Telemedicine for concussions (8/22/19 newsletter)

Aug 26

We are pleased to have Carleton College students and alumni interning with Concussion Alliance. Intern contributors this week:

Editor: Galen Moller
Contributors: Eloïse Cowan, Hannah Kennicott, and Julian Szieff.

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Education

How parents can advocate for concussion protocol for their child’s sports team

Implementing a Concussion Protocol for Your Child’s Team is a recent article by the International Concussion Society. It advises parents on how to speak with representatives of school and club-based athletic programs; they recommend that teams implement the Mayo Clinic Concussion Check program. For more information, see our blog post about the Concussion Check protocol.

Sports

AFL provides concussed players with independent team of experts

A Brisbane Times article by Peter Ryan reports that the Australian Football League has instituted a new program for players suffering from long-term concussion symptoms, providing them access to an independent panel of medical experts. The athletes have a say in which experts will make up the team assessing their symptoms; the experts are assembled on a case-by-case basis. Once selected, the experts work with the athletes to discuss information about their injury, second opinions, and treatment options.

Cannabis

The connection between retired professional athletes and the cannabis industry

Green Entrepreneur recently drew attention to the influx of investments in the cannabis industry by professional athletes. Indeed many former players, such as Joe Montana from the NFL or Riley Cote from the NHL, have launched recreational product brands: Caliva and BodyChek Wellness, respectively. Cote elucidates these decisions stating that “cannabis and sports five or 10 years ago couldn’t coexist in a sentence, and now [cannabis] is looked upon as the ultimate recovery tool”. For players who often suffer from chronic pain or traumatic brain injuries, cannabis could provide an alternative to opioid painkillers while also providing a business opportunity to retired athletes.

Diagnostics

Study finds four prevalent vision dysfunctions after TBI

Optometry and Vision Science published a study concerning four prevalent vision dysfunctions resulting from a TBI. Natalya Merezhinskaya, PhD et al. did a systematic review and analysis of 22 research studies, and found that of patients who had suffered a TBI, 42.8% had accommodative dysfunction (eyes have trouble focusing), 36.3% had convergence insufficiency (eyes unable to work together to view near objects), 18.2% had visual field loss (which was less prevalent with mTBI, compared to moderate and severe TBI), 0% had visual acuity loss (the clarity or sharpness of vision, typically 20/20).

Concussion Alliance would like to point out the 0% in visual acuity loss can lead to a lack of diagnosis for vision dysfunction after a concussion, as the family optometrist will measure primarily for visual acuity. See our page on Vision Therapy.

Therapies

Telemedicine to be implemented in Georgia high schools for concussion testing

An article by mHealth Intelligence shed light on innovative telemedicine usage in Georgia schools for concussion testing and treatments. Starting this fall, the platform will be available for 6,000 high school students, thanks to a partnership between Ware County School District and Gwinnett Medical Center-Duluth’s Concussion Institute. This virtual care program will create a support system involving parents, caregivers, and educators to aid in the diagnostic and elaboration of a care plan for injured students available at a distance. The article underlines that telemedicine in high schools is only the beginning of the integration of mobile health programs in medical centers.

Veterans

Podcast: Army research ream studies brain micro-environment and demyelination post-TBI

Engineer and researcher Ashley Eidsmore was featured on an Army Podcast’s “What We Learned Today” episode to report on research from the Army Research Laboratory of the U.S. Army Combat Capabilities Development Command (CCDC). The lab is studying how traumatic injury changes the structure of brain tissue. Eidsmore explains that the researchers use x-ray diffraction to examine how TBIs affect cellular environments and the demyelination of neurons.

Mental Health

Cognitive behavioral therapy for insomnia also effective for other mood symptoms

In an article in The Conversation, researchers Lianne Tomfohr-Madsen PhD et al. discuss their study of cognitive behavioral therapy for insomnia (CBT-I), a type of psychotherapy. They found that CBT-I “provides remission of insomnia in 80 to 90 percent of adolescents with persistent post-concussion symptoms, and also reduced their post-concussion symptoms, including depression and anxiety. The study, published in Head Trauma Rehabilitation, found a 9% remission rate for those study participants who did not receive CBT-I. The authors also refer to other research which found that “some level of insomnia is present in two-thirds of adolescents with slow recovery from a concussion.”

Statistics

Data from CARE Consortium made publicly accessible through FITBR informatics system

An article by Newswise recapitulated advancements from the NCAA-DoD Concussion Assessment, Research, and Education (CARE) Consortium. Data from CARE is now publicly available through the Federal Interagency Traumatic Brain Injury Research (FITBR) informatics system which was developed by the National Institutes of Health and the Department of Defense. This data not only comprises information on the short-term effects of repetitive head injury but also blood samples, brain scans, demographics, etc. This expansive and accessible database will provide material for researchers to advance the care of athletes and service academy members.

Women's Health

What’s at stake; the story of Brittni Souder and the danger of girls soccer

While concussion in sports discussions often focus on football, in high school by far the biggest culprit is girl’s soccer. While the explanation for this gender gap in concussion risk is debated (some claim a later neck muscle development in girls), the difference of 12.1% more concussions in girls than boys is shocking (34.5% to 22.4%). Watch a TV interview of Brittni Sounder and read more about this important topic in this blog post by Julian Szieff.

Culture

Elon Musk’s company Neuralink announces futuristic neural implant

Scientific American drew attention to Elon Musk’s recent announcement of a neural implant development at the California Academy of Sciences. This device, created by Musk’s company Neuralink, would record and stimulate the activity of individual neurons in the brain in such a way that it would allow quadriplegics to control smart devices with only their thoughts and provide sensory feedback or visual stimulation.

Though this small system of electrodes showcases unprecedented technical innovation, further development is needed before it can reach the height of Musk’s ambition for it. Neuralink states that they face the challenge of rendering the device fully wireless and shrinking electrical connections to create electrodes that do not damage vasculature. Notwithstanding such problems, the company plans to begin human trials by next year.