In about a month, I will be giving a talk about traumatic brain injury (TBI) and how different imaging modalities can assist with diagnosis to a group of mental health professionals in Denver.
Concussion and TBI are something that has been discussed here before (
http://www.cerescanimaging.com/Cerescan-Blogs/The-First-Guy-s-Blog/May-2010-%281%29/Hyperbaric-Chamber-treatments-for-post-concussive-.aspx) and has been in the news frequently.
The National Football League and John Hopkins University recently had a conference and set up some objectives when it comes to head injuries associated with football.
Certainly, the main points that have come out of the meeting will be applicable to high school and collegiate levels sports too.
We should not think that it is only related to football.
Watching the World Cup this weekend and observing the players repeatedly use their heads, just emphasizes the importance of knowing more about TBI and concussion and how they relate to brain health.
The objectives in the NFL meeting were:
“…an Evidence-Base Perspective was to assess the current scientific knowledge on this subject and to make recommendations for the future research needed to answer the remaining questions regarding the diagnosis and treatment of traumatic brain injury (TBI).” *
Four main areas which require additional consideration and recommendation:
1. Biomarker research
There is a call for more longitudinal studies to investigate potential biomarkers for TBI and understand the differentiation of conditions, assess therapeutic interventions, and use imaging modalities (MRI and PET were mentioned) to aid in diagnosis.
2. Long term understanding of neuropsychiatric disorders
Examine players over the long term to understand how TBI and its effects will change over time
3. Research recommendations for chronic traumatic encephalopathy (CTE)
CTE is a pathological condition believed to be caused by repeated head trauma resulting in large accumulations of tau proteins, killing cells in regions responsible for mood, emotions, and executive functioning. The conference suggests research to learn more about the pathology and biology and start a basic research program (using animal models) to test some of these specific hypotheses concerning the cause of CTE.
4. Recommendations for mitigating the consequences of TBI in football
There is a call for more research and a creation of a database to record impacts and hits which will help to establish a medical record and history
So, it is clear that there are merits in these recommendations because it is advancing knowledge pertaining to TBI and basic science associated with TBI. There are some short audio files at the end of the website (http://www.hopkinsmedicine.org/mediaII/TBI.html) which have good basic information about concussion and why it has become so prevalent. Awareness in high school and college is really critical to making sure that people take care of themselves. A point I find particularly interesting is how the very definition of concussion has changed. It used to be that concussion was defined as a loss of consciousness, but now it is recognized that 90% of concussions do not have that. Furthermore, some people who have received a mild TBI or concussion develop some psychiatric conditions with little or no previous history. That makes differential diagnosis difficult, so these recommendations for more research, as well as using brain imaging to increase the chances of making the right diagnosis, is key.
* http://www.hopkinsmedicine.org/mediaII/TBI.html