Adam Richard Militana MD, Presenter: Nothing to Disclose

Manus Donahue PhD, Abstract Co-Author: Nothing to Disclose

Megan Kay Strother MD, Abstract Co-Author: Nothing to Disclose

Allen K. Sills MD, Abstract Co-Author: Nothing to Disclose

Gary S. Solomon MD, Abstract Co-Author: Nothing to Disclose

Victoria L. Morgan PhD, Abstract Co-Author: Nothing to Disclose

The measurement of cerebrovascular reactivity (CVR) in response to increased levels of carbon dioxide may be important to investigate in an athlete following concussion because this most closely simulates the physiologic challenge that she will encounter upon return to physical activity. To date, no study has been published using functional MRI (fMRI) to assess CVR following sports-related concussion. The purpose of this study is to measure CVR using fMRI in college athletes following a sports-related concussion and to correlate this measure with days after injury and headache symptomatology.

We enrolled 6 college athletes (3M/3F, 18-22 yrs) 3-6 days following a diagnosed sports related concussion and 11 healthy controls (5M/6F, 18-23 yrs, 7 athletes) with no history of concussion. CVR was measured using fMRI via a 5% carbon dioxide block paradigm. A total of 18 regions of interest (ROIs) were evaluated across the brain. A subjective headache score (HAS) was reported at the time of scanning from 0-4.

CVR was increased approximately 37% across all ROIs in athletes following concussion compared to controls (p=0.025). We found that HAS was negatively correlated with days after injury (p=0.01). Across all ROIs, CVR was negatively correlated with days after injury (p=0.07). Individual regions which demonstrated this negative correlation and also had increased CVR in the concussion subjects were: right inferior parietal lobule, dorsomedial prefrontal cortex, right dorsolateral prefrontal cortex and right thalamus. Of these, the right inferior parietal lobule showed increased CVR correlated with increased HAS (p=0.02).

We observed markedly increased CVR in college athletes in the days following a sports-related concussion. Furthermore, this increase is associated with more recent injury, and in one region it is also associated with increased headache symptoms. These preliminary results suggest that a hypereactive vasodilatory response to hypercarbia may be an indicator of acute injury and contribute to recurrent headache symptoms. Future work will investigate the role of CVR changes in symptoms upon an athlete's return to physical activity. [NIH UL1 TR000445]    

Our findings suggest that CVR is increased in the days following sports related concussion and this may be related to headache symptomatology.

Militana, A, Donahue, M, Strother, M, Sills, A, Solomon, G, Morgan, V, Increased Cerebrovascular Reactivity Correlated with Subjective Headache Scores in the Days Following Sports Related Concussion.  Radiological Society of North America 2014 Scientific Assembly and Annual Meeting, - ,Chicago IL. http://archive.rsna.org/2014/14007969.html