NCAA Div 1 athletes put the needs of the team over their health (5/16/19 newsletter)

May 16

Welcome to the Concussion Alliance Weekly Update Newsletter! If you like this newsletter, forward it to a friend and suggest they subscribe.

Education

The American Speech-Language-Hearing Association is hosting a live online chat with Pamela A. Smith, Ph.D. from Bloomsburg University about traumatic brain injury in older people and its impact on cognitive function. The talk, sponsored by SIG 15 Gerontology, is on Tuesday, May 21 from 7:00 p.m.–9:00 p.m. EST.

Sports

A study published in PLOS ONE reveals that NCAA Division 1 athletes strongly consider the needs and culture of their team when determining whether or not they will report concussion symptoms. Authors Corman et al. also found that most athletes did not consider concussion education memorable; were uncertain about the probability of negative consequences for their head injuries; and believed that if there were any consequences, they would not arise until later in life.

When should an athlete retire from contact sports? Dr. Cameron Marshall DC, in Ask A Concussion Doc podcast, suggests that the most important factor is not the number of concussions, but how well the athlete has recovered from each concussion. Marshall discusses numerous research studies that indicate that while symptoms are gone within an average of 10-15 days (for adults), the brain has not fully recovered for 30 days. Typically athletes are returned to sport when symptoms are gone, resulting in a return to play while the brain is still vulnerable to further injury. Episode 45. SoundCloud, iTunes, YouTube

In an interview with Omnisport, FIFPro vice-president Francis Awaritefe challenged the current FIFA safety guidelines regarding concussions. Addressing Jan Vertonghen’s controversial return to play following a concussion during the UEFA Champions League (soccer), Awaritefe said that “the game's administrators aren't taking it [concussions] seriously at all,” and that until the health of players comes first, situations like Vertonghen’s will continue to occur.

Mental Health

A study published in the Journal of the International Neuropsychological Society examined the relationship between psychological resilience and post-concussion symptoms (PCS) in adolescents ages 13 to 18. The researchers, Christianne Laliberté Durish et al., hypothesized that one of the reasons lower psychological resilience is a predictor of persistent PCS is that lower resilience is associated with anxiety and depressive symptoms. They surveyed 93 adolescent patients who were experiencing persistent PCS and cognitive problems over a month after their concussions occurred. Their results indicate that the anxiety and depressive symptoms associated with lower psychological resilience could play a role in whether or not adolescents experience PCS.

Children with more severe ADHD have higher incidences of mild traumatic brain injury, according to Semir Karic et al. in Child: Care, Health, and Development.

Diagnostics

Veterans with persistent symptoms from combat-related concussions have abnormal levels of gamma waves in their brains, as measured by a neuroimaging technique called magnetoencephalography, or MEG. In a study published in Cerebral Cortex by Ming-Xiong Huang et al., the level of gamma waves were elevated in brain areas associated with cognitive functioning, and the participants with elevated gamma waves had poorer performances on tests of executive functioning and visuospatial processing. The level of gamma waves were lower in brain areas associated with emotions such as fear, anxiety, and depression. According to an article in News Medical, Huang suggests that MEG scan could be used as a diagnostic tool, saying it is 85% accurate for the diagnosis of mTBI, although there are only 20 to 30 MEG scanners in the United States.

The Department of Defense Medical Labs has developed a new assessment tool that monitors the levels of cortisol, luteinizing hormone, and testosterone. It could lead to earlier clinical diagnoses of mTBIs in service members, which may increase opportunities for treatment.

Complimentary & Alternative Therapies

A retrospective cohort study in Japan found that patients with traumatic brain injuries who were treated with acupuncture had a significantly decreased risk of developing dementia. The study looked at 15,440 TBI patients, ages 20-70 years old, who were diagnosed with a TBI between 1998 and 2007. At the end of the study period in 2012, authors Ying-Hsu Juan, MD, et al. found that the TBI patients who had acupuncture had a 42% lower risk of developing dementia than the TBI patients who did not get acupuncture. The study, published in The Journal of Head Trauma Rehabilitation, noted that “those who received more than five sessions of acupuncture benefited most from it.”

Therapies Under Development

Brain wave researchers Ming-Xiong Huang and his group believe that their discoveries about abnormalities in brain waves of concussed patients could guide the use of brain stimulation for concussion recovery. They are studying the use of transcranial electrical stimulation (TES) and transcranial magnetic stimulation (TMS). According to NeuroScience News, “Huang and his team are currently working with two TES [transcranial electrical stimulation] companies to gain approval of their brain stimulation instruments by the U.S. Food and Drug Administration.”

Helmets

The conflation of concussion prevention and social equity has a new front. While wealthier areas are purchasing the new Vicis Zero1 Youth football helmets for their teams, Geekwire reports that less affluent teams are crowdfunding to raise the money needed to buy the Vicis helmets, which sell for $495 each. This is the first year that Virginia Tech has released youth football helmet ratings. According to their ratings, the Zero1 Youth helmet was associated with a hypothetical risk of concussion that was 67% lower than the second-place helmet. High school football teams will pay more, as they will need the larger size Zero1, which costs $950. Vicis is only two years old, but already their helmets are used by 28 NFL teams and 120 NCAA teams. The company provides discounts up to 20% for team orders, and discounted service rates for teams crowdfunding on FundMyTeam.

A newly-funded project at the University of Colorado is using computer models of helmets provided by the NFL to perform computer-generated tests evaluating helmet safety. Their goal is “to improve helmet safety using a recently developed high-performance polymer called liquid-crystal elastomers (LCEs).” The project was selected as part of the 2019 cycle of Pac-12 Student-Athlete Health and Well-Being grant funding.

CTE

The Financial Times named The Beautiful Brain as the podcast of the week: “The Beautiful Brain is a four-part podcast from Audible that examines how far the world has come in recognizing CTE and how far it has yet to go. Research carried out by doctors, pathologists and neuroscientists is increasingly plentiful but the sporting world remains largely in denial. Produced and presented by Hana Walker-Brown, the story takes us in unexpected directions, from the football pitch and academics’ offices to support groups for victims of domestic violence (as well as affecting sports men and women, victims of physical abuse have also shown symptoms of CTE).”