Understanding concussions in young athletes has been a medical mystery for years, but now a University of Pittsburgh School of Medicine study has revealed the significant value of functional magnetic resonance imaging, or fMRI, and neuropsychological tests to determine when it is safe-to-play again.
Between 1.4 and 3.6 million concussions occur each year, and the majority happen at the high school sports level. The injury is defined by traumatic force to the head or upper body, which causes the brain to shake, often resulting in a loss of consciousness, amnesia, or extreme dizziness. The severity and diagnosis in each case is difficult to determine because no two concussions are alike.
The five-year study, funded by the National Institutes of Health and published in the August issue of Neurosurgery, shows that there's an important link between changes in brain activity and clinical recovery. This activity can be diagnosed when clinical neuropsychological testing, known as ImPACT, is done before and after an injury, coupled with an fMRI, to show if levels of functioning have returned to the athlete’s personal baseline.
The Pitt study is the first to examine the relationship between changes in the clinical computerized ImPACT results on patients and brain function as measured by fMRI.
“These results confirm crucial objective information that is commonly obtained by neuropsychological testing to help team doctors and athletic trainers make critical decisions about concussion management and safe return-to-play,” says Dr. Mark Lovell, founding director of the UPMC Sports Medicine Concussion Program.
Although the study's results are considered preliminary, fMRI is an important evolving technology that will provide further insights for sound decisions in young athletes and may help shape guidelines in the future.
Writer: Deb Smit
Source: Dr. Mark Lovell, Susan Manko, University of Pittsburgh Medical Center