Researchers from Berkeley, Duke, UNC Chapel Hill and University of Arizona used a new type of MRI called “diffusion kurtosis imaging” (“DKI”) to take brain scans of 16 high school football players, ages 15 to 17, before and after a single season of football. DKI is an extension of Diffusion Tensor Imaging, (DTI) discussed in prior posts. Early studies suggest that it outperforms DTI in capturing certain microstructural changes in the brain. The football players who were scanned all wore helmets and none of them were diagnosed with a concussion. The researchers also measured head impact exposure during every practice and game using the Head Impact Telemetry (HIT) system, which has been widely used in other head impact studies. The study, which is the cover story of the November issue of the journal Neurobiology of Disease, is one of the first to look at how impact sports affect the brains of children at this age.
There’s new evidence supporting immediate removal of athletes from play following concussion.
A new study published in the September, 2016 issue of Pediatrics provides evidence that returning to play immediately following a sports related concussion, even without a “second impact” nearly doubles, on average, the length of time required to recover and exposes athletes to a greater risk of protracted symptoms. As the authors point out in their report, the Institute of Medicine and National Research Council stated in 2013 that
“the culture of sports negatively influences SRC [sports related concussion] reporting and that athletes, coaches, and parents do not fully acknowledge the risks of playing while injured.”
Sony Pictures has made a movie about the devastating long term effects of concussion in professional football players, and the NFL’s efforts to cover this up. Will Smith stars as Nigerian doctor Bennet Omalu, the pathologist who first discovered the prevalence in players of a degenerative disease known as chronic traumatic encephalopathy (CTE). A trailer for the movie has just been released and can be seen here.
This movie promises to bring even greater public attention to the growing body of evidence, discussed in many past posts in this blog, demonstrating that concussion can in some cases trigger a chronic degenerative process with permanent consequences. Read More
The New England Journal of Medicine has published the most exhaustive analysis to date of brain injury in children and adolescents. The results reinforce the critical importance of safety helmets for children under 12 and the importance of safety helmets and seatbelts for adolescents.
The data analyzed in the study was from over 40,000 pediatric brain injuries. The most common cause of trauma in children under 12 was falls, often from bicycles. Motor vehicle accidents, sports injuries and assaults were the most frequent mechanisms of injury among adolescents. Read More
Findings released on November 25, 2014 in the Journal of Neurotrauma indicate that the presence of a blood protein known as SNTF shortly after a sports-related concussion can predict the severity of post-concussion symptoms in professional athletes.
The authors of the study – Robert Simon, PhD, and Douglas H. Smith, MD, professor of neurosurgery and director of the Center for Brain Injury and Repair at the University of Pennsylvania – noted upon release of this study of SNTF in concussion patients that
“these observations lend further support to the growing awareness that concussion is not trivial, since it can induce permanent brain damage in some individuals.”Read More
Good News for Future Players, Bad News for Past and Current Players Left to Seek Compensation on an Individual Basis
On July 29, 2014, the NCAA and representatives of college athletes announced an agreement to settle a concussion class action lawsuit that came on the heels of a similar lawsuit against the NFL. The settlement will need to be approved by the Court, a process that could take several months. It is anticipated that several former athletes experiencing the long-term effects of concussions suffered in college sports will object to the settlement, since it does not provide any direct compensation – unlike the proposed settlement in the NFL case. Players with concussion claims are left to pursue those claims on an individual basis. Read More
Several recent developments demonstrate increasing recognition of the serious potential consequences of concussion, and commitment to minimize those consequences through appropriate treatment of concussion:
Physicians have an ethical obligation to become knowledgeable about concussion.
On June 9, 2014 the American Academy of Neurology, the largest professional association of neurologists, released a position paper stating that doctors have an ethical obligationto educate and protect athletes from sports concussion and clear them to play only when the athlete is medically ready, standing firm against objections from players, athletes and coaches. The statement declares that sports concussion “is a major issue in the world of health care” and requires more attention from physicians. Read More
Most current guidelines recommend “cognitive rest” during the initial stages of recovery from concussion. “Cognitive rest” involves limiting activities that require attention and concentration such as reading, doing homework, text messaging, playing video games, working online, watching movies and television and listening to music. Cognitive rest has been recommended in the past based on somewhat limited evidence suggesting that failing to minimize these activities in the early stages following a concussion could delay recovery. Read More