Grant: Project Grant

Concussion is a major health concern, with over 4 million cases each year in North America. These injuries are associated with impairments in thinking (confusion, feeling "slow"), emotion (anger, depression) and physical function (dizziness, nausea). Most patients recover within 1 to 2 weeks after injury and are able to return to normal daily activities. However, for 10-25% of patients (the "miserable minority"), impairments last months to years after injury, reducing their quality of life and leading to lost work hours and medical costs. Little is currently known about the brain changes that underlie such differences in patient symptoms and recovery time. One likely cause is injury to the autonomic nervous system (ANS), which controls automatic processes like heartbeat, breathing and body temperature. Patients with more severe injury show signs of disturbed ANS, such as changes in heartbeat patterns, but we do not yet know how which of the brain areas that control the ANS are affected, or how these changes relate to specific symptoms. In this study, we propose to use a combination of magnetic resonance imaging (MRI) of the brain and heart monitoring to study early changes in the ANS and the brain, and how they relate to patient outcomes. This research will provide novel information about the brain's recovery from injury. It may be used to enhance guidelines for concussion management and to improve low-cost technology such as heart monitors, to better identify patients at risk of prolonged recovery and direct them towards appropriate interventions.