Grant: Team Grant: Mild Traumatic Brain Injury in Children and Youth

One in seven children will have had a concussion by age ten, and 11% of those children continue to have symptoms three months later. These symptoms, referred to as post-concussion symptoms (PCS), include headaches, fatigue, sleep disruption, mood and concentration difficulties. They often result in missed school and both physical and psychological consequences to children and their families. The neurological basis of PCS is not clear, although recent evidence suggests dysfunction in GABAergic neurotransmitter systems. Even though PCS affects thousands of Canadian children every year, there is no evidenced-based medical treatment. Melatonin is produced naturally in our brain and is best known for its actions in maintaining our 24-hour internal clock. Although it is widely available as an over-the-counter sleep aid, there is a growing interest in its pain-relieving, and brain injury protective effects, including its GABAergic effects. Our previous research found that 85% of children with PCS and sleep problems, reported improvement when treated with Melatonin. The proposed study will compare treatment with oral melatonin to placebo in youth with PCS. We hypothesize that those treated with melatonin will have fewer symptoms. We will examine the relationship between PCS, sleep and response to treatment. We will also use new technologies to examine the GABAergic brain systems and they are affected by melatonin treatment. These methods include functional magnetic resonance imaging and transcranial magnetic stimulation. Our study has the potential to provide a safe treatment for PCS in children. It will also allow us to discover how neuronal networks and brain connectivity changes during treatment and recovery so that we can provide even better interventions in the future.