Concussion: Beyond the Cascade

• Published in: Cells (Basel, Switzerland) Vol. 12; no. 17; p. 2128
• Main Authors: Neumann, Kiel D, Broshek, Donna K, Newman, Benjamin T, Druzgal, T Jason, Kundu, Bijoy K, Resch, Jacob E
• Format: Journal Article
• Language: English
• Published: Switzerland MDPI AG 22.08.2023; MDPI
• Subjects: Adenosine triphosphate; Athletes; Biomarkers; Brain; Brain Concussion; Brain research; Central Nervous System; Concussion; Cytokines; Development and progression; Diagnosis; Discordance; Football players; Glucose; Homeostasis; Humans; Inflammation; Injuries; Macrophage Activation; Medical imaging; Metabolism; microglial activation; Nervous system; Neuroimaging; neuroinflammation; Pathophysiology; PET; Physiology; positron emission tomography; Review; Secondary schools; Sports injuries; Student athletes; Tomography; Traumatic brain injury; TSPO; United States; TSPO; concussion; positron emission tomography; neuroinflammation; PET; microglial activation
• ISSN: 2073-4409; 2073-4409
• DOI: 10.3390/cells12172128

Sport concussion affects millions of athletes each year at all levels of sport. Increasing evidence demonstrates clinical and physiological recovery are becoming more divergent definitions, as evidenced by several studies examining blood-based biomarkers of inflammation and imaging studies of the central nervous system (CNS). Recent studies have shown elevated microglial activation in the CNS in active and retired American football players, as well as in active collegiate athletes who were diagnosed with a concussion and returned to sport. These data are supportive of discordance in clinical symptomology and the inflammatory response in the CNS upon symptom resolution. In this review, we will summarize recent advances in the understanding of the inflammatory response associated with sport concussion and broader mild traumatic brain injury, as well as provide an outlook for important research questions to better align clinical and physiological recovery.