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Why do some people seem to suffer no consequences from a concussion while others have symptoms as severe as personality change? A new type of brain scan helps explain why, and could help doctors and patients determine the likely outcomes of a concussion.

The new technique analyzes data from brain imaging studies, according to the study published in the journal Brain Imaging and Behavior today. Concussion victims have unique spatial patterns of brain abnormalities that change over time, researchers found, which could help predict which head injuries are likely to have long-lasting neurological consequences.
Photo: Sciepro/Science Photo Library/Corbis
Earlier studies identified differences in patients with concussions and those without, but the new technique takes the additional step of parsing out the differences in patients who have concussions. 
"In fact, most researchers have assumed that all people with concussions have abnormalities in the same brain regions," said Dr. Michael Lipton, the study's lead author. “But that doesn’t make sense, since it is more likely that different areas would be affected in each person because of differences in anatomy, vulnerability to injury and mechanism of injury.”
The technology driving the analysis is called diffusion tensor imaging, a new form of MRI that the researchers also used recently to show the cumulative effects of frequent headers in soccer players. The researchers used it on 34 patients within two weeks of injury and again three and six months later. DTI detects subtle damage to the brain by measuring the direction of diffusion of water in white matter.

To analyze the data, the researchers developed a new software tool (called Enhanced Z-score Microstructural Assessment Pathology). They used it to observe whether brain tissue had maintained its integrity at a microstructural level. They found abnormal brain regions in concussion patients. Each concussion patient also had a unique spatial pattern that evolved over the study period.

"The brain may be trying to compensate for the injury by developing and enhancing other neural connections," Lipton said.
The findings could also help doctors tailor treatment to individual injuries.
Motor vehicle accidents are the most common cause of traumatic brain injury in the U.S., followed by sports.

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