MedicalResearch.com Interview with: Claudia Robertson, MD Professor, Department of Neurosurgery Baylor College of Medicine One Baylor Plaza Houston, Texas 77030 Medical Research: What are the...
MedicalResearch Interview with:
Patrick S. F. Bellgowan, PhD
Laureate Institute for Brain Research
Faculty of Community Medicine, The University of Tulsa,
Tulsa, Oklahoma
MedicalResearch: What are the main findings of the study?
Dr. Bellgowan: These results demonstrate 14% and 24% smaller hippocampal volumes in collegiate football players with and without a history of concussion relative to education-, sex- and age-matched controls participants. Further, the number of years of tackle football experience was correlated with smaller hippocampi and slower baseline reaction times. The hippocampus plays a key role in memory and emotional regulation. Volumetrics of other medial temporal lobe structures (I.e. The amygdala) did NOT show differences among groups suggesting that this effect is localized to the hippocampus.
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MedicalResearch.com Interview with:
Jane Topolovec-Vranic, PhD
Clinical Researcher, Trauma and Neurosurgery Program
Assistant Professor, Department of Occupational Science and Occupational Therapy, University of Toronto
Associate Member, Graduate Department of Rehabilitation Sciences, University of Toronto
MedicalResearch.com What are the main findings of the study?
Answer: In our study we found that almost half of the men interviewed in a homeless shelter in Toronto had experienced a traumatic brain injury in their past, and that most of them had experienced their first brain injury prior to becoming homeless, usually in the early teenage years.
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MedicalResearch.com Interview with:
Pashtun Shahim, MD
Clinical Neurochemistry Laboratory
Institute of Neuroscience and Physiology
Department of Neurochemistry
Sahlgrenska University Hospital, Mölndal
Sweden
MedicalResearch.com: What are the main findings of the study?
Dr. Shahim: Sports-related concussion in professional ice hockey players is associated with acute axonal and astroglial injury. Plasma total tau, which is a highly central nervous system-specific protein, is a promising biomarker to be used both in the diagnosis of concussion and in the decision-making when an athlete can be declared fit to return to play.
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MedicalResearch.com Interview with:
Steven Rowson, Ph.D.
Research Assistant Professor
Virginia Tech
Wake Forest University
MedicalResearch.com: What are the main findings of the study?
Dr. Rowson: We found that there were large differences in concussion risk between football helmet types. This is the first study to address this question while controlling for the number of times each helmet type was impacted.
This allowed us to compare apples to apples. For example, we're not comparing starters who frequently get hit in one helmet type to second string players who don't get hit as much.
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MedicalResearch.com Interview with:
John W. O'Kane M.D.
Associate Professor Family Medicine and Orthopaedics and Sports Medicine
Medical Coordinator, U.W. Intercollegiate Athletics
University of Washington Sports Medicine Clinic, Seattle
MedicalResearch.com: What are the main findings of the study?
Dr. O’Kane: In 11 to 14 year old female elite soccer players the concussion incidence was 13% with a rate of 1.2 per 1000 athletic exposures. Symptoms lasted a median of 4 days and players with light or noise sensitivity, emotional lability, memory loss, nausea, and concentration problems took significantly longer to recover. Heading the ball accounted for 30.5% of concussions and the vast majority of concussions (86%) occurred in games. The majority of players (58.6%) reported playing with symptoms and less than half (44.1%) sought medical attention for their symptoms. Those seeking medical attention were symptomatic longer and were less likely to play with symptoms.
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MedicalResearch.com Interview with:
William P. Meehan III, MD
Director, Micheli Center for Sports Injury Prevention
Director, Sports Concussion Clinic, Boston Children?s Hospital
Waltham, MA 02453
MedicalResearch.com: What are the main findings of this study?
Dr. Meehan: The study has 2 findings that I believe are the most worthy of attention. First, although cognitive rest has been recommended as a therapy for concussion for several years now, there has been little data showing its effect. This lack of data has led to variability in the recommendations for cognitive rest, with some experts not recommending it all, and others recommending athletes avoid all cognitive activity, lying alone in a dark room even, until they are completely recovered. As you can imaging, this has generated controversy. We believe this is the first study showing the independent, beneficial effect of limiting cognitive activity on recovery from concussion.
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MedicalResearch.com Interview with:
Dewleen G. Baker, MD
Department of Psychiatry
School of Medicine, University of California,
Veterans Affairs San Diego Healthcare System
Veterans Affairs Center of Excellence for Stress and Mental Health
San Diego, California
MedicalResearch.com: What are the main findings of the study?
Dr. Baker: Pre-deployment psychiatric symptoms, combat intensity, and traumatic brain injury (TBI) were significant predictors of post-deployment PTSD symptom severity. However, the strongest predictor was deployment-related TBI; mild TBI increased symptom scores by 23%, and moderate to severe injuries increased scores by 71%.
