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Neurobiological effect of selective brain cooling after concussive injury

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Abstract

The search for effective treatment facilitating recovery from concussive injury, as well as reducing risk for recurrent concussion is an ongoing challenge. This study aimed to determine: a) feasibility of selective brain cooling to facilitate clinical symptoms resolution, and b) biological functions of the brain within athletes in acute phase of sports-related concussion. Selective brain cooling for 30 minutes using WElkins sideline cooling system was administered to student-athletes suffering concussive injury (n=12; tested within 5±3 days) and those without history of concussion (n=12). fMRI and ASL sequences were obtained before and immediately after cooling to better understanding the mechanism by which cooling affects neurovascular coupling. Concussed subjects self-reported temporary relief from physical symptoms after cooling. There were no differences in the number or strength of functional connections within Default Mode Network (DMN) between groups prior to cooling. However, we observed a reduction in the strength and number of connections of the DMN with other ROIs in both groups after cooling. Unexpectedly, we observed a significant increase in cerebral blood flow (CBF) assessed by ASL after selective cooling in the concussed subjects compared to the normal controls. We suggest that compromised neurovascular coupling in acute phase of injury may be temporarily restored by cooling to match CBF with surges in the metabolic demands of the brain. Upon further validation, selective brain cooling could be a potential clinical tool in the minimization of symptoms and pathological changes after concussion.

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Acknowledgements

This study was supported by Spartan Medical, Inc. and Welkins, LLC. The authors would like to thank the Penn State student-athletes who participated in this study. We would like to express special thanks to Siemens AG, Healthcare Sector for providing us with the advanced 3D ASL WIPS package.

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Authors and Affiliations

  1. Penn State Center for Sport Concussion, Pennsylvania State University, 19 Recreation Building University Park, University Park, PA, 16802, USA

    Alexa Walter, Katie Finelli, Brian Johnson, Peter Seidenberg, Timothy Bream & Semyon Slobounov

  2. Department of Kinesiology, Pennsylvania State University, 19 Recreation Building University Park, University Park, PA, 16802, USA

    Alexa Walter, Katie Finelli, Brian Johnson & Semyon Slobounov

  3. Social, Life, and Engineering Sciences Imaging Center, Pennsylvania State University, 19 Recreation Building University Park, University Park, PA, 16802, USA

    Xiaoxiao Bai & Thomas Neuberger

  4. 120G Chandlee Lab University Park, University Park, PA, 16802, USA

    Xiaoxiao Bai

  5. 113 Chandlee Lab University Park, University Park, PA, 16802, USA

    Thomas Neuberger

  6. Penn State University Intercollegiate Athletics, Pennsylvania State University, 19 Recreation Building University Park, University Park, PA, 16802, USA

    Peter Seidenberg & Timothy Bream

  7. 1850 E. Park Avenue, Suite 112, State College, PA, 16803, USA

    Peter Seidenberg

  8. Lasch Building University Park, University Park, PA, 16802, USA

    Timothy Bream

  9. NIH, NINDS, Medical Neurology Branch Building 10 Room 7D37 10 Center Drive MSC 1428, Bethesda, MD, 20892, USA

    Mark Hallett

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  1. Alexa Walter
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  2. Katie Finelli
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  3. Xiaoxiao Bai
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  9. Semyon Slobounov
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Correspondence to Alexa Walter.

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Walter, A., Finelli, K., Bai, X. et al. Neurobiological effect of selective brain cooling after concussive injury. Brain Imaging and Behavior 12, 891–900 (2018). https://doi.org/10.1007/s11682-017-9755-2

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