Neuroimaging study shows concussions are harder on older brains

Age matters when it comes to recovering from mild traumatic brain injury. Perhaps unsurprisingly, it’s the younger patients who have more malleable neural plasticity, and so recover more fully and more quickly, than their older fellow sufferers.

Researcher David Yen-Ting Chen, MD, of Taipei Medical University in Taiwan, and colleagues report this study conclusion ahead of print in Radiology.

The authors performed fMRI exams on 13 concussed young adults (21 to 30 years old), 13 concussed older adults (51 to 68 years old) and 26 age- and gender-matched control subjects.

Analyzing postconcussion symptoms, neuropsychological test results and working memory activity in both injured groups at one month post-injury and at six-week followup, Chen and his team found that mild traumatic brain injury (MTBI) tends to affect older patients in ways that are both more profound and longer-lasting.

The evidence of better neural plasticity in younger patients showed up during the six-week follow-up, when working memory activation patterns, along with decreased postconcussion symptoms, were seen in younger patients but not in older patients.

In the younger patients, fMRI revealed initial hyperactivation (greater than normal neural activity) in the right precuneus and right inferior parietal gyrus (P = .047 and P = .025, respectively) in conditions compared with those of younger control subjects.

The uptick in activity may imply “partial compensatory or inefficient hyperactivation in young patients at initial imaging; in these patients, more activation is associated with poorer task performance and a more severe brain injury,” the authors write.

In the older patients, the researchers observed less than normal activity, hypoactivation, in the right precuneus and right inferior frontal gyrus (P = .013 and P =.019, respectively) compared with older control subjects.

In their study discussion, the authors express hope that their findings will help lead to age-specific care protocols for concussion patients.