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Concussion and Alzheimer's patients show similar brain abnormalities, study

by Loren Bonner, DOTmed News Online Editor | June 18, 2013
Dr. Saeed Fakhran,
lead author of the study
It's been known for some time among medical professionals that patients who have had mild traumatic brain injury (MTBI) exhibit similar symptoms to patients with Alzheimer's disease. Now, new research is finding similarities in brain scans between the two patient groups.

According to a study published online this week in the journal Radiology, the distribution of white matter brain abnormalities in some patients after mild traumatic brain injury (MTBI) closely resembles that found in early Alzheimer's dementia.

"We wanted to find a way to find the abnormalities most responsible for the patient's symptoms," Dr. Saeed Fakhran, lead author of the study and assistant professor of radiology in the division of neuroradiology at the University of Pittsburgh School of Medicine, told DOTmed News. "To our surprise, when we looked at these abnormalities, it turned out they were very similar to those seen in Alzheimer's patients. We didn't start out trying to compare the two entities, but when we saw the symptomatic abnormalities in patients with concussion, the similarities were too striking to ignore."

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Researchers studied data from imaging exams performed on 64 MTBI patients and 15 control patients, using an advanced MRI technique called diffusion tensor imaging, which identifies microscopic changes in the brain's white matter. They found that there was a relationship between white matter injury patterns and how severe symptoms were after MTBI on patients' MRI scans that were normal. The researchers evaluated sleep-wake disturbances, among other things. Sleep-wake disturbances are among the earliest findings of Alzheimer's patients and they have also been present in MTBI patients.

In addition, results from the study suggest that concussion symptoms are not due to a direct traumatic injury, despite what has been widely believed.

"The injury merely acts as a trigger which then leads to a neurodegenerative cascade. This should give hope to MTBI patients, as their symptoms are not from damage already done at the time of injury, but from a neurodegenerative cascade, which may be potentially prevented," said Fakhran.

Given that the response looks similar to Alzheimer's disease, Fakhran said he hopes his study will lead to greater cooperation between groups studying Alzheimer's disease and MTBI, to help understand both diseases and ultimately work toward creating better treatments.

Fakhran and his team plan to conduct more follow-up studies where patients will be imaged immediately following a concussion. In this study, patients were imaged and evaluated at multiple points -- ranging from days, to weeks, to months -- after their concussion.

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