Science Update

New study demonstrates biomarkers that predict symptom recovery after concussion

The treatment of concussions and traumatic brain injury (TBI) is a clinical challenge. Medical treatments for post-concussion symptoms have consisted mainly of opiates for headaches, anti-depressants, anti-nauseas, anti-vertigo, stimulants, and other medications to increase neurotransmitter levels.

Previous research has demonstrated that athletes who wait to report a concussion may experience prolonged recovery times. Those who do not receive immediate treatment are at risk for further damage to the brain and will most likely take much longer to recover. Research indicates that intense physical activity during this vulnerable time immediately after a concussion can be detrimental.

In a new study published July 3 in Neurology, researchers investigated the effect of acute elevations in serum inflammatory markers and their association with symptom recovery following a sports-related concussion.

This study included 84 high school and collegiate football players, including 41 concussed athletes and 43 control athletes. Laboratory assessment included serum levels of interleukin (IL)–6, IL-1β, IL-10, tumor necrosis factor, C-reactive protein, interferon-γ, and IL-1 receptor antagonist. The Sport Concussion Assessment Tool, 3rd edition (SCAT3) symptom severity scores were also collected. These assessments were taken at a pre-injury baseline, 6 and 24-48 hours post-injury as well as at approximately 8, 15, and 45 days post-concussion. The total number of days athletes were symptomatic following the concussion was the primary outcome variable.

As a result, IL-6 and IL-1RA were significantly elevated in the concussed athletes at 6 hours relative to pre-injury and other post-injury visits, as well as compared to controls. Levels of IL-6 and IL-1RA significantly discriminated concussed from control athletes at 6 hours post-concussion. In addition, IL-6 levels at 6 hours post-concussion were significantly associated with the duration of symptoms.

These results demonstrate the potential use of these markers in identifying athletes at risk for prolonged recovery after a sports-related concussion.

Nutrient Considerations

Research supports early treatment of high dose omega-3 fatty acids in improving outcomes from TBIs. The brain needs to be saturated with omega-3s in order for the brain to heal. If these individuals do not have an optimal supply of EPA and DHA, healing will likely be impaired. In addition, there is no negative impact supporting these patients with optimal nutrition to regain as much function as possible.

Glycerophosphocholine (GPC) has also been used to help prevent damage to brain cells after blood flow, and thus oxygen, has been cut off to those cells.  GPC also supports the brain’s ability to recover after TBIs and helps reduce the symptoms associated with concussion and post-concussion syndrome. GPC is a form of choline that has been shown to protect and repair damaged brain cells.

Other supportive nutrients to consider include curcumin, magnesium l-threonate, acetyl-l-carnitine, phosphatidylserine, BCAAs, creatine, zinc, exogenous ketones and MCT oil.

By Michael Jurgelewicz, DC, DACBN, DCBCN, CNS

Source: Morgan E. Nitta, Jonathan Savitz, Lindsay D. Nelson, T. Kent Teague, James B. Hoelzle, Michael A. McCrea, Timothy B. Meier. Acute elevation of serum inflammatory markers predicts symptom recovery after concussion. Neurology, 2019; 10.1212/WNL.0000000000007864 DOI: 10.1212/WNL.0000000000007864