The Link Between Concussions and Multiple Sclerosis

In today’s world, we are told that ‘if an individual has experienced a severe jolt or blow to the head, which has left them dazed, confused, or wobbly - they have concussion”. (Medical News Today: MNT)

According to Christian Nordqvist, a writer for MNT, a concussion causes a temporary loss of brain function. This lapse in brain function can lead to compromised brain activity and can also “cause cognitive, physical, and emotional symptoms”.

Recent research has showed that concussions may lead to Multiple Sclerosis (MS) or other brain-related conditions in later life.

According to Medical News Today, individuals who suffer a concussion in adolescence may be at greater risk of developing MS as an adult.

A study on concussion and MS

To seek a possible correlation between concussions in youth and MS later in life, Professor Montgomery and his colleagues gleaned information from the national Swedish Patient and Multiple Sclerosis Registers to identify 7,292 cohorts with MS (Medical News Today/MNT).

Those with MS were grouped according to age of diagnosed concussion: childhood, from birth to age 10 and adolescents between the ages of 11 and 20 years.

Each patient with MS was matched with 10 people who did not have MS but shared the same sex, year of birth, and area of residence. In that manner, the study totaled 80,212 participants. (MNT)

While MNT reports that research showed no correlation between childhood concussions and MS, there was a great disparity for those who had concussions during adolescence ages 11 to 20.

In the adolescent group, those who were diagnosed once with a concussion were shown to be 22% more likely to contract later-life MS. However, for those who suffered more than one concussion during the years labeled as adolescence, the risk of MS was increased more than twofold. (MNT)

Study on concussions in youth athletes

A study on concussions in athletes, published in the American Journal of Sports Medicine (AJSM), included 43 high school athletes. The goal of the study was to determine if the current concussion management guidelines were appropriate in classifying and managing mild concussions. (MNT)

According to MedicineNet, common symptoms of a mild concussion include: headache, difficulty concentrating, dizziness or lightheadedness, and nausea.

Unless otherwise cited, the following information on the study was taken from the AJSM article referenced above:

The study was entitled “Grade 1 or ‘Ding’ Concussions in High School Athletes.” (Mark R. Lovell, Michael W. Collins, et al)

It researched the current guideline suggesting that athletes in the study with ‘mild’ concussions may return to play if no neurologic symptoms occur for 15 minutes after the injury.

Prior to the opening of the sports season, the participating high school athletes completed a neuropsychological performance test and a symptom ratings exercise to create a baseline.

The tests were repeated at two times during the 1st week following mild concussion, to establish any changes from the baseline test results.

Thirty-six hours after injury, mildly concussed high school athletes demonstrated a decline in memory.

Conclusions of the study were: “Athletes with grade 1 concussion demonstrated memory deficits and symptoms that persisted beyond the context in which they were injured. This data suggests that current grade 1 return-to-play recommendations that allow for immediate return to play may be too liberal”.

Clinical Relevance of the study determined that “reconsideration of the current concussion grading systems appears to be warranted.”

American Academy of Neurology Guidelines

It is noteworthy that in 2010, the American Academy of Neurology said to keep an athlete, suspected of having a concussion, removed from play until seen by a physician. The Academy stressed that the physician or health care professional be experienced in evaluating for concussions. According to their guidelines, the player is to be ‘sidelined’ until they are symptom-free and deeded ready by that physician to return to play sports.

The Academy also said to provide the family with a fact sheet on concussions, and notes that more subtle problems of a concussion may not be apparent at the time of injury. These include memory deficits, changes in personality and changes in mental status. Should these occur, the family is urged to make an appointment with the original physician who treated that child/teen, or to go to the emergency room ASAP.

Input from a Sports Concussion Clinic

According to the Sports Concussion Clinic at LA’s Children’s Hospital, the best medicine for a concussion is rest, to include early bedtimes, late wake-ups and naps. A break from all exercise and athletic activity needs to be coupled with cognitive rest: Giving the brain a rest from thinking is the goal. This cognitive rest not only means to limit intense studying or reading, but also a break from texting, computer time, emails, phone calls, video games or loud music/television.

The LA Sports Concussion Clinic article informs us that “For most athletes with mild concussions, symptoms resolve within seven to ten days, but all athletes and injuries are unique. The doctor will evaluate your child with tests of memory, concentration, balance and more”, (to determine when it’s safe to return to sports).

If an athlete is allowed to return to sports before symptoms are gone, post-concussion syndrome can set in. This condition can lead to issues such as prolonged headaches and poor school performance, per the Concussion Clinic.

Also, according to the Clinic, if the player gets another blow to the head while the initial concussion is still healing, this can result in ‘second impact syndrome’ to include the potential for fatal brain swelling.

The Clinic’s advice? “When in doubt, sit it out!”

Of interest to this topic is that it’s state-mandated for Michigan student athletes to complete concussion education. The curriculum, based on the Centers for Disease Control and Prevention (CDC) Heads-Up program, can be accessed online. It is recommended that this or a similar education program be used to target schools without an athletic trainer. The user-friendly program educates on the signs, symptoms and dangers of concussion.)

Knowing the facts about concussions, and when it’s safe for athletes to return to the team, can keep our athletes active and healthy. (Including the parents in the concussion training would make them more empowered to play an active part in this process.)

The CDC informs us that “Involving parents, coaches and students can create a safe playing environment.”

If you are interested in starting a Heads-Up training program at your school, learn all you can about the curriculum, write out a proposal, and make an appointment to sit down with your school administrator to approach the issue, in a respectful and professional manner.

Whatever route we may take regarding this issue, we must be unified in seeking the best solution for our children.

Stand up for your child’s safety!

References

https://www.medicalnewstoday.com/articles/319505.php

https://www.medicalnewstoday.com/articles/158876.php

https://www.emedicinehealth.com/concussion/page5_em.htm

https://www.chla.org/sports-concussion-clinic?c=ipINKTOAJsG&b=8360759

https://healdove.com/injuries/concussion-recovery