The Food and Drug Administration on Wednesday approved a first-ever blood test to detect the telltale signs of serious brain injury, bringing to fruition a long quest to make the diagnosis of concussions simpler and more precise.
After deliberations that took less than six months, the FDA approved the marketing of the Banyan Brain Trauma Indicator to aid the evaluation of concussions in adults. The speedy approval of such a blood test, after it was assigned the FDA designation of a “breakthrough” product, is expected to drive down the number of CT scans performed on patients who seek emergency-room care for a possible concussion, reducing both costs and patients’ exposure to radiation.
The new test identifies two brain-specific proteins that appear in the blood within 12 hours after a brain injury. Levels of these two proteins — Ubiquitin Carboxy-terminal Hydrolase-L1 and Glial Fibrilliary Acidic Protein — released from the brain into the blood can help predict which patients may have brain lesions visible by CT scan and which won’t.
Adolescent female athletes suffer concussion symptoms twice as long as their male counterparts, according to a new study in The Journal of the American Osteopathic Association. Researchers found the extended recovery period may be due to underlying conditions including migraines, depression, anxiety and stress.
The research analyzed the medical records of 110 male and 102 female athletes, ages 11 to 18, with first-time concussion diagnoses. The median duration of symptoms was 11 days for boys and 28 days for girls. The data also showed that symptoms resolved within three weeks for 75 percent of boys, compared to 42 percent of girls.
“These findings confirm what many in sports medicine have believed for some time,” said lead researcher John Neidecker, DO, a sports concussion specialist in Raleigh, North Carolina. “It highlights the need to take a whole person approach to managing concussions, looking beyond the injury to understand the mental and emotional impacts on recovery when symptoms persist.”
Youth football players are exposed to more and more forceful head impacts as they move up in age- and weight-based levels of play, according to researchers at Wake Forest Baptist Medical Center.
Their study, published in the June issue of the Journal of Neurotrauma, employed in-helmet sensors to record the number and location of impacts and the linear and rotational acceleration they caused to the heads of 97 players ages 9 to 13 in one youth football organization during practices and games at three different levels of competition over four seasons
“By recording more than 40,000 head impacts, this study represents the largest collection of biomechanical head impact data for youth football to date,” said study author Jillian Urban, Ph.D., assistant professor of biomedical engineering at Wake Forest School of Medicine, a part of Wake Forest Baptist. “Our findings clearly show a trend of head impact exposure increasing with increasing level of play.”
The relationship between head injuries suffered during contact sport and Alzheimer’s disease is now being called into question thanks to research by the Sahlgrenska Academy, which has revealed that hockey players with multiple concussions probably have other injuries in their brains.
“There seem to be two separate conditions and pathologies involved here,” says Pashtun Shahim, a doctor and researcher of neurology and physiology.
He himself has met the 28 sportspeople who were the subjects of the research, the majority of whom were elite ice hockey players from Sweden (both male and female).
All of them had experienced long-term problems after suffering concussion on multiple occasions, with complaints including sensitivity to noise and light, irritability, depression, difficulty concentrating and memory problems.
In what authors say is the largest-scale study to date, an analysis of high-school soccer injuries from 2005 to 2014 reveals similarly increasing rates of concussion among boys and girls but differences in nonconcussion injuries, with boys’ rates dropping while girls’ rates hold fairly steady. Researchers believe the data they’ve collected may help coaches and trainers create more targeted injury prevention programs.
Overall, injury rates during the study period were recorded at 2.06 per 1,000 “athletic exposures” (AEs)—defined as “a single athlete participating in a single practice or competition.” That works out to 6,154 injuries in the study group (55.4% sustained by girls and 44.6% by boys), which researchers say corresponds to an estimated 3.38 million injuries nationally for the 10-year study period. Data were drawn from the National High School Sports-Related Injury Surveillance System, High School Reporting Online (RIO), based on a nationally representative sample of 100 schools in the US. The study appears in the British Journal of Sports Medicine.
