Brain Damage Can Occur With Mild Head Trauma
October 4, 2019
The Jerusalem Post — A new study led by Prof. Alon Friedman, a neuroscientist and surgeon who established the Inter-Faculty Brain Sciences School at Ben-Gurion University of the Negev (BGU), has found evidence that there could be damage to the brain’s protective barrier even without a reported concussion.
Prof. Friedman holds the Dr. Helena Rachmanska-Putzman Chair in Neurology and is also a member and former director of the University’s Zlotowski Center for Neuroscience.
The results of the research, published in the Journal of Neurotrauma, underscore the need for brain-imaging techniques that could help predict damage to one’s blood-brain barrier regardless of symptoms, thereby potentially preventing the onset of neurodegenerative disorders such as Parkinson’s, depression and dementia.
The study, a collaboration between BGU, Stanford University in California and Trinity College in Dublin, used a contrast-enhanced MRI developed by Prof. Friedman and his team to examine high-risk populations—specifically professional mixed martial arts (MMA) fighters and adolescent rugby players—to investigate whether the integrity of the blood-brain barrier (BBB) was altered and to develop a technique to better diagnose mild brain trauma.
For the first time, the researchers were able to detect damage to the BBB, which protects the brain from pathogens and toxins caused by mild traumatic brain injury (mTBI), even without the players exhibiting any symptoms.
Prof. Friedman told The Jerusalem Post that the results of the study show that the brain-imaging techniques being developed could be used to monitor athletes to better determine safer guidelines for “return to play.”
The research comes only two years after a team from Boston University School of Medicine published a study that found chronic traumatic encephalopathy (CTE) in 99% of brains obtained from National Football League (NFL) players, and also in college and high school players. CTE is a progressive, degenerative brain disease found in people with a history of repeated head trauma that results from what Friedman calls a “leaky” BBB.
“The problem with CTE is that it can only be diagnosed after death, when pathologists are looking at the brain itself,” Friedman explained. “Until now, there has been no way to diagnose or treat CTE in advance.“The big question, then, is to what extent concussion symptoms are related to BBB damage or if they are independent,” he continued. “If you have a concussion and do not develop damage, you can also have no concussion symptoms and still have damage.”
Friedman said that today, treatments for mTBI are not research-based and different doctors suggest treating it differently.“We are missing objective measurements to gauge how the repair process is going, if damage to the BBB is improving,” Friedman said.
“The current theory today is that it is the outer surface of the brain that is damaged in a concussion since, during an impact, the brain ricochets off of skull surfaces like Jell-O,” Friedman said. “However, we can see now that the trauma’s effects are evident much deeper in the brain and that the current model of concussion is too simplistic.”