Multiple Concussions: From Preclinic to Clinic, Volume II

Building on the success of the Research Topic ”Multiple Concussions: From Preclinic to Clinic", the launch of this second volume aims to update readers on recent developments in the field of multiple and sub-concussion research.Concussion is classified within the category of mild traumatic brain injury, occurring when an external force, unnecessarily acting directly to the head, causes a rapid acceleration-deceleration of the brain. It is prevalently encountered in both contact and non-contact sports. On classical neuroradiological screening (CT scan or MRI), the majority of concussed patients show no detectable abnormalities, although they may manifest a well-characterized range of early symptoms (loss of consciousness, confusion, headache, nausea and vomiting), and later symptoms (persistent headache, reduced concentration, fatigue, and disturbances of memory, sleep and mood). In individuals without a previous history of concussion, these symptoms generally resolve within 1–2 weeks. Transitory cognitive dysfunction may accompany the post-concussive period and typically improves alongside the clinical symptoms. However, part of the force acting at the time of impact, is absorbed by the “soft” brain tissue and can trigger biochemical, metabolic and molecular changes (collectively known as the neurometabolic cascade of concussion) that may persist long after symptom resolution and apparent neurocognitive recovery.To date, no easily measurable biomarkers of diagnostic and prognostic value are available to assess the “real” biochemical, metabolic and molecular recovery of the post-concussed brain. Given this deficiency, it remains inappropriate to base return-to-play or return-to-learn decisions solely on the disappearance of symptoms and normalization of neurocognitive functions. Indeed, during the prolonged period of healing, the brain remains in a “window of vulnerability” to a second concussion, which, in the worst-case scenario, can lead to second impact syndrome and potentially fatal outcomes. In most cases, repeat concussions may not give rise to symptoms that differ substantially from those of a single concussion. What is strikingly different is their duration. Moreover, the crucial question of “how many are too many” remains unanswered, and it is not yet fully understood when or how repeat concussions may contribute to chronic traumatic encephalopathy. Further research is also needed to determine whether multiple sub-concussive episodes can result in lasting alterations in brain-cell function, and how individuals affected by repeated head impacts can be supported in their return to education, work, sport and daily activities.This Research Topic welcomes contributions ranging from preclinical and clinical research to review papers, as well as clinical management and educational return-to-learn/return-to-play frameworks, addressing the aforementioned questions in the field of multiple concussions as well as sub-concussions. The Topic Editors are particularly interested in, though not limited to, the following subtopics:o Evaluation of potential molecular biomarkers in patients with multiple concussions and their correlation with symptoms and neurocognitive testso Investigating the effects of sub-concussions in humanso Preclinical models answering the question on “how many are too many”, and providing information on the point-of-no-return that will lead to irreversible neurodegenerationo Preclinical models describing the potential molecular mechanisms that may contribute to the development of chronic traumatic encephalopathyo Clinical management and return-to-learn/return-to-play protocols following repeat or sub-concussive exposureo Monitoring cumulative concussive and sub-concussive burden in student and athlete populationsTopic Editor Dr. Giuseppe Lazzarino is a shareholder and consultant of LTA-Biotech srl. Additionally, Dr Valentina Di Pietro is confounder, shareholder and consultant of Marker AG https://www.markerhealth.com/ an emerging biotech company who has recently developed a CE mark saliva-based concussion test. She is also listed as inventor to the patent files related to biomarkers used in this test. The other Topic Editors have no potential conflicts of interest to declare. Topic editors: Giuseppe Lazzarino, Stefano Signoretti, Valentina Di Pietro, Zachary William Bevilacqua Source: https://www.frontiersin.org/research-topics/85368/multiple-concussions-from-preclinic-to-clinic-volume-ii