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Bedside to Bench symposium explores sports concussions

Feb. 5, 2015, 9:18 AM

by Emily Mason

Concussions suffered on the playing field will not cause permanent brain damage if treated appropriately, Vanderbilt University experts said during a recent symposium sponsored by the Vanderbilt Program in Molecular Medicine (VPMM).

“Concussion is not necessarily a benign injury, but when treated properly it can be a benign outcome,” said Gary Solomon, Ph.D., associate professor of Neurological Surgery.

Appropriate treatment includes physical and mental rest. Return to school and play need to be gradual and occur in discrete stages, said Allen Sills, M.D., associate professor of Neurological Surgery. Most importantly, athletes should not return to play until they are free of all symptoms.

A new MRI method shows an increase in cerebrovascular reactivity in a brain following concussion.

Last week’s “Bedside to Bench” symposium on sports concussions was part of a series of VPMM seminars designed to expose graduate students to the potential clinical impact of their research.

Sports concussions receive a lot of recent attention because of the setting in which they occur, Sills said. “Athletes play in a very public and emotionally charged environment,” he said. “You don’t have 70,000 people watching you go through other diseases.”

Some studies suggest that athletes who have more than one concussion are at increased risk for developing a condition called chronic traumatic encephalopathy (CTE). The condition involves the buildup of an abnormal form of a protein called “tau” in the brain, and results in dementia in later life.

But Solomon said abnormal tau could come from sources other than concussion and, in fact, tau buildup is found in approximately 20 different brain diseases. “There has yet to be a conclusive study showing a relationship between multiple mild concussions and dementia later in life,” he said.

The seminar concluded with a presentation by Vicky Morgan, Ph.D., associate professor of Radiology and Radiological Sciences and Biomedical Engineering, who is using magnetic resonance imaging (MRI) to investigate the consequences of sports concussions.

Most concussions cannot be identified on standard computerized tomography (CT) or MRI scans because they do not affect the structure of the brain, but rather how the brain functions, Morgan explained.

New MRI methods may be able to identify some of these functional changes. One exciting area of research involves visualizing the response of blood vessels in the brain to stimulation, such as an injury. This measure is called cerebrovascular reactivity, or CVR.

Morgan and her colleagues have detected increased CVR in the brains of athletes who have had a recent concussion. This indicates that the brain has become hypersensitive to both physical and mental stimulation, sometimes resulting in the severe headaches associated with concussion.

For now, the researchers said they are striving to better understand the long-term consequences of concussion, improve diagnostic testing, and improve sports equipment to prevent concussions.

VPMM is a clinical enrichment program designed to expose Ph.D. students and post-doctoral fellows to clinical problems as well as clinical and translational research during their training.

For more information about the program visit: https://medschool.vanderbilt.edu/vpmm/about. Registration for new students and post-doctoral fellows for next academic year will be posted on the website this spring with an application deadline of June 2015.

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