Ann Neurol-Harvard University found: Concussion can lead to changes in cerebrovascular regulation mechanism

Among the nearly 200,000 concussions that occur each year, people aged 10-19 have the highest incidence
.

This high incidence at a young age is worrying because its potential sequelae are beyond the scope of primary symptoms

Among adolescents and young adults, standard neuroimaging rarely recognizes signs of nerve damage in sports-related concussions.
Only 1.
5-3% of CT and MRI show signs of nerve damage within 30 days after injury
.

Although advanced neuroimaging shows some changes in neural integrity and functional connectivity after a concussion, asymptomatic young adult athletes with a history of concussion have reported similar changes6, and the correlation with self-reported symptoms is poor

, The destruction of the physiological mechanisms that support nerve function may be the source of symptoms after a concussion

In healthy people, cerebral blood vessels regulate cerebral blood flow by buffering changes in arterial carbon dioxide (that is, through vasoactivity) and changes in arterial pressure (that is, through auto-regulation)
.

Previous data have shown that there is cerebrovascular dysfunction in adults with persistent post-concussion symptoms

Whether these changes in

Based on the middle cerebral artery blood flow velocity, they assessed the cerebral vasoactivity and autoregulation of 28 concussion participants (≤14 days after injury) and 29 matched control groups
.

Participants in the concussion group returned for an 8-week follow-up evaluation

They found out
.

There were no significant differences between the groups in demographic, clinical, and hemodynamic variables

The vasoactivity of the concussion group was significantly higher (P = 0.
02)
.

In the concussion group, 60% of the change in resting cerebral blood flow velocity is explained by the two components of vascular reactivity and auto-regulation-the slope of decline and the effectiveness of auto-regulation (adjusted R2=0.

In addition, lower mean arterial pressure, lower response to increased arterial pressure, and lower vasoactivity were significantly associated with greater symptom burden (adjusted R2 = 0.
72, p <0.
01)
.

At the 8-week time point, except for the 4 concussion participants, the symptom burden of all the other participants had improved, but the vascular reactivity did not improve (P <0.
01)
.

The 8-week change in vascular reactivity was positively correlated with the amount of aerobic exercise (adjusted R2=0.

The symptom burden of all other participants has been improved, but the vascular reactivity has not improved .
The symptom burden of all other participants has been improved, but the vascular reactivity has not improved.

The significance of this study is that concussion leads to changes in cerebrovascular regulation mechanisms, which in turn explains the changes in resting cerebral blood flow velocity and acute symptom burden
.
In addition, although the symptoms are alleviated, these changes still exist for a long time, but they are actively changed by aerobic exercise
.
These findings provide a mechanism framework for further study of cerebrovascular-related symptoms
.

Concussion leads to changes in cerebrovascular regulation mechanisms, which in turn explains changes in resting cerebral blood flow velocity and acute symptom burden
.
Concussion leads to changes in the cerebrovascular regulation mechanism, which in turn explains the changes in resting cerebral blood flow velocity and the burden of acute symptoms
.

Original Source: Aaron SE, Hamner JW, Ozturk ED, Hunt DL, Iaccarino MA, Meehan WP 3rd, Howell DR, Tan CO.
Cerebrovascular Neuroprotection after Acute Concussion in Adolescents.
Ann Neurol.
2021 Jul;90(1):43-51 .
doi: 10.
1002/ana.
26082.
Epub 2021 Apr 28.
PMID: 33855730.

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