Blows to the Head May Cause Brain White Matter Changes Even Without Concussion

Researchers have found that repeated blows to the heads of athletes may be associated with changes in brain white matter, and may also be linked to reduced cognition even if those impacts do not cause concussion. A study on athletes involved in contact sports vs. athletes participating in noncontact sports over a season revealed a small increase in diffusivity in the white matter. Contact sports athletes performed poorly than expected in cognition tests at the end of the season and had larger changes in brain white matter.

The study involved 80 non-concussed varsity football and ice hockey players who wore helmets that could record the acceleration time history of the head just after the impact, and 79 non–contact sport athletes. The researchers assessed both groups before the season and shortly after the season using diffusion tensor imaging and neurocognitive measures. The contact athletes were engaged at intense level, playing football or ice hockey 5 or 6 times in a week. These players could have sustained around 500 to 600 impacts over a season.

The data obtained through this analysis showed small, but critical differences in the brain white matter between the contact and non-contact athletes. The important findings were:

  • Measures of head impact exposure did associate with matter diffusivity measures in various brain regions such as corpus callosum, thalamus, cerebellar white matter, hippocampus and amygdale.
  • The magnitude of change in the corpus callosum revealed the diffusivity after the season was associated with worse performance on a measure of verbal learning and memory.
  • No difference was observed between the contact and noncontact athletes at the beginning of the season which suggested that no cumulative changes occurred over years of sustaining head impacts.

However, the researchers could not find out the exact reason why one blow caused concussion in one person while a similar blow does not cause concussion at a different time or in a different person. The next step of the study will be to find out how long these changes will sustain and identify whether there exists a subgroup with higher vulnerability and its cause.

Studies such as the above can have a great impact on finding new ways for maintaining a healthy brain. The data collected during these studies may include audio resources which will have to be accurately transcribed. In the above mentioned study, data on two different cohorts of athletes, two different time points and biomechanical exposure and cognition was collected, which may have required a lot of medical transcription work. Researches related to neurology should be accurately documented and the data managed efficiently either by good transcription services in neurology or good documentation via an EMR.