Pediatric concussion remains without a reliable scanning tool to image injury or guide therapies. Previous studies with MRI use methods, such as diffusion tensor imaging, functional MRI and functional connectivity MRI, that have not yet been sensitive or specific enough to be used as clinical scans. MR spectroscopy allows measures of the chemical composition in parts of the brain. Recent advances in MR spectroscopy allow for the detection of levels of neurotransmitters, including gamma-amino butyric acid (GABA) which is a widespread inhibitory transmitter. GABA function is critical for cognition and may be abnormal in trauma. Abnormal GABA levels may impair recovery in animal models of injury. Our group combines a dedicated sports concussion program, a work-in-progress collaboration with Siemens Medical Imaging group, and an advanced imaging system (3T magnet with 32 channel head coil) along with a radiology research group with expertise in pediatric neuroimaging. We will address several areas of research interest by developing and studying MR spectroscopy of GABA in a tightly defined pediatric sports concussion population, with appropriate controls.
Our first aim will detect GABA levels in a clinically relevant time fram (30 min) by applying research protocols to state-of-the art clinical scanners.
The second aim will be to demonstrate the difference in GABA between adolescents with concussion and those without. We will use functional MRI of working memory to target the measurement areas to make sure we are sensitive to brain areas at risk in concussion, based on the common deficits in working memory seen after concussion. In the third aim, the GABA levels will be correlated with post-concussion memory assessments and other MRI brain measures of structure and function. These results will form the basis for future clinical trials showing the utility of GABA spectroscopy in the management of pediatric concussion.
Novel methods of imaging the brain after concussion may help explain the short- and long-term effects of sports concussions in adolescents. Instead of imaging just the brain structure, this project attempt to measure a neurotransmitter, gamma-amino butyric acid (GABA) in the brain. GABA is important in cognitive functions and direct measure would be a powerful assessment of the brain following concussion.
