Repetitive head impacts are the cause of blood vessel damage in brain after sport-related injuries

Findings from new study suggest that repetitive head trauma, as opposed to single head impacts, result in damaged blood vessels in the brain.

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In a 4-year  longitudinal study, a team of scientists at Trinity College Dublin (Ireland) reported improvements in understanding how concussive brain injury causes damage to blood vessels in the brain. 

The team used sensor-enabled mouthguard technology and dynamic contrast-enhanced MRI to confirm the amount of ‘leaky’ blood vessels within the brain caused by head impacts in participants of combat or collision sports such as mixed martial arts and rugby. 

The researchers discovered that repetitive concussive brain injuries caused the blood vessel damage, as opposed to single head impacts.

“This was a hypothesis-driven project whereby we challenged the hypothesis that repetitive head trauma would induce damage to small blood vessels in the brain that we would then be able to image with a novel form of MRI-based brain scans,” commented Assistant Professor, Mathew Campbell (Trinity College Dublin). 

Mild trauma is currently a significant challenge for clinicians due to the lack of robust biomarkers or objective imaging approaches for diagnosis and subsequent injury management. The clinical symptoms associated with concussive brain injuries such as dizziness and confusion all occur independent of adverse findings on CT or MRI scans. 

“Our findings, for the first time, suggest that repetitive head trauma can lead to an MRI signal that we can definitively link to the number and severity of impacts to the head. It appears that the repetitive nature of these impacts as opposed to single events are causing damage to the capillaries of the brain,” explained Consultant Neurologist, Colin Doherty (St James’s Hospital, Dublin, Ireland). 

The findings from this study suggest repetitive head impacts induce changes to micro-vessels of the brain, which could potentially lead to the development of more robust and objective return-to-play guidelines and improve future safety across all sports. 

“This study has highlighted the critical importance of continued efforts to study the underlying effects of concussive brain injuries in all sports. It is imperative that the governing bodies take note of these findings and work together to protect athletes now and in the future,” added co-author Professor Mick Molloy, former Chief Medical Officer of World Rugby (Dublin, Ireland).

Source: O’Keeffe E, Kelly E, Liu Y et al. Dynamic blood brain barrier regulation in mild head trauma. J. Neurotrauma. doi:10.1089/neu.2019.6483 (2019) (Epub ahead of print);

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