Journal of Neurotrauma
Functionally-Detected Cognitive Impairment in High School Football Players Without Clinically-Diagnosed Concussion
Head trauma and concussion in football players has recently received considerable attention. Post-mortem evidence suggests that accrual of damage to the brain may occur with repeated blows to the head, even when individual blows fail to produce clinical symptoms. There is an urgent need for improved detection and characterization of head trauma to reduce future injury risk and promote development of new therapies. This study examined neurologic performance and health in the presence of head collision events in high school football players, using longitudinal measures of collision events (HIT system), neurocognitive testing (ImPACT), and functional MRI (fMRI). Longitudinal assessment (including baseline) was conducted in 11 males (ages 15-19) participating on the varsity and junior varsity football teams at a single high school. We expected and observed subjects in two previously described categories: (1) no clinically-diagnosed concussion and no changes in neurological behavior and (2) clinically-diagnosed concussion with changes in neurological behavior. Additionally, we observed players in a previously undiscovered third category who exhibited no clinically-observed symptoms associated with concussion, but who demonstrated measurable neurocognitive (primarily visual working memory) and neurophysiologic (altered activation in dorsolateral prefrontal cortex, DLPFC) impairments. This new category was associated with significantly higher numbers of head collision events to the top-front of the head, directly above DLPFC. Observation of this category suggests that more players are suffering neurologic injury than are presently detected via traditional concussion-assessment mechanisms. These individuals are unlikely to undergo clinical evaluation and thus continue to participate in football-related activities even when changes in brain physiology (and potential brain health) are present, likely increasing risk of future neurologic injury.
Thomas M. Talavage, Eric Nauman, Evan L. Breedlove, Umit Yoruk, Anne E Dye, Katie Morigaki, Henry Feuer, Larry J. Leverenz. Journal of Neurotrauma. -Not available-, ahead of print. doi:10.1089/neu.2010.1512.
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2 comments:
Ryan - a dedicated athlete, started playing flag football at the age of 7 and then began little league baseball practice and soon he joined the basketball team in school. By the time Ryan got to high school he joined the Football Team, Indoor Track team and was the only freshman who made their Golf Team. We were so busy with practice and game schedules it was a wonderful time. He was also doing well in his studies in high school ranking in the top 20. Ryan excelled in Football- he was the quarterback and running back and a top scorer for the Mount Saint Michael H.S. football team -. I have clippings from all his feats- even a great shot which appeared in the NY Daily News of him running in the rain covered with mud to score a touchdown. It is now 2010 and Ryan is now 24 years old. He suffered a breakdown while at Sacred Heart University in Connecticut March 17, 2004 and has been hospitalized on and off ever since.During Ryan's one-month stay at Cornell Weill Hosp. on E. 68th St. in Manhattan - January 2010 the doctors there were concerned that all the medications he has been given over the past 6 years to treat his complicated schizoaffective/bipolar/depression illness were being compromised by the symptoms he was presenting that relate to frontal lobe injury to the brain. (disinhibition, low frustration levels, easy to anger, inappropriate behavior, low concentration level, etc) These injuries were sustained during his years of playing football enduring "mini concussions" on the playing field and then being sent back in to play the game when he was a young teenager. All the medication that he takes cannot alleviate his symptoms because of the added complication of frontal lobe injury. We are trying to find a better treatment plan for our son with a healing lesson for himself and to educate children and parents. To this day, he still loves football and describes every right move and wrong move the players make.There is no way to document how many times he suffered hitting his head but we do know that he remembers that he would often feel a buzz in his head, be disoriented , sit on the bench and then he would continue to play the rest of the game. there are too many stories which have been kept quiet.such as NFL players who cannot control their rage and emotions, hearing voices, committing suicide, and suffering early dementia.I wrote to my Bronx Assemblyman Michael R. Benedetto and he and Senator Klein introduced legislation in April 2010 to protect high school athletes against serious injuries caused by concussions after hearing Ryan's story.The legislation received a major boost when Senator Jeffrey Klein introduced the bill in the State Senate.Once the bill is hopefully passed in NY State - I hope to concentrate on raising interest in a SPORTS RELATED THERAPY CENTER where retired Football Players and retired Coaches could be part of the staff along with the doctors and therapists.if patients are encouraged and treated in a positive setting (such as with sports and respected role models) the results could be outstanding. There are currently centers in England which have been using football therapy to treat mental illness, depression and brain injuries.This is so important as they begin to learn to focus on life again and will encourage organizational and study skills - job training, etc. Thank you for listening
Here's hoping that this SPORTS RELATED THERAPY CENTER will be a reality one day.
SincerelyCarol OMalley
Clemalley@aol.com
Ryan - a dedicated athlete, started playing flag football at the age of 7 and then began little league baseball practice and soon he joined the basketball team in school. By the time Ryan got to high school he joined the Football Team, Indoor Track team and was the only freshman who made their Golf Team. We were so busy with practice and game schedules it was a wonderful time. He was also doing well in his studies in high school ranking in the top 20. Ryan excelled in Football- he was the quarterback and running back and a top scorer for the Mount Saint Michael H.S. football team It is now 2010 and Ryan is now 24 years old. He suffered a breakdown while at Sacred Heart University in Connecticut March 17, 2004 and has been hospitalized on and off ever since.
During Ryan's one-month stay at Cornell Weill Hosp. on E. 68th St. in Manhattan - January 2010 the doctors there were concerned that all the medications he has been given over the past 6 years to treat his complicated schizoaffective/bipolar/depression illness were being compromised by the symptoms he was presenting that relate to frontal lobe injury to the brain. (disinhibition, low frustration levels, easy to anger, inappropriate behavior, low concentration level, etc) These injuries were sustained during his years of playing football enduring "mini concussions" on the playing field and then being sent back in to play the game when he was a young teenager. we trying to do all we can ---my greatest fear is that he will give up hope
He does pass the time writing song lyrics which are quite good....but he smokes and eats too much and says it's because "he is suffering" and mostly because of the side effects of all the medications. There is no way to document how many times he suffered hitting his head but we do know that he remembers that he would often feel a buzz in his head, be disoriented , sit on the bench and then he would continue to play the rest of the game. This is a major issue which needs to be addressed for all children in all sports -children, parents and coaches need to be on the same page and realize that these are young brains and these are our children. There are too many stories which have been kept quiet.such as NFL players who cannot control their rage and emotions, hearing voices, committing suicide, and suffering early dementia.I wrote to my Bronx Assemblyman Michael R. Benedetto and he and Senator Klein introduced legislation in April 2010 to protect high school athletes against serious injuries caused by concussions after hearing Ryan's story.The legislation received a major boost when Senator Jeffrey Klein introduced the bill in the State Senate.
Once the bill is hopefully passed in NY State - I hope to concentrate on raising interest in a SPORTS RELATED THERAPY CENTER where retired Football Players and retired Coaches could be part of the staff along with the doctors and therapists. there are currently centers in England which have been using football therapy to treat mental illness, depression and brain injuries.
This is so important as they begin to learn to focus on life again and will encourage organizational and study skills - job training, etc. Thank you for listening
Here's hoping that this SPORTS RELATED THERAPY CENTER will be a reality one day.Sincerely
Carol OMalley
Clemalley@aol.com
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