Written by Joyce Smith, BS. This study has important implications for young athletes at risk of mTBI and for retired athletes with a history of earlier age concussions.
Mounting evidence suggests that mild traumatic brain injury (mTBI), or concussion, is associated with a greater risk of developing Alzheimer’s disease or another dementia years after the original head injury, suggesting that these injuries have longer-term effects that can accelerate cognitive decline. Some research suggests that, because of the aging process, older brains at age of injury onset are more vulnerable to the effects of mTBI than younger brains. 1,2. Other studies suggest that concussions sustained at an earlier age also pose a high risk for brain structure decline because older brains cannot adequately compensate for brain damage that was sustained years ago 3. There is also the concern that the aging brain, already weakened by the normal aging process, may be more vulnerable to new injuries sustained later in life 3.
A study by Trembley and team 4 investigated whether patients who sustain an mTBI earlier in life fare better or worse than patients who sustain an mTBI at an older age. They conducted a multi-cohort, case-controlled study of patients with a history of mTBI. One group (recent mTBI) cohort sustained its injuries two years prior to the study, the second cohort (remote mTBI), sustained its brain injury more than three decades ago. Each cohort had an age-matched control. Sensitive MRI-based measures of brain structure integrity were used to compare the two cohorts.
The results support the thesis that patients who sustained an mTBI in young adulthood present with more structural brain abnormalities than patients of a similar age who sustained their mTBI in late adulthood. Thus, it appears that damaging interaction between the long-term effects of an earlier mTBI and the aging process appear to outweigh the negative effects of sustaining an mTBI at an older age.
The authors suggest that brain concussions cause a lifelong cascade of neurodegeneration, and pose significant long-term health risks for people who are injured in adolescence or early childhood. They believe that young athletes are at particular risk, and those who are first exposed to contact sports at young ages may be at the highest risk of poor neurological outcomes later in life. They also hypothesize that the brain never fully recovers from concussion, therefore creating an urgent need to implement new policies and procedures for preventing TBI in these young at-risk populations. They suggest that these at-risk populations might develop significant neurological impairments later in life as a result of injuries sustained in adolescence and early adulthood.
Source: Tremblay, Sebastian, Martine Desjardins, Patrick Bermudez, Yasser Ituraea-Medina, Alan C. Evans, Pierre Jolicoeur, and Louis De Beaumont. “Mild traumatic brain injury: The effect of age at trauma onset on brain structure integrity.” NeuroImage: Clinical (2019): 101907.
© 2019 The Author(s). Published by Elsevier Inc. This is an open access article under the CC BY-NC-ND license. (http://creativecommons.org/licenses/BY-NC-ND/4.0/).
Click here to read the full text study.
Posted September 9, 2019.
Joyce Smith, BS, is a degreed laboratory technologist. She received her bachelor of arts with a major in Chemistry and a minor in Biology from the University of Saskatchewan and her internship through the University of Saskatchewan College of Medicine and the Royal University Hospital in Saskatoon, Saskatchewan. She currently resides in Bloomingdale, IL.
References:
- Peters ME. Traumatic brain injury (TBI) in older adults: aging with a TBI versus incident TBI in the aged. International psychogeriatrics. 2016;28(12):1931-1934.
- Griesbach GS, Masel BE, Helvie RE, Ashley MJ. The impact of traumatic brain injury on later life: effects on normal aging and neurodegenerative diseases. Journal of neurotrauma. 2018;35(1):17-24.
- Henry LC, Tremblay S, De Beaumont L. Long-term effects of sports concussions: bridging the neurocognitive repercussions of the injury with the newest neuroimaging data. The Neuroscientist. 2017;23(5):567-578.
- Tremblay S, Desjardins M, Bermudez P, et al. Mild traumatic brain injury: The effect of age at trauma onset on brain structure integrity. NeuroImage: Clinical. 2019:101907.