Recent research indicates that a concussion increases the risk of musculoskeletal injury. Neuromuscular changes after concussion might contribute to the increased risk of injury. Many studies have examined gait postconcussion, but few studies have examined more demanding tasks. This study compared changes in stiffness across the lower extremity, a measure of neuromuscular function, during a jump-landing task in athletes with a concussion (CONC) to uninjured athletes (UNINJ).
A Canadian study published in JAMA turns the current thinking on postconcussion physical activity on its head. According to researchers, early return to physical activity within 1 week of concussion may actually decrease the likelihood of persistent symptoms in the pediatric population.
The prospective cohort study included 2,413 children and adolescents between the ages of 5 and 18 years. At 7 days and at 28 days postinjury, participants filled out questionnaires about their physical activity and rated their postconcussion symptoms using the Post-Concussion Symptom Inventory. Of the respondents, 30.5% rested for the first 7 days, and 69.5% participated in some sort of physical activity, including light aerobic exercise, sport-specific exercise, noncontact drills, full-contact practice, or full competition.
Authors of a new study of college athletes say that concussion creates a “window of susceptibility” in players that more than triples the risk of a later lower extremity musculoskeletal injury over nonconcussed athletes. This finding, they write, “implies that return-to-play guidelines may not be sufficient … to protect athletes” from other, later injuries.
Researchers tracked injury patterns among 73 concussed athletes (52 male, 21 female) in the University of Florida’s football, lacrosse, soccer, and basketball programs, pairing each athlete with 2 nonconcussed athletes who played the same sport and position. The concussed athletes in the study—referred to by authors as the “exposed” athletes—were all returned to play with at least 30 days left in the season. Monitoring of in-season injury incidence continued for the rest of the season, or as much as 90 days after return to play, whichever came first. Athletes with a history of concussion within the past 6 months were excluded, as were those whose concussions occurred outside the competitive season.
A new study of 5 years’ worth of concussion data from NCAA sports reveals that men’s wrestling is the sport with the highest rate of sports-related concussion (SRC), but men’s football remains on top in terms of the sheer number of athletes who experience SRC while in practice or competition. And in men’s and women’s sports that can be directly compared—lacrosse, ice hockey, soccer, and others—female athletes tend to have higher rates of SRC than their male counterparts.
Researchers analyzed statistics from the NCAA Injury Surveillance Program (ISP) and found that between the 2009-2010 and 2013-2014 academic years, the overall SRC rate was 4.47 per 10,000 athlete exposures, or about 10,560 SRCs annually. Among reported SRCs, about 1 in 11 was recurrent. In almost every sport, the majority of SRCs occurred in practice, while the actual rates of SRCs were higher in competition settings.
Topping the list in terms of SRC rates was men’s wrestling, which reported an overall rate of 10.92 per 10,000 athlete exposures. Next was men’s ice hockey at 7.91, followed closely by women’s ice hockey at 7.52. Men’s football had a 6.71 rate of SRCs, but with an estimated 3,417 SRC incidents annually, it took the position as the sport that produced the most SRCs overall. Research results were published in the American Journal of Sports Medicine in September.
An upcoming film that tells the story of the forensic pathologist who first identified chronic traumatic encephalopathy (CTE) through work with professional football players is already drawing attention for its portrayal of the sport. Still, some believe the studio behind the movie may have softened its approach in fear of reprisal from the National Football League (NFL), according to a recent article from the New York Times (NYT).
Concussion follows Bennet Omalu (as played by Will Smith) as he uncovers the degenerative brain disease and links it to repeated blows to the head suffered by pro players. According to the NYT article, the discovery “led to one of the NFL’s biggest crises: a possibility that the game itself could be lethal.” A trailer for the movie was released in late August.
While the movie does address the link between CTE and pro football, a NYT review of leaked emails to and from Sony Pictures Entertainment, the film’s maker, reveals what reporters describe as discussions about “how to avoid antagonizing the NFL by altering the script and marketing the film more as a whistle-blower story, rather than a condemnation of football or the league.”