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New Method Enhances Diagnosis Of Brain Injury After Mild Concussion

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A new development could make it easier to visualise the damage resulting from mild concussions that occur on the field of play.

Researchers in Israel have come up with an enhanced diagnostic approach using Magnetic Resonance Imaging (MRI) for detection and localisation of vascular pathology and blood-brain barrier (BBB) breakdown in professional American football players.

The new contrast-enhanced MRI was, for the first time, able to identify significant BBB damage following “unreported” trauma or mild concussions. It´s hoped that the study could improve decision making on when an athlete is fit to return to sports.

Prof. Alon Friedman from the Ben-Gurion University Brain Imaging Research Center explained: “Until now, there wasn´t a diagnostic capability to identify mild brain injury early after the trauma. In the NFL, other professional sports and especially school sports, concern has grown about the long-term neuropsychiatric consequences of repeated mild Traumatic Brain Injury (mTBI) and specifically sports-related concussive and sub-concussive head impacts.”

The method developed by Prof. Friedman generates more detailed brain maps showing brain regions with abnormal vasculature, or a “leaky” BBB.

To investigate the new diagnostic, researchers recruited 16 American football players from the Israeli professional team Black Swarm, as well as 13 track and field athletes who served as controls.

Results showed that 40% of the football players with unreported concussions had evidence of “leaky BBB” compared with 8.3% of the control athletes. There was a clear association between American football and increased risk for BBB pathology that could not be seen before, Prof. Friedman said.

Not all the players showed pathology, indicating that repeated, mild concussive events might impact players in different ways. Improving the level of diagnosis of individual players could provide the basis for more rational decision making on “return to play” for professionals as well amateurs of any age, according to Ben-Gurion University of the Negev.

Details of the discovery have been published in the latest issue of JAMA Neurology.