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Study shows brain recovery lags behind clinical recovery after sports concussion

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The brain is often still recovering from a concussion when athletes are given medical clearance to return to play, according to a new study.

Researchers from St. Michael’s Hospital in Toronto, Canada, used advanced MRI to measure brain structure and function in 27 university athletes within the first week after a concussion and again after they were medically cleared to return to play. These findings were compared with a group of 27 uninjured athletes.

The results, published in Scientific Reports, show that brain changes seen in the first MRI scan were still present when athletes were cleared to return to sport, including:

* Persistent differences in the structure of the brain’s white matter, the fibre tracts that allow different parts of the brain to communicate with each other; and

* Differences in brain activity, particularly in areas associated with vision and planning, with athletes that took longer to recover also showing changes in areas of the brain associated with bodily movement.

The study included both male and female varsity athletes in seven different contact and non-contact sports.

Lead author Dr Nathan Churchill, a post-doctoral fellow in St. Michael’s Neuroscience Research Program, said the study findings suggest that following a concussion, changes in the brain persist even after other symptoms have resolved.

“This is the first concrete evidence we have that the brain is lagging behind in terms of recovery from a concussion,” he said. “Our study shows that the neurobiological consequences of concussion may outlast the symptoms we’re typically looking for when determining whether an athlete is ready to return to play.”

The researchers did not, however, examine whether athletes would be at risk for further injury by returning to play when these brain changes were still present.

Further research is needed to determine whether or not athletes need more time between acute injury and returning to play to fully recover.

Dr Tom Schweizer, head of the Neuroscience Research Program and a co-author of the paper, stressed that, in general, the health benefits of participating in sport still outweigh the risk of concussion.

“Our findings help us to better understand how the brain changes over the course of recovery, which will in turn help to guide concussion management,” he added. “The more we know about concussion, the better we can reduce potential risks.”