Even one hard hit could last a lifetime

In recent years, more and more studies have come out that underline how harmful concussions can be to the brain in the long run. Head trauma and concussions are being linked to conditions like Alzheimer’s disease, chronic traumatic encephalopathy (CTE) and loss of cognitive function. Now, research is showing that concussions may potentially increase the risk of multiple sclerosis as well.

“The link between concussions and neurological diseases is strong,” explained Dr. Justin Tunis, primary care sports medicine physician. “Concussions cause disruptions in the way that the brain functions—so when someone gets a concussion, the most important organ in the body gets damaged. Trauma can disrupt the development and functioning of the brain, which is especially harmful to adolescents, since their brains are still developing.”

What is multiple sclerosis and how is it affected by concussions?
Multiple sclerosis (MS) is a degenerative neurological disease where the immune system attacks the protective coating that surrounds the nerves. This coating, known as myelin, protects the nerves and helps the transmission of signals from the brain. As the protective coating is destroyed, it becomes harder for the brain to transmit signals through these nerves. This disrupts the brain’s ability to communicate with the rest of the body and can cause unpredictable symptoms like numbness, tingling, blindness, blurry vision, fatigue and trouble walking or standing.

MS is classified as either relapsing or progressive. Relapsing means the MS symptoms come and go in waves. Progressive means the symptoms are consistent and get worse. Researchers still don’t know exactly what causes MS, but it’s likely a combination of environmental and genetic factors.

A new study examined more than 80,000 people, nine percent of whom had MS, and found that head trauma, especially repeated trauma, is related to an increased risk of MS later in life. There was no association between concussions as a child and MS (likely because their brain is still growing rapidly enough to recover), but researchers found that people who experienced one concussion in adolescence were 22 percent more likely to be diagnosed with MS later on in life.

“It’s very possible that MS has a genetic component that can be aggravated by environmental factors,” said Dr. Tunis. “Previous research suggests that head trauma can trigger an abnormal immune response in the brain which causes the immune system to attack the nerves. This doesn’t happen to all people when they get a concussion, but for people who are already genetically predisposed to MS, it increases their risk.”

Preventive measures for concussion-related MS
“In general, it’s important to avoid concussions as much as possible,” said Dr. Tunis. “This means wearing proper safety equipment while riding a bike, playing a sport or participating in any other potentially rough activity. Be conscious of any head or neck injuries, and if you develop symptoms such as dizziness, nausea and/or sleep disruption, talk to your doctor or go to an emergency room for an evaluation.”

Not all concussions are going to lead to MS, however. Every year, nearly 2 million children suffer concussions in the US, but they’re usually not severe enough to have lasting effects. Regardless of the severity, concussions still need to be treated appropriately.

If you do get a concussion, follow all of your doctor’s recommendations for treatment. Be sure to give your brain adequate time to rest. Avoid things that make your symptoms worse such as loud music, bright lights, technology and physical activity until you’re cleared by your doctor.

While there is no cure for MS at this time, there are some new medications that are helping slow the onset and reduce symptoms. For those with relapsing MS, there are medications that can help alter the course of the disease. There are no treatments for progressive MS yet.  Talk with your doctor if there’s anyone in your family who has had MS to help assess your risk.

Primary care sports medicine physician Justin Tunis, MD, sees patients at Geisinger Community Medical Center in Scranton. To schedule an appointment with Dr. Tunis or another sports medicine physician, please call 800-275-6401 or visit Geisinger.org.

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