Using Your Head
Mayo Clinic finding a way to diagnose concussions with more certainty
By Riley Andersen
At the Mayo Clinic in Arizona, neurologists are discovering new ways to diagnose concussions. Research shows that autonomic reflex testing, which measures involuntary changes in heart rate and blood pressure, consistently shows significant changes in those with concussions. The findings were presented at the American Academy of Neurology annual meeting held in San Diego last week.
Today, doctors count on self-reports from the patients of symptoms to make a diagnosis of concussions. Besides the report of symptoms, or lack thereof, there is no regular test to decide whether the injured person’s brain has fully recovered from a concussion. In light of brain-research studies, doctors are positive that there is a lag between when the patient believes that symptoms have resided and when the brain has actually healed. This means that a fast, definitive tool is needed to tell whether a brain has fully recovered from a concussion.
“This has the potential to change the way we approach concussion patients,” says Dr. David Dodick, a neurologist and director of the Mayo Clinic Concussion Program. “One of the challenges of treating someone with a concussion is to reliably make a diagnosis: to know when the brain is injured and to know when the brain [has] actually recovered.”
“Autonomic nervous system dysfunction has long been recognized as a possible complication of people with severe traumatic brain injury but has rarely been associated with people with concussions or milder forms of brain injury,” adds co-author Dr. Brent Goodman, a Mayo neurologist and autonomic system expert.
The autonomic nervous system involuntarily controls heart rate, blood pressure, digestion, respiratory rate and perspiration.
In one study, doctors watched over 21 patients after they had received concussions. All of them experienced big changes in heart rate and blood pressure during autonomic testing. The physicians concluded that these changes were due to concussion.
“Contrary to popular belief, the symptoms of dizziness that patients feel just after a concussion may, in some cases, be symptoms of autonomic system impairment rather than a vestibular or inner ear disturbance,” says Dr. Bert Vargas, a Mayo neurologist.
More research is needed, but the Mayo team is optimistic, Dodick says.
“This study shows a possible electrophysiological biomarker that indicates that a concussion has occurred. We are hopeful that with more research this will be confirmed and that this may also be a biomarker for recovery,” he says.
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