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‘Brain Rest’ Advised After Concussions, Study Confirms

Wednesday, January 8th, 2014

A new study has confirmed what doctors have long advised–that children who suffer concussions should engage in “brain rest” and abstain from cognitively challenging activities including reading, playing video games, and sending text messages for several days after the injury.  More from The Boston Globe on the study:

A new study conducted by researchers at Boston Children’s Hospital tracked 335 student athletes who were treated for concussions incurred on the playing field. They found that those who took the most time off from tasks that required a lot of thinking had the quickest recovery from headaches, dizziness, nausea, and other concussion symptoms.

A majority of those who got the most cognitive rest were symptom-free 40 days after their head injury, but it took 100 days for symptoms to resolve in the majority of those who got the least amount of rest, according to the study published Monday in the journal Pediatrics.

While the study couldn’t determine exactly how much rest was optimal, study co-author Dr. William Meehan said the results confirmed the sensibility of recommendations to avoid mental challenges right after a concussion.

“For the first three to five days, we tell our patients with concussions that they should really aim to be at a zero level or complete cognitive rest,” said Meehan, director of the sports concussion clinic at Boston Children’s. That means no reading, homework, text messaging, or video game playing; basically, it’s fine to lie in bed quietly, watching TV or listening to music with the volume on low.

“Those experiencing severe symptoms may prefer to be resting anyway,” Meehan said, “but those with mild symptoms may think they can go back to school or resume exercise right away, which may delay their recovery.”

After a few days, kids can slowly add mental activities such as doing a crossword puzzle or sending a few text messages to see how they feel. “If symptoms exacerbate, they should go back to resting,” Meehan said. If they’re feeling okay, they can continue to gradually add mental challenges, resuming some school work on a lighter schedule. Throughout, they should continue to assess their symptoms and cut back if the headaches or dizziness return.

The brain likely needs to rest from mental processing to reserve its precious energy to balance its systems after the injury. Neurologists believe that the blunt trauma to the brain triggers nerve cells to release a flood of chemicals causing an imbalance that leads to concussion symptoms. At the same time, there’s often reduced blood flow to the brain following an injury which lowers the brain’s supply of glucose for energy. Any glucose expended for mental challenges means less energy is available to restore a biochemical balance.

“Concussions are really a problem with brain function and the movement of ions, or charged particles, around the cell membrane,” Meehan said. This type of malfunction, though, doesn’t appear on brain imaging tests, though technological advances may enable such imaging in the future.

For the time being, parents helping their kids recover from concussions may need to explain why rest is necessary when the brain scan looks fine.

Image: Kids playing soccer, via Shutterstock

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