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Concussion Impairs Long-Term Brain Structure and Function

By MedImaging International staff writers
Posted on 28 Oct 2019

$Image: CBF (L) and gray-matter volume fraction (R) for athletes with and without a history of concussion (Photo courtesy Nathan Churchill / St. Michael\'s Hospital).$

Image: CBF (L) and gray-matter volume fraction (R) for athletes with and without a history of concussion (Photo courtesy Nathan Churchill / St. Michael\'s Hospital).

A new study based on magnetic resonance imaging (MRI) scans reveal some brain abnormalities linger for over a year following concussion.

Researchers at the University of Toronto (UT; Canada), St. Michael’s Hospital (Toronto, Canada), and Sunnybrook Research Institute (Toronto, Canada) consecutively recruited 24 college athletes who experienced a concussion, along with 122 healthy controls. Both groups underwent 3T MRI scans with a protocol that included 3D T1-weighted magnetization prepared rapid acquisition gradient echo (MPRAGE) imaging, 2D pulsed arterial spin labeling (ASL), diffusion-weighted imaging (DWI), and resting-state functional MRI (fMRI).

The initial MRI scans were performed on average four days after the trauma, with follow-up scans undertaken when the athletes were cleared to return to the field, and again one year after that return. Each scan gathered information on global functional connectivity (GFC), cerebral blood flow (CBF), grey matter volume (GMV), white-matter fractional anisotropy (FA), and mean diffusivity (MD). The results revealed that different aspects of brain physiology showed different patterns of recovery over time. Both GFC and FA displayed no significant effects one year after return to play, whereas CBF and MD exhibited persistent long-term effects.

The effects of concussion on MRI parameters were also dependent on acute symptom severity and time to return to play for all post-injury time points. At return to play, fMRI and CBF were normal, and FA showed normal water molecule flow in the white matter. However, one year later significantly reduced CBF was shown, with average decrease of 10 mL/100 g of blood per minute. MRI also showed increasing significant elevations in MD, primarily in posterior and superior corona radiata of the concussed area, which may indicate edema. The study was published on October 16, 2019, in Neurology.

“Despite concussion being conventionally described as a transient disturbance in brain function, there is growing evidence that neurobiological recovery may be incomplete at return to play,” concluded lead author Nathan Churchill, PhD, of St. Michael's Hospital and UT. “The MRI measures also showed an association between the clinical severity of the concussion and the recovery timeline, reinforcing that neurobiological recovery may be highly variable across individuals, and partly dependent on initial clinical presentation.”

A concussion is the most common and least serious type of a mild traumatic brain injury (TBI). The word comes from the Latin concutere, which means “to shake violently.” The effects are usually temporary, and can include headaches, confusion, amnesia, problematic balance and coordination, and sometimes loss of consciousness.

Related Links:
University of Toronto
St. Michael’s Hospital
Sunnybrook Research Institute

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69 (51.021575927734): SELECT id,name,sponsor_text FROM jos_deeppockets dp left outer join jos_channel_sponsor cs on dp.id=cs.fid WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id=215 ORDER BY `ordering`

70 (403.88107299805): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294779793 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

71 (353.09791564941): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294779793 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

72 (58.889389038086): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

73 (68.902969360352): SELECT show_live FROM jos_com_show_setting LIMIT 1

74 (41.961669921875): SELECT show_live FROM jos_com_show_setting LIMIT 1

75 (51.021575927734): SELECT show_live FROM jos_com_show_setting LIMIT 1

76 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

77 (46.014785766602): SELECT show_live FROM jos_com_show_setting LIMIT 1

78 (41.007995605469): SELECT show_live FROM jos_com_show_setting LIMIT 1

79 (39.100646972656): SELECT show_live FROM jos_com_show_setting LIMIT 1

80 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

81 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

82 (35.04753112793): SELECT show_live FROM jos_com_show_setting LIMIT 1

83 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

84 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

85 (36.001205444336): SELECT show_live FROM jos_com_show_setting LIMIT 1

86 (38.14697265625): SELECT show_live FROM jos_com_show_setting LIMIT 1

87 (72.002410888672): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294779793 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

88 (46.968460083008): SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294779793 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

