Concussions: A Review of Physiological Changes and Long-Term Sequelae

Area of Science:

• Neurology
• Sports Medicine
• Neuroscience

Background:

• Concussions, or mild traumatic brain injuries (mTBIs), are common in athletes.
• Repetitive head impacts can lead to chronic traumatic encephalopathy (CTE), causing personality and memory issues.
• The exact injury mechanism involves brain acceleration/deceleration.

Purpose of the Study:

• To review physiological changes and long-term consequences of concussions in athletes.
• To evaluate diagnostic and prognostic indicators beyond symptom resolution.
• To inform return-to-play decisions.

Main Methods:

• A comprehensive literature search was conducted from April 2012 to April 2022.
• Databases used included PubMed/MEDLINE and Embase.
• Nineteen articles were included in the final review.

Main Results:

• Neuroimaging reveals structural and functional brain changes (thalamus, hippocampus, corpus callosum, white matter).
• Altered brain metabolism, blood flow, glucose utilization, fatigue levels, and IL-6 biomarkers indicate persistent effects.
• These changes can persist beyond symptom resolution, impacting athletes' long-term health.

Conclusions:

• Concussion consequences, including structural and functional brain alterations, can extend beyond symptom recovery.
• Physiological changes may lead to long-term issues like cognitive decline, gait disturbances, and increased injury risk.
• Prompt concussion symptom management is vital to prevent irreversible brain damage and ensure athlete safety.