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MedicalResearch.com Interview with:
Miranda M. Lim, MD, PhD
Assistant Professor, Sleep Medicine
Division of Pulmonary and Critical Care
Portland VA Medical Center and Oregon Health & Science University
MedicalResearch.com: What are the main findings of the study?
Dr. Lim: People with traumatic brain injury (TBI) often have persistent sleep-wake disturbances including excessive daytime sleepiness and nighttime insomnia, yet the link between a hard blow to the head and drowsiness remains a mystery. We report that a dietary supplement containing branched chain amino acids helps keep mice with TBI awake and alert. The findings suggest that branched chain amino acids, something all humans produce from foods in their normal diets, could potentially alleviate sleep problems associated with TBI. In experiments with brain-injured mice that had trouble staying awake, we found that feeding the animals a dietary supplement enriched with branched chain amino acids improved wakefulness. Treated mice not only stayed continuously awake for longer periods of time, they also showed more orexin neuron activation, neurons known to be involved in maintaining wakefulness. (Previous studies have shown that people with narcolepsy lose significant amounts of orexins.) Branched chain amino acids are the building blocks of neurotransmitters, the chemicals released by neurons in the brain, including glutamate and GABA. We believe that branched chain amino acids act to restore the excitability of orexin neurons after brain injury, which could potentially promote wakefulness. Further studies are needed to pinpoint the exact mechanism of branched chain amino acids effect on sleep pathways in the brain, and to determine any side effects.
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MedicalResearch.com Interview with:
Dr. Andrew R. Mayer, PhD
The Mind Research Network Lovelace Biomedical and Environmental Research Institute
MedicalResearch.com: What are the main findings of the study?
Dr. Mayer:
a) Just because mTBI patients self-report reduced and/or no post-concussive symptoms does not mean that they have completed the healing process.
b) Current gold-standards in the clinical world (CT scans and self-report) may not be accurately capturing brain health after injury.
c) Diffusion imaging shows promise for being a more sensitive biomarker for measuring recovery than currently used techniques.
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MedicalResearch.com Interview with:
Prof David K Menon MD PhD FRCP FRCA FFICM FMedSci
Head, Division of Anaesthesia, University of Cambridge
Consultant,
Neurosciences Critical Care Unit
BOC Professor,
Royal College of Anaesthetists
Professorial Fellow, Queens' College, Cambridge
Senior Investigator, National Institute for Health Research
Box 93, Addenbrooke's Hospital,
Cambridge CB2 2QQ, UK
MedicalResearch.com: What is the background for your study?
Dr. Menon: We have known for some time that a history of traumatic brain injury (TBI) results in a significant (between 2 and 10 fold) increase in the likelihood of getting dementia in later life. On possible mechanistic explanation for this comes from the finding that about a third of individuals who died of TBI, regardless of age, are found at autopsy to have deposits of β-amyloid in the brain, often Aβ42, which is the same variant of amyloid seen in the brain of patients who have Alzheimer’s Disease.
However, such detection after death has made it impossible to examine the linkage of such early amyloid deposition to late dementia. More recently, imaging with positron emission tomography (PET) and Pittsburgh compound B (PIB) has been used to image amyloid deposits in Alzheimer’s Disease. However, the technique had not been validated in traumatic brain injury.
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John Hart, M.D.
Medical Science Director at the Center for BrainHealth
Jane and Bud Smith Distinguished Chair
Cecil Green Distinguished Chair
The University of Texas at Dallas
MedicalResearch.com: What are the main findings of the study?
Dr. Hart: Football players often sustain numerous concussive and subconcussive impacts—head impacts that do not elicit neurologic symptoms that may lead to white matter damage. We evaluated a population of retired NFL players in order to study the relationship between white matter integrity and the manifestation of depressive symptoms. We identified, for the first time, a correlation between depression and white matter abnormalities in former players with a remote history of concussion using diffusion tensor imaging (DTI).
Our data demonstrated a significant association between white matter integrity, as measured by DTI Fractional Anisotropy (FA), and the presence as well as severity of depressive symptoms in retired NFL athletes with a history of concussive or subconcussive impacts. We also found that dysfunction of the anterior aspect of the corpus callosum (forceps minor) and its projections to the frontal lobe can identify those with depression with 100% sensitivity and 95% specificity.
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Medical Research.com Interview with
Dr. Anna Nordström MD
Department of Community Medicine and Rehabilitation, Rehabilitation Medicine, Umeå University, SE-901 87 Umeå, Sweden
Medical Research.com: What are the main findings of the study?
Dr. Nordström: We have found that low cognitive function and factors related to low socioeconomic status and intoxications are strong independent risk factors for mild traumatic brain injury in men.
Medical Research.com: Were any of the findings unexpected?
Dr. Nordström: Our knowledge of risk factors that predispose people to sustaining such injury is limited. Previous research has inferred that mild traumatic brain injuries have important long-term consequences on cognitive function. However, we found similar deficits in cognitive function in subjects that sustained a mild traumatic brain injury before and after cognitive testing. Thus our data suggest that the injury itself may not reduce cognitive function.
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