Exploring the Evolving Approach to Concussion Care

The 4th Annual Updates in Neurology CME Symposium, hosted by Northwestern Medicine, will bring together neurology specialists on October 9, 2026, in Chicago to discuss the latest advances in the diagnosis, treatment, and management of a broad range of neurologic conditions. The 1-day symposium will feature evidence-based presentations covering topics across neurology, including movement disorders, sleep medicine, headache, neuromuscular disease, epilepsy, Alzheimer disease, multiple sclerosis, neuro-ophthalmology, and neuroradiology.

Among the featured presentations is “Updates in Concussion,” led by Kyle Marden, MD, a sports neurologist and medical director of the Concussion and Sports Neurology Program at Northwestern Medicine. In his presentation, Marden will provide an overview of the latest developments in concussion care, addressing evolving approaches to evaluation and management as well as areas of ongoing research. He also will discuss some of the challenges clinicians continue to face when caring for patients with concussion.

To gain more insight into his presentation, NeurologyLive^® sat down with Marden. In this interview, Marden discusses the current state of concussion care, recent developments in the field, and some of the questions that remain as clinicians and researchers work to improve diagnosis, treatment, and recovery.

NeurologyLive: Can you provide a general overview of your talk updates in concussion delivered at the Updates in Neurology CME Symposium?

Kyle Marden, MD: My talk is about the updates in concussion. As we know, concussion care is kind of like a maze. What do I do in the beginning and at the end? How do I get back to my activities of life and my quality of life?

That’s what the talk is about: talking about the updates in regards to what is concussion, how do we treat it, are there biomarkers that can help with diagnosis, and give a program or a guideline for physicians and providers to take back to help our patients get back to their activities of life.

What are some of the key points or main takeaways from the talk?

One of the main points, back several years ago, was “rest is best,” such as rest of the brain. But sometimes we can rest a little bit too long. What I mean by that is rest for about 24 to 48 hours is the best in the beginning. Then we want early return to activity, whether it be cardiovascular exercise, back to their academics, or back to cognitive activity.

If you think about it, your brain’s used to all this activity, so we want to have that gradual return. We want to give the brain back that stimulation that it was used to. We’ve seen that this is actually helpful for earlier return.

So, it’s not necessarily just sitting in a dark room and doing nothing for a prolonged period of time. We want that gradual return to activity and to get people back to their normal activities while still being mindful of their symptoms and their recovery.

What is exciting you in the concussion space right now?

In this space, it’s more biomarkers, whether that be blood-based biomarkers, imaging-based, or even using devices to help with earlier diagnosis.Because right now, our diagnosis is based on symptoms. That’s the gold standard. So with research, we’re trying to find what can be the most helpful to assist in our symptoms, especially when symptoms are minimal.

If you can really, truly objectively say that this person’s had a concussion, that can be very helpful. Right now, we’re relying on what the patient is telling us, what their symptoms are, and what we see during our evaluation. So if we can have something that gives us that objective information, especially early on, that could be really helpful.

Previously, you discussed the findings of your research on the feasibility of pupillometry in concussion diagnosis and recovery monitoring in collegiate athletes. Since then, have you noticed any changes in the application of these findings in the real world, or in reviewing the endpoints or analysis of the study?

Biomarkers, especially imaging, as a potential are helpful from a group-based perspective, seeing a change from the group of no concussion versus someone that’s had a concussion. But we’re finding more difficulty with individuals and finding that signal within person to person.So that’s a difficulty, especially with biomarker research, is finding that individuality for a diagnosis. We’re trying to work through that with our research.

It’s one thing to say that we can see a difference between a group of people who have had a concussion and a group who haven’t. But then, when you have an individual patient sitting in front of you, can you use that same information to say, “Yes, this individual has had a concussion”? That’s where some of the difficulty comes in, and that’s something we’re continuing to work through.

Is individualized concussion care something that you could see happening in the next 3 to 5 years?

I’d say we kind of already do that now, even with our initial evaluations, finding out who you were before the concussion and finding those risk factors that may put you into that category at risk for persisting symptoms with concussion.

Did you have prior migraines? Did you have prior issues with sleep? Did you have prior issues with vision? Because sometimes concussion can make those higher risk factors a little bit worse. So you may have more frequent migraines, or you may have even more trouble with sleep. Our job as physicians is to key in on those patients and do earlier treatment, maybe bemore aggressive with their rehabilitation.

We’re already trying to individualize care based on who that person was before the concussion and what their risk factors are. As we learn more and have more research, hopefully we can become even more individualized in how we diagnose and treat these patients.

If you had to tell clinicians just one piece of important information that they should remember regarding concussion diagnosis or management, what would it be?

Really, it goes back to our earlier discussions: early return to activity. We don’t want people to be stuck in a cave where they’re doing nothing for weeks on end. 

We also don’t want people to do too much in the beginning, go back fully to their activity, and maybe have a further risk for head injury, especially in that early phase of recovery.

That gradual, stepwise recovery is key. That can help individuals recover faster. Soit’s finding that balance between not doing anything and doing too much too soon.

Are there any final thoughts you have on the current state of the concussion space?

I’d just like to say again that concussion care is like a maze. There’s been so many updates in the last 10 years, the last 5 years, even over the past couple of years.

I’m really excited about where the future of concussion is going because, as we do more research and find more information, we are helping more individuals and being more efficient in getting those people back to their daily activities and quality of life.

I think that’s really the goal: finding better ways to diagnose concussion, better ways to treat it, and ultimately getting people back to their daily lives and their quality of life.

Transcript edited for clarity.