A University of Pittsburgh School of Medicine study has linked changes in brain function directly to the recovery of young athletes by showing changes in brain function that occur after injury. The National Institutes of Health funded this five-year study that is published in the August issue of the scientific peer-reviewed journal, Neurosurgery, the official journal of the Congress of Neurological Surgeons.

According to Dr. Mark Lovell, associate professor in the departments of orthopedic surgery and neurological surgery at the University of Pittsburgh School of Medicine - the study found that abnormal brain activity in children and adolescents on functional MRI (fMRI) was clearly related to their performance on neuropsychological tests of attention and memory and to their report of symptoms such as headaches. The study's co-author Michael Collins, Ph.D., assistant professor in the departments of orthopedic surgery and neurological surgery at Pittsburgh's School of Medicine, and assistant director of the UPMC program stated that the findings have several implications for understanding the recovery process after sport-related concussions. "Although the results of this study must be considered preliminary, fMRI represents an important evolving technology that is providing further insight now for safe return-to-play decisions in young athletes and may help shape guidelines in the future."

The Centers for Disease Control and Prevention has reported that between 1.4 and 3.6 million sports and recreation-related concussions occur each year - the majority happening at the high school level. Dr. Lovell noted that an explosion of scientific research over the past decade has taught researchers much about mild traumatic brain injury or concussion - including the knowledge that mismanagement of even seemingly mild concussions can lead to serious consequences in young athletes.

When an athlete suffers a traumatic force to the head or upper body that causes the brain to shake inside the skull, a concussion can occur. A concussion injury is defined as a change in mental status such as loss of consciousness, amnesia, disorientation, confusion or mental fogginess. Because no two concussions are the same, and symptoms are not always straightforward, the severity, effects and recovery of concussion are hard to figure out. And, research has proven that until a concussed brain is healed completely, the brain may be vulnerable to further injury. This had led to more published studies that have raised awareness and significantly changed the way sport's concussions are treated. Much of this research has included data that proves the usefulness of objective neuropsychological test data as part of the comprehensive clinical evaluation to determine clinical recovery following concussion.

UPMC is one of the few centers that has the capability to collect both neuropsychological fMRI and neuropsychological data from injured and clinically managed athletes, making it possible to exam the relationship between changes in computerized neuropsychological testing completed in a medical clinic and brain function as measured by fMRI. The fMRI can show brain activity, not just the anatomy; whereas, traditional brain scanning techniques such as MRI and CT can help in viewing changes to the brain anatomy in more severe cases, but cannot identify subtle brain-related changes believed to occur on a metabolic rather than an anatomic level. fMRI can determine by measuring cerebral blood flow and metabolic changes, which parts of the brain are activated in response to different cognitive activities.

The study utilized a computer-based neuropsychological test called ImPACT (Immediate Post-Concussion and Cognitive Testing) that measures cognitive function including attention, memory, speed of response and decision-making. Dr. Lovell and his colleagues developed ImPACT over the past decade. The University of Pittsburgh and other academic institutions throughout the world have also examined ImPACT. For more information on published research concerning sport's concussion management, visit the UPMC Sports Medicine Concussion Program website at www.upmc.com/Communications/MediaRelations/MediaKits/Kits/ConcussionMain.htm.