Limiting screen use may shorten recovery time (9/16/21 newsletter)

Sep 17

Happy Fall! We're back into the swing of things here at Concussion Alliance with another excellent newsletter from our volunteer writers and some exciting updates about our organization!

This Friday (9/17) is National Concussion Awareness Day! Concussion Alliance is running a campaign to spread awareness that a concussion is a treatable, rehabilitative injury. However, we can't do it alone. Check out our Instagram post for more details on how you can help shift public perception about paths to recovery.

We appreciate the volunteers and leadership team members who created this edition:

Writers: Lori Mae Yvette Calibuso Acob, Malayka Gormally, Conor Gormally, Minhong Kim, Alyssa Schaechinger, Josh Wu, Shelly Seth, Wyatt Hill, Will Altaweel, & Ming Shen

Editors: Conor Gormally and Malayka Gormally.

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Opportunities

Clinical Trial for veterans with insomnia & head injury

A clinical trial is enrolling service members and veterans to test the efficacy of an online Cognitive Behavioral Therapy app for insomnia (SHUTi), customized specifically for military members. The study is online; contact the study authors via email at cnrm-ecbti@usuhs.edu or call or text (301) 456-5474; researchers are closing enrollment at the end of September.

Return of UCalgary Online Concussion Course

We are pleased to announce that the superb University of Calgary Online Concussion Course begins on September 13. The course is free, non-credit, self-paced, and built “for those who are interested in preventing, detecting, and managing concussions.” The last day you can register for the course is October 7 – you must finish by November 8.

September 22, 11 am PST: A free, online course, Navigating the New Normal and Experiencing the Benefits of Group Coaching will be presented by Anita Chin, Certified Life Coach. The course is hosted by the Brain Injury Alliance of Washington State (BIAWA). Register in advance.

September 22, 1 pm EST: A free webinar, So I’ve Hired a Personal Injury Lawyer, Now What?, will be presented by the Brain Injury Society of Toronto. Register in advance.

September 29, 1 pm EST: A free webinar, Tips for Brain Injury Survivors from a Personal Injury Lawyer, will be presented by the Brain Injury Society of Toronto. Register in advance.

Education

Video now available: watch Conor’s 8-minute presentation about our unique internship program

This past summer, Concussion Alliance submitted an abstract to the IBIA Virtual World Congress on Brain Injury about our internship program; the abstract was accepted and selected for oral presentation! The presentation, entitled “Bringing Concussion Advocacy to the Next Generation of Healthcare and Public Health Professionals: Concussion Alliance’s Novel Service Learning Undergraduate Internship,” is an 8-minute video that you can view on our website.

If you’ve ever been curious about what the internship program entails, this presentation is for you! If you would like to learn more about the internship program or support our efforts to bring concussion education and advocacy to undergraduate students planning careers in healthcare and public health, please don’t hesitate to reach out via the contact form on our website.

Sports

Study finds association between sports participation history – including exposure to high-risk sports – and concussions in freshman collegiate athletes

Research in Sports Medicine recently published a study by Jaclyn Caccesea et al. investigating the relationship between individuals’ history of sports participation, including estimated age of first exposure (eAFE) to high-risk sports, and concussion history in first-year (i.e., freshmen) collegiate athletes.

The study sample included 9,696 eligible first-year NCAA varsity athletes from 2014-2017 that completed baseline concussion testing. Participants were asked to self-report the years of participation in sports, the type of sport, the number of concussions (athletic- and non-athletic-related), and the dates the concussions occurred. Researchers separated the sports into contact and non-contact categories. Using logistic regression models, they discerned an association between years of sport participation, type of sport, and concussion history among all NCAA athletes. The data demonstrate that each additional year of participation in contact sports increases the risk of concussion by 5% after age 12. However, every year of participation in a non-contact sport decreases the risk of concussion by 3-5%.

This study acknowledges the dangers of contact sports at a young age. Unfortunately, the study is limited by its participant’s self-reported responses and the potential unrecognized or undiagnosed concussions in youth due to the limited medical coverage at youth games. But the implication of a comparatively higher concussion risk in contact sports could point to a possible combination of youth participation in both contact and non-contact sports to mitigate the risk of concussion during childhood. Future studies should also consider factors that impact sports selection and age of first exposure to high-risk sports, such as socioeconomic status or geographic location.

Cannabis & Psychedelics

Wesana Health funds brain research lab to study psychedelics at the University of South Carolina

Wesana Health, a company founded by former NHL player Daniel Carcillo, is funding the formation of the BrainStorm Lab at the University of South Carolina to research traumatic brain injuries (TBI) and treatments.

Carcillo’s company is a “data-driven life science company” that aims to provide individualized treatments that utilize psychedelics for recovering TBI patients. An article from Chicago Inno states that Wesana Health is allocating $1.5 million to research possible treatments surrounding psychedelics, particularly psilocybin, for TBIs. Carcillo founded Wesana after suffering from repeated head impacts and traumatic brain injuries in the NHL that did not improve with various forms of treatment. He states that therapeutic psilocybin worked better than any other treatment.

In November 2020, a law was passed in Oregon that legalized medical psilocybin for treating depression, anxiety, and addiction. This law increased the amount of research towards the additional benefits of psychedelic drugs, and the BrainStorm Lab is aiding in analyzing its widespread potential uses.

The lab will work with patients who have endured traumatic brain injuries, such as athletes, Olympians, people who have been in the military, and other TBI patients. Patient evaluations are expected to start in the next six months, with hopes of improving neurological and cognitive performance.