89 (46.014785766602): SELECT id,name,title FROM jos_deeppockets WHERE cat=10 AND TYPE='file_folder' AND published=1 AND id != 294743300 AND id != 294743301 AND id != 294743302 AND id != 294743303 AND id != 294743304 AND id != 294743305 AND id != 294743306 AND id != 294743307 AND id != 294743308 AND id != 294743309 AND id != 294743310 AND metakey != 'aacc' ORDER BY `ordering`

90 (51.975250244141): SELECT show_live FROM jos_com_show_setting LIMIT 1

91 (32.186508178711): SELECT show_live FROM jos_com_show_setting LIMIT 1

92 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

93 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

94 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

95 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

96 (33.140182495117): SELECT show_live FROM jos_com_show_setting LIMIT 1

97 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

98 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

99 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

100 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

101 (27.894973754883): SELECT show_live FROM jos_com_show_setting LIMIT 1

102 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

103 (26.941299438477): SELECT show_live FROM jos_com_show_setting LIMIT 1

104 (63.180923461914): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

105 (42.915344238281): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

106 (52.928924560547): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294779793 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

107 (46.014785766602): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294779793 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

108 (67.949295043945): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

109 (44.822692871094): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

110 (48.160552978516): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294779793 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

111 (555.03845214844): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.id=294779793 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

112 (739.09759521484): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

113 (588.17863464355): SELECT dp.name, dp.id, dp2.name as channel, ex.name as author_name, ex.specialization, ex.images FROM jos_deeppockets as dp LEFT JOIN jos_experts as ex ON ex.id = dp.author LEFT JOIN jos_deeppockets as dp2 ON dp2.id = dp.fid WHERE dp.author != 0 AND dp.cat = 10 AND dp.published = 1 AND ( (dp.fid = 294743300) OR (dp.fid = 294743301) OR (dp.fid = 294743302) OR (dp.fid = 294743303) OR (dp.fid = 294743304) OR (dp.fid = 294743305) OR (dp.fid = 294743306) OR (dp.fid = 294743307) OR (dp.fid = 294743308) OR (dp.fid = 294743309) OR (dp.fid = 294743310) ) ORDER BY RAND() LIMIT 1

114 (109.91096496582): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

115 (61.988830566406): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

116 (71.048736572266): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

117 (38.862228393555): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

118 (56.982040405273): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

119 (39.100646972656): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

120 (271.08192443848): SELECT * FROM trending_articles WHERE `journal_id` = 10 AND `timestamp` <= NOW() + INTERVAL 7 DAY ORDER BY `order`

121 (!!!!! 22820.949554443): SELECT * FROM jos_deeppockets WHERE jos_deeppockets.cat = 10 AND jos_deeppockets.type = 'deeppockets_item' AND jos_deeppockets.published = 1 AND jos_deeppockets.created + INTERVAL 14 DAY >= NOW() ORDER BY jos_deeppockets.hits DESC LIMIT 7

122 (117.06352233887): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

123 (162.12463378906): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

124 (599.86114501953): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294779793 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294779793 AND type='deeppockets_item' AND published='1' LIMIT 1

125 (!!!!! 451760.05363464): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

126 (83.208084106445): ( SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.video != '' AND dp.video_source != '' AND dp.cat = 10 AND dp.published = 1 AND dp.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) UNION ( SELECT dpa.id, dpa.name, dpa.title, dpa.video, dpa.video_source, dpa.created FROM jos_deeppockets_archive AS dpa WHERE dpa.video != '' AND dpa.video_source != '' AND dpa.cat = 10 AND dpa.published = 1 AND dpa.type != 'deeppockets_item_link' ORDER BY created DESC LIMIT 3 ) ORDER BY created DESC LIMIT 3

127 (62.942504882812): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

128 (39.815902709961): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800513 LIMIT 1

129 (48.87580871582): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

130 (34.093856811523): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800359 LIMIT 1

131 (30.040740966797): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

132 (27.894973754883): SELECT dp.id, dp.name, dp.title, dp.video, dp.video_source, dp.created FROM jos_deeppockets AS dp WHERE dp.id = 294800361 LIMIT 1

