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An estimated 3.8 million sports- and recreation-related concussions occur in the U.S. each year, and an even greater number of subclinical concussions, or injuries that cannot be diagnosed as concussions but have similar effects, are often unrecognized.
Now, researchers at BWH have found that a specialized imaging technique called magnetic resonance spectroscopy (MRS) may help diagnose chronic traumatic encephalopathy (CTE), a disorder caused by repetitive head trauma that currently can only be definitively diagnosed at autopsy.
Results of the study were presented Dec. 1 at the annual meeting of the Radiological Society of North America.
“The devastating effects of brain injuries suffered by pro football players who repeatedly suffered concussions and subconcussive brain trauma during their careers have put the spotlight on CTE,” said Alexander P. Lin, PhD, a principal investigator at the BWH Center for Clinical Spectroscopy. “However, blows to the head suffered by all athletes involved in contact sports are of increasing concern.”
Studies have shown that people who suffer repetitive brain trauma are more likely to experience ongoing problems, from permanent brain damage to long-term disability.
CTE has also been associated with memory difficulty, impulsive and erratic behavior, depression and eventually, dementia.
“Cumulative head trauma invokes changes in the brain, which over time can result in a progressive decline in memory and executive functioning in some individuals,” Lin said. “MRS may provide us with noninvasive, early detection of CTE before further damage occurs, thus allowing for early intervention.”
In MRS, sometimes referred to as “virtual biopsy,” a powerful magnetic field and radio waves are used to extract information about chemical compounds within the body, using a clinical magnetic resonance scanner. The technology used in the study was developed by Saadallah Ramadan, PhD, at the BWH Center for Clinical Spectroscopy, which is led by Carolyn Mountford, PhD.
During the study, which was conducted in collaboration with Dr. Robert Stern, PhD, Chris Nowinski, Ann McKee, MD, and Robert Cantu, MD, from the Boston University Center for the Study of Traumatic Encephalopathy, researchers analyzed the MRS results of five retired professional male athletes and five age-and size-matched controls between the ages of 32 and 55.
They found that compared with the brains of the control patients, the brains of the former athletes with suspected CTE had increased levels of choline, a cell membrane nutrient that signals the presence of damaged tissue, and glutamate/glutamine. MRS also revealed altered levels of gamma-aminobutyric acid (GABA), aspartate, and glutamate in the brains of former athletes.
“By helping us identify the neurochemicals that may play a role in CTE, this study has contributed to our understanding of the pathophysiology of the disorder,” Lin said. “Being able to diagnose CTE could help athletes of all ages and levels, as well as war veterans who suffer mild brain injuries, many of which go undetected.”