The theory of neuroplasticity holds that the brain will change and adapt to different conditions including to childhood injuries. This theory is often challenged and sometimes referred to as a “myth.” However, a new study by Seena Fazel and colleagues from the Department of Psychiatry at University of Oxford in the United Kingdom delivered data that supports the claims of neuroplasticity theorists. Fazel’s conclusions reveal that the later a mild TBI is sustained, the worse the health and social outcome is for the patient. The study also found a causal effect between childhood Traumatic Brain Injuries (TBIs) and the risk of brain impairment and social dysfunction at later stages in life.

Dr. Fazel and colleagues used national registers in Sweden covering 1.1 million individuals born between 1973 and 1985 to determine whether children and adolescents experiencing milder forms of TBI would have significant medical and social problems in adulthood. The researchers identified all those who had sustained at least one traumatic brain injury up to the age of 25 and their unaffected siblings. The data sets used allowed the team “to examine the extent to which injury severity and recurrent injuries predict a range long-term outcomes.” The authors wrote about five principal findings.

• First, they found a connection between suffering a mild TBI and a) disability pension; b) psychiatric visits; c) inpatient hospitalization; d) premature mortality; e) low educational attainment; and f) and receipt of welfare benefits. The risk of these outcomes was increased between 18-52%.

• Second, they found that the greater the initial injury the greater the negative outcome. As an example, the percentage of risk for disability pension skyrocketed to 106% compared to uninjured siblings.

• The third finding revealed that recurring TBIs—such as multiple concussions from sports activities—resulted in even worse outcomes

• Fourth, they found the association with those who had TBIs across the indicators showed a 1-6% higher chance of poor adult performance.

• Fifth, which should help direct attention to preventative measures; they found a correlation between the age of the injury and the long-term outcomes. “The older the age at first head injury, and particularly after the age of 15 years, substantially increased the risks of all examined outcomes.”

The team was able to include people who had died young to evaluate the idea of neuroplasticity in TBI patients. The findings, which need to be further validated, were consistent with the “hypothesis that neuroplasticity in early life may have long-term protective effects.” These effects were most noticeable in relation to psychiatric hospitalization and they increased with the age of injury (i.e., there was less effect on those who had a first TBI between 0-4 years than those who sustained one between 20-24 years). The research team did not find any factors other than neuroplasticity to explain the differences.

The study provides direction for TBI treatment at different ages of injury. Fazel calls for age-sensitive clinical guidelines and preventive strategies for children and adolescents; guidelines that take into account the long term health and social effects of early TBIs. Even mild TBIs can be considered serious—especially if they are recurring from sports or other activities.