Diagnostics

Neurolytixs seeks regulatory approval for groundbreaking blood test diagnosis of concussion

Clinical scientists at Neurolytixs have discovered a way to change concussion diagnosis amongst young athletes: with a prick of a finger. This game-changing technology yields up to 96% accuracy with the help of artificial intelligence. Currently, the test is limited to youth athletes, but the company hopes to expand its use to clinical and military settings eventually.

In an article published in The London Free Press, Douglas Fraser, co-founder of Neurolytixs, explained the dynamics of the blood test. According to Fraser, the blood test looks at metabolite markers, such as changes in lipid levels, after a concussion. To determine such changes, young athletes provide a blood sample at the start of the season as a baseline measurement. If a possible concussion occurs, the athlete will give a new blood test within 72 hours of the incident to compare against the athlete's original sample. Within 20 minutes, lab analysis can determine whether or not the athlete has a concussion.

Currently, concussions are diagnosed through a subjective process of physical, cognitive, and behavioral observations. The Neurolytixs blood test claims to offer a quantitative measure of concussion through analysis of changes in four lipids whose levels decrease following a concussion. This novel approach has the potential to provide better diagnosis, protecting the long-term health of young athletes.

Neurolytixs is now moving forward for the FDA for full regulatory approval.

Self-care

Concussions may impair patients’ sense of smell

A press release from the University of Montreal, published in Science Daily, describes how researchers have found that even mild concussions can result in an impaired sense of smell and elevated anxiety. One study examined hospital patients admitted for concussions and patients with broken bones but no concussion. Within 24 hours of injury, over 50% of concussion patients reported a reduced sense of smell compared to 5% of patients with broken bones. Another experiment found that concussion patients’ sense of smell eventually returned. However, their reported anxiety did not return to pre-accident levels, with 65% of patients reporting anxiety symptoms a year later. Although further research needs to be done, a reduction in one’s ability to smell has the potential to provide another indicator of a concussion.

Therapies Under Research

Omega-3 fatty acids improve concussion outcomes in mature male rats

A review study by Craig S. Patch et al., published in Current Neurology and Neuroscience Reports, found that high clinical doses of omega-3 fatty acids improved concussion outcomes for mature male rats. This systematic review consisted of 18 articles that met the authors' inclusion criteria.

The studies included used water maze, rotarod, and beam walking performance to assess neurological and cognitive outcomes in male rats. Researchers found that motor, sensory, reflex, and balance function better in male rats administered with omega-3 fatty acids at 7+ days post-injury.

While most of the articles reviewed adhered to ARRIVE (animal research) guidelines, criteria for proper sample size and statistical methodology were sometimes not met. Specifically, some authors did not clearly describe selection, performance, and detection bias.

Despite these limitations, this systematic review suggests that omega-3 fatty acids improve concussion outcomes for mature male rats. However, more studies need to be conducted to verify these findings.

Youth

Study finds that limiting screen time following a concussion may shorten recovery time

See our blog post to read this synopsis.

Women's Health

Female athletes are less likely to be removed from play following a sport related concussion

A recent study by Aaron Zynda, published in The American Journal of Sports Medicine, examines the differences in sport removal rates following a sport-related concussion (SRC) in male and female athletes. This study focused on sex-comparable sports – sports with direct male and female counterparts – such as men’s and women’s basketball. In this study, all SRCs were recorded in the institution’s Head Injury Reporting System (HIRS). Any athlete who suffered an SRC was placed into one of two categories: Removed from play (at the time of injury) or not removed from play (their injury was not addressed immediately, and they continued playing).

Over 4000 SRCs were included in this study, with most of which coming from female soccer players. Following analysis, the authors determined that female athletes were less likely to be removed from gameplay than their male counterparts in the same sport. This finding is concerning, as the cause of this difference is unknown. There are many potential reasons for this outcome, including lower reporting rates from females or negligence by athletic trainers and coaches. Overall, it is crucial for future research to examine what is causing this difference in removal rate following SRCs, as the continued difference would be very concerning for the health of female athletes.

CTE and Neurodegeneration Issues

Kyle Krull’s story demonstrates the significance of CTE in young athletes

A recent article published in the Chicago Sun-Times tells the story of Kyle Krull, a 25-year-old former football player who suffered from chronic traumatic encephalopathy (CTE) – a neurodegenerative disease associated with repetitive head impact.

Krull was a successful football player throughout high school and into college. However, it became evident that chronic headaches and post-concussion symptoms were already beginning to impact him during his high school football career. After playing football at Western Illinois University for one season, Krull decided to quit and transfer to Western Michigan. However, Krull was already experiencing more severe symptoms, such as irritability, sleeping difficulties, and cognitive problems. Upon graduating from college, his symptoms worsened, as he began to lose feeling in his extremities and had emotional outbursts that he later was unable to remember.

Unfortunately, CTE is not a neurodegenerative disease that is possible to officially diagnose before death. Although its likelihood of manifestation is attributed to the amount of repetitive head injuries an individual experiences, the cognitive and behavioral symptoms are too closely similar to those of other neurocognitive diseases, making diagnosis prior to death very difficult. CTE diagnosis is primarily made post-mortem with a brain autopsy.

Sadly, Krull committed suicide in the summer of 2019 and was diagnosed with CTE posthumously. His family hopes that people will show a continuous effort to learn about CTE and that contact sports work to enforce changes to protect athletes from head injuries.