Concussion Leads to Dementia If Neglected

AS PROFESSIONAL sports teams battle lawsuits for dementia caused by concussion, new research shows damage to the brain can persist for decades after a head trauma. Learn why. Find out what to do.

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"Even when you are symptom-free, your brain may still not be back to normal," says Dr. Maryse Lassonde, a neuropsychologist and the scientific director of the Quebec Nature and Technologies Granting Agency.

Lassonde, whose work is supported by the Canada Foundation for Innovation, was a consultant with the Montreal Canadiens hockey team, treating players with concussions for 15 years. She simultaneously undertook research into the effects of concussions on children and young athletes as well as older athletes.

A concussion is traumatic brain injury that changes the way your brain functions. When the skull is jolted or impacted by a hard surface, the brain shifts, slamming against the skull, causing damage and swelling to the brain. If treated correctly, brain will heal. But if not, results can be deadly.

To study the effects of concussions, Lassonde had athletes perform specific visual and auditory tasks and also mapped their brains with the help of EEG and MRI equipment, in addition to testing brain chemistry.

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Her research demonstrates that brain waves remain abnormal in young athletes for two years following a concussion, and atrophy occurs in the motor pathways of the brain following a hit.

The results of her work, which have been published in the journals Brain and Cerebral Cortex, have important implications for the regulation of amateur and professional sports, the treatment of players and the importance of preventing violence in hockey and football.

Concussions Lead to Attention Problems

"That tells you that first of all, concussions lead to attention problems, which we can see using sophisticated techniques such as the EEG," says Lassonde. "This may also lead to motor problems in young athletes."

The long-term effects in older former athletes are even more persistent.

By studying older athletes who suffered their last concussion 30 years earlier, and comparing them to healthy peers who had not experienced concussions, Lassonde discovered those who had suffered a head trauma had memory and attention deficits and motor problems similar to the early symptoms of Parkinson's disease. Further testing of these older athletes turned up a thinning of the cortex in the same regions of the brain that Alzheimer's disease usually affects.

"This thinning correlated with memory decline and attention decline," Lassonde says.

In addition to the recovery time required following a concussion, adds that young players who return to their sport too early and suffer a second concussion risk serious brain damage or death.

"If a child or any player has a concussion, they should be kept away from playing or doing any mental exercise until their symptoms abate," Lassonde says. "Concussions should not be taken lightly. We should really also follow former players in clinical settings to make sure they are not ageing prematurely in terms of cognition."

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What to do After a Concussion

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Getting Better: Tips for Adults

• Get plenty of sleep at night, and rest during the day.
• Avoid activities that are physically demanding (e.g., heavy housecleaning, weightlifting/working-out) or require a lot of concentration (e.g., balancing your checkbook). They can make your symptoms worse and slow your recovery.
• Avoid activities, such as contact or recreational sports, that could lead to another concussion. (It is best to avoid roller coasters or other high speed rides that can make your symptoms worse or even cause a concussion.)
• When your health care professional says you are well enough, return to your normal activities gradually, not all at once.
• Because your ability to react may be slower after a concussion, ask your health care professional when you can safely drive a car, ride a bike, or operate heavy equipment.
• Talk with your health care professional about when you can return to work. Ask about how you can help your employer understand what has happened to you.
• Consider talking with your employer about returning to work gradually and about changing your work activities or schedule until you recover (e.g., work half-days).
• Take only those drugs that your health care professional has approved.
• Do not drink alcoholic beverages until your health care professional says you are well enough. Alcohol and other drugs may slow your recovery and put you at risk of further injury.
• Write down the things that may be harder than usual for you to remember.
• If you’re easily distracted, try to do one thing at a time. For example, don’t try to watch TV while fixing dinner.
• Consult with family members or close friends when making important decisions.
• Do not neglect your basic needs, such as eating well and getting enough rest.
• Avoid sustained computer use, including computer/video games early in the recovery process.
• Some people report that flying in airplanes makes their symptoms worse shortly after a concussion.

Getting Better: Tips for Children

Parents and caregivers of children who have had a concussion can help them recover by taking an active role in their recovery:

• Having the child get plenty of rest. Keep a regular sleep schedule, including no late nights and no sleepovers.
• Making sure the child avoids high-risk/ high-speed activities such as riding a bicycle, playing sports, or climbing playground equipment, roller coasters or rides that could result in another bump, blow, or jolt to the head or body. Children should not return to these types of activities until their health care professional says they are well enough.
• Giving the child only those drugs that are approved by the pediatrician or family physician.
• Talking with their health care professional about when the child should return to school and other activities and how the parent or caregiver can help the child deal with the challenges that the child may face. For example, your child may need to spend fewer hours at school, rest often, or require more time to take tests.
• Sharing information about concussion with parents, siblings, teachers, counselors, babysitters, coaches, and others who interact with the child helps them understand what has happened and how to meet the child’s needs.

SOURCES:

• Center for Disease Control and Prevention
• The Canada Foundation for Innovation
  The Canada Foundation for Innovation gives researchers the tools they need to think big and innovate. By investing in state-of-the-art facilities and equipment in Canada's universities, colleges, research hospitals and non-profit research institutions, the CFI is helping to attract and retain the world's top talent, to train the next generation of researchers, to support private-sector innovation and to create high-quality jobs that strengthen the economy and improve the quality of life for all Canadians. For more information, visit innovation.ca.