133 (529.05082702637): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

134 (540.97175598145): SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

135 (318.05038452148): SELECT name FROM jos_deeppockets WHERE id=215

136 (44.107437133789): SELECT name FROM jos_deeppockets WHERE id=215

137 (592.94700622559): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

138 (609.15946960449): SELECT *, DATE_FORMAT(publish_up,'%d %b %Y') AS date_publish_up, DATE_FORMAT(publish_down,'%d %b %Y') AS date_publish_down FROM jos_events WHERE state=1 AND publish_up > NOW() and extra_info REGEXP '((;)|(^))215((;)|($))' AND catid IN (0,110) ORDER BY publish_up ASC LIMIT 3

139 (97.990036010742): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

140 (65.803527832031): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

141 (!!!!! 18086.910247803): TRUNCATE TABLE jos_trademed_module

142 (!!!!! 2675.0564575195): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294779793 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

143 (234.12704467773): SELECT dp.*, ch.title as channel, exp.name as author_name, exp.specialization as author_specialization, exp.images as author_photo FROM jos_deeppockets_archive as dp LEFT JOIN jos_experts as exp ON exp.id = dp.author LEFT JOIN jos_deeppockets as ch ON dp.fid = ch.id WHERE 1=1 AND dp.cat=10 AND dp.id=294779793 AND (dp.type='deeppockets_item' OR dp.type='deeppockets_item_link') AND dp.published='1' LIMIT 1

144 (344.03800964355): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

145 (154.97207641602): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND (type='deeppockets_item' OR type='deeppockets_item_link') AND published='1' LIMIT 1

146 (96.08268737793): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

147 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

148 (!!!!! 1088.8576507568): SELECT jos_item.* FROM jos_item INNER JOIN jos_number ON jos_item.numberID=jos_number.id WHERE 1=1 AND (jos_item.imgMini<>'') AND jos_item.type='L' AND jos_item.numberID= ( SELECT jos_number.id FROM jos_number WHERE jos_number.journalID IN (10) and jos_number.id in (select distinct jos_number.id from jos_number join jos_item on jos_item.numberid=jos_number.id where jos_item.type='P') ORDER BY (CONVERT(SUBSTRING(issue,1,2),SIGNED) + (CONVERT(SUBSTRING(issue,3,2),SIGNED)*100)) DESC LIMIT 0,1 ) ORDER BY RAND() DESC LIMIT 6

149 (79.154968261719): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

150 (58.889389038086): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

151 (39.100646972656): SELECT fid FROM jos_deeppockets WHERE cat=10 AND id=294779793 AND type='deeppockets_item' AND published='1' union SELECT fid FROM jos_deeppockets_archive WHERE cat=10 AND id=294779793 AND type='deeppockets_item' AND published='1' LIMIT 1

152 (30.994415283203): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

153 (69.141387939453): select distinct links.* from jos_textlinks links join jos_textlinks_placement placement on links.id=placement.link_id where journal_id=(10) and (channel_id=215 or channel_id is null)

154 (28.848648071289): SELECT livesite FROM jos_dp_categories WHERE id=10 AND published='1' LIMIT 1

155 (115.87142944336): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

156 (44.107437133789): SELECT * FROM jos_deeppockets WHERE 1=1 AND id=294779793 AND published='1' union SELECT * FROM jos_deeppockets_archive WHERE 1=1 AND id=294779793 AND published='1' LIMIT 1

157 (40.054321289062): select jos_twitters.link from jos_twitters where cat=10

158 (26.226043701172): select jos_facebook.link from jos_facebook where cat=10

159 (25.98762512207): select jos_google_plus.link from jos_google_plus where cat=10

160 (26.226043701172): select jos_linkedin.link from jos_linkedin where cat=10

161 (245.09429931641): update jos_bannersmanager_banner set impmade=impmade+1 where id in(14615,14202,14203)

162 (!!!!! 2053.0223846436): insert into jos_banners_delta values (14615,'2025-06-19 07:34:20','216.73.216.120','view'),(14202,'2025-06-19 07:34:20','216.73.216.120','view'),(14203,'2025-06-19 07:34:20','216.73.216.120','view')

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