prompt doctors to begin treatment early, when it's likely to be most useful. "The problems in functioning caused by concussions often don't become evident until weeks or months after the injury, suggesting that the brain pathology may actually expand over time," he notes. "By detecting brain injury early with DTI and then initiating cognitive rehabilitation therapies for those patients, we may be able to limit the effects of concussions."
"We are really excited by these findings," indicates Craig Branch, Ph.D., a co-author of the study and director of the Gruss MRRC. "For the first time we appear to be able to identify the subtle pathology sometimes caused by concussion, providing researchers a 'pathology target' for the development of therapies to reduce or eliminate the damage identified by this novel imaging method." Dr. Lipton adds that DTI could help in evaluating the effectiveness of existing therapies for concussion.
The group's paper, "Diffusion tensor imaging implicates prefrontal axonal injury in executive dysfunction following mild traumatic brain injury," appears in the August 26 print edition of Radiology. In addition to Drs. Lipton and Branch, other Einstein scientists involved in the study were Edwin Gulko, Molly E. Zimmerman, Ph.D., Benjamin W. Friedman, M.D., Mimi Kim, Sc.D., Tamar Gold, and Keivan Shifteh, M.D.
About Albert Einstein College of Medicine of Yeshiva University
Albert Einstein College of Medicine of Yeshiva University is one of the nation's premier centers for research, medical education and clinical investigation. It is home to 2,775 faculty members, 625 M.D. students, 225 Ph.D. students, 125 students in the combined M.D./Ph.D. program, and 380 postdoctoral research fellows. In 2008, Einstein received more than $130 million in support from the NIH. This includes the funding of major research centers at Einstein in diabetes, cancer, liver disease, and AIDS. Other areas where the College of Medicine is concentrating its efforts include developmental brain research, neuroscience, cardiac disease, and initiatives to reduce and eliminate ethnic and racial health disparities. Through its extensive affiliation network involving eight hospitals and medical centers in the Bronx, Manhattan and Long Island – which includes Montefiore Medical Center, The University Hospital and Academic Medical Center for Einstein – the College of Medicine runs one of the largest post-graduate medical training programs in the United States, offering approximately 150 residency programs to more than 2,500 physicians in training. For more information, please visit www.aecom.yu.edu
Deirdre Branley | EurekAlert!
Team discovers how bacteria exploit a chink in the body's armor
20.01.2017 | University of Illinois at Urbana-Champaign
Rabies viruses reveal wiring in transparent brains
19.01.2017 | Rheinische Friedrich-Wilhelms-Universität Bonn
An important step towards a completely new experimental access to quantum physics has been made at University of Konstanz. The team of scientists headed by...
Yersiniae cause severe intestinal infections. Studies using Yersinia pseudotuberculosis as a model organism aim to elucidate the infection mechanisms of these...
Researchers from the University of Hamburg in Germany, in collaboration with colleagues from the University of Aarhus in Denmark, have synthesized a new superconducting material by growing a few layers of an antiferromagnetic transition-metal chalcogenide on a bismuth-based topological insulator, both being non-superconducting materials.
While superconductivity and magnetism are generally believed to be mutually exclusive, surprisingly, in this new material, superconducting correlations...
Laser-driving of semimetals allows creating novel quasiparticle states within condensed matter systems and switching between different states on ultrafast time scales
Studying properties of fundamental particles in condensed matter systems is a promising approach to quantum field theory. Quasiparticles offer the opportunity...
Among the general public, solar thermal energy is currently associated with dark blue, rectangular collectors on building roofs. Technologies are needed for aesthetically high quality architecture which offer the architect more room for manoeuvre when it comes to low- and plus-energy buildings. With the “ArKol” project, researchers at Fraunhofer ISE together with partners are currently developing two façade collectors for solar thermal energy generation, which permit a high degree of design flexibility: a strip collector for opaque façade sections and a solar thermal blind for transparent sections. The current state of the two developments will be presented at the BAU 2017 trade fair.
As part of the “ArKol – development of architecturally highly integrated façade collectors with heat pipes” project, Fraunhofer ISE together with its partners...
19.01.2017 | Event News
10.01.2017 | Event News
09.01.2017 | Event News
20.01.2017 | Materials Sciences
20.01.2017 | Life Sciences
20.01.2017 | Life Sciences