New imaging technique may help predict long-term impact of concussions

In a new study, researchers are using a novel technique to map the damage caused by concussions, in hopes that someday they will be able to accurately predict which patients are at-risk for long term neurological consequences.

Concussions are high variable injuries that have a wide range of potential symptoms.  While most people recover from concussions with no ill effects, as many as 30 percent suffer from permanent impairment such as a change in personality or difficulty concentrating.

Dr. Michael Lipton, who made headlines last December with a study that found soccer headers may lead to brain damage, has been using a brain imaging technique known as diffusion tensor imaging (DTI) to analyze the unique patterns of brain abnormalities caused by concussions.

“People with concussions have tremendous variability in symptoms or problems,” explained Lipton, who is also the associate director of Gruss Magnetic Resonance Research Center at Albert Einstein College of Medication and medical director of magnetic resonance imaging (MRI) services at Montefiore Medical Center. “So, here, we’re sort of taking the covers off the underlying uniqueness of the injury.”

According to Lipton, even two people who have been hit in the same place on the head and suffer a concussion may have completely different symptoms.

“Right now if you look at a group of people with traumatic brain injuries, there’s a whole host of symptoms,” Lipton explained.  “…There’s no way to understand what it is about the brain that may underpin those different outcomes.”

Lipton and his colleagues hope some of the mystery behind concussions may be solved by DTI, which can detect subtle damage by measuring diffusion of water in the brain’s white matter – giving an indication as to whether or not the tissue’s structural integrity has been affected.

For the study, the researchers used DTI on 34 patients diagnosed with mild traumatic brain injury and on 30 people with no injury.  The patients were imaged within two weeks of the injury, then again at three and six months afterward.

The concussion patients showed unique spatial patterns of diffusion, both from each other and from the uninjured participants, which changed over time -- as well as indications that the brain was trying to increase connections in other areas to compensate for the injured sections.

Lipton said he hopes the imaging technique will reveal certain symptom-related patterns among patients and “set the stage to use individualized information doctors can use to make a stab at making personalized predictions for [concussion] patients.”

The study was published Friday in the journal Brain Imaging and Behavior.