Watch Dr Remika Mito accept the research grant award and hear a bit about the project.
Project Summary:
Sports-related concussion is a rapidly growing public health concern in Australia and overseas. The detection and management of concussion is incredibly important, as mismanagement can lead to persistent or long-term problems. Despite the recent spotlight on the short- and long-term effects of concussion, we still do not have any device that medical practitioners can use to diagnose a concussion in an individual. Having such a device could hugely improve the short-term management of concussion, and could help to predict the long-term outcomes in an individual. The goal of this project is to determine if we can detect a concussion in an individual’s brain using specialised brain imaging tools
Concussion is a mild traumatic brain injury resulting from a biomechanical force to the head. This injury causes some neurological impairment, and a range of variable, and often subtle symptoms. On a standard brain scan (MRI), there are no visible abnormalities that can be detected after a concussion. As such, the signs and symptoms of a concussion have long been thought to be the result of a disturbance in brain function, rather than any visible change to the brain.
Recently, a specialised type of brain imaging tool, known as diffusion MRI, has been able to detect subtle changes in the brain’s white matter (the brain’s connections or ‘wires’) following a concussion.
Our research group at the Florey has developed world-leading diffusion MRI technologies (www.mrtrix.org), which are able to detect very specific changes to the brain’s wiring. We have applied these techniques to various neurological conditions, including Alzheimer’s disease, epilepsy, motor-neuron disease, and more recently, concussion. This tool, if it is able to detect the signs of concussion in an individual, could be a highly valuable biomarker in clinical practice.
The aim of our project is to translate these advanced imaging technologies to clinical practice in concussion. The project has two parts:
- We will acquire advanced brain scans in 40 healthy volunteers. These ‘healthy’ brains will serve as an important reference data set that is needed to interpret the abnormalities that arise following brain injury
- We will analyse diffusion MRI data from professional athletes from the Australian Football League (AFL) who suffer from a concussion. These athletes are enrolled through an AFL-funded research program. A summary report of white-matter changes will be generated for each person. Finally, we will test whether this provides clinically useful information that can be reported to their treating doctors.
Outcomes:
Dr Mito and her team hypothesised that advanced diffusion MRI measurement of white matter could detect concussion in an individual, and that the measurement would relate to signs and symptoms of concussion in an individual. As a result, one of the key parts of their research was establishing a reference image from healthy volunteers to compare against scans from those with acute concussion.
They successfully constructed this reference image, and compared it against scans from people with other neurological conditions to confirm that differences could be observed. But in individuals with an acute sports-related concussion, they did not observe any significant abnormalities compared to the reference image. Their preliminary findings also demonstrate that is a high level of individual variation in acute concussion.
Overall, their findings suggest that white matter changes in acute concussion are likely to be highly individualised. When they performed group-level comparisons, they found common regions of white matter to exhibit abnormality in acute concussion. However, these regions may not necessarily be the most abnormal area of white matter in a given individual, so they couldn’t use these specific white matter tracts as biomarkers of concussion. To detect subtle brain white matter abnormalities in concussion, it is likely that large reference data sets will be needed in future.
Outcomes submitted October 2022.
The Brain Foundation is dedicated to funding the next generation of Australian research into brain disorders, diseases, and injuries, with the ultimate goal of advancing diagnoses, treatments, and patient outcomes.