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Blows to the Brain: Insight from Tragedy

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The Purdue University study focused on collisions to the head in 21 high school football players over the course of a full season. Image: Purdue University

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The Purdue University study showed brain differences among high school football players by creating a platform providing longitudinal data from “healthy through injury and recovery”. Image: Purdue University

On the playing field, in a swimming pool or on a ski slope, sports enthusiasts come in many shapes and sizes. The variety of sports available means that there is something for everyone. Sports are recommended as a healthy option, but there could be the possibility of serious head injury involved in almost every sport resulting from an accident.

Many people don’t realize the seriousness of brain injuries, or how they present themselves. Some blows to the head do not manifest with immediate reactions such as vomiting or dizziness. In the case of concussions in sport, adrenaline acts as a painkiller, possibly causing sportspeople to ignore the injury and continue to play. This means that many injuries are not detected at the onset, and can be aggravated if athletes continue their activity.

Traumatic Brain Injury (TBI) is more widespread in the U.S. than breast cancer, HIV/AIDS, multiple sclerosis, and spinal cord injuries. Every year an estimated 1.7 million people sustain a TBI; of these people, 52,000 die.

Women are more at risk of sustaining brain injuries due to anatomical differences. They have an average of 50% less isometric neck strength, 23% less neck girth, 43% less head-neck segment, and 50% greater head-neck peak angular acceleration. Although women are more at risk, they are also more concerned about their health and are more likely to report concussions in comparison to male athletes.

This doesn’t mean that we should all stop exercising for fear of what might happen; health professionals believe that at present little is known about the damage that can occur from an impact injury to the head. Studies are being conducted to determine what our brains look like before an impact in order to analyze the type of damage that may occur from different injuries.

“There is a lack of knowledge in how to diagnose and treat brain injuries. In order to advance in these areas, it is imperative to understand brain injury and optimize recovery methods,” comments Jonathan A. Murray, Managing Director of Research Circle Technology at GE Healthcare. “When head injuries occur, GE Healthcare wants to help doctors and patients and their families feel confident about the best treatment option. We feel that starts with longitudinal studies.”

A better way to study injuries and optimize therapies

Doctors don’t usually examine athletes until after they have suffered an injury; they therefore don’t have a base line for comparison. As a leader in MRI and a believer in prevention, GE Healthcare collaborated with Purdue University to establish a platform providing longitudinal data from “healthy through injury and recovery” on a high school football team. The study was largely funded by the Indiana Spinal Cord and Brain Injury Research Board.

The research is being developed at Purdue University with Jefferson High School (Lafayette, Indiana), The study is advancing the understanding of concussions by utilizing a non-invasive, in vivo method to study these injuries. It is an important step in improving knowledge of brain injuries and may help lead to improved return to play and life, better therapies, and better guidance of protective equipment design and proper play techniques.

“It is hard to study the brain. We always do it after an injury or tragedy, so we rarely know what the brain looked like before the injury. There is rarely a baseline to use as comparison,” Murray says.

One of a kind study

During the first-year, this groundbreaking study focused on collisions to the head in 21 high school football players over the course of a full season. This was the first study of its kind to combine MRI, functional MRI (fMRI ), biomechanical monitoring, and cognitive testing at multiple times before, during, and after the season to evaluate the effects of hits to the head—including those not leading to a concussion.

There were four stages to the study: Baseline assessment, in-game monitoring, in-season follow up, and post-participation follow up. Baseline MRI and fMRI readings were taken before the season started using the Signa*† HDx 3.0T from GE Healthcare.

Now in its third year, the Purdue study includes a second football team, as well as a girls’ high school soccer team; providing better insight as to how a lack of head protection impacts the rate of concussion.

Tom Talavage, the co-director of Purdue University’s MRI facility,is also studying students playing sports that are considered to be non-contact, such as track and volleyball. Talavage says the Jefferson High football players should be considered “heroes,” as they have graciously volunteered their time to help further the groundbreaking study and prevention of concussions. Several of the players moved on to college, but they have agreed to return for a study on how their first college football season compares to high school.

Today and the Future Ahead

A year ago, Thomas K. Foo, Chief Scientist of Diagnostic and Biomedical Technologies at GE Global Research said: “A head-only MR system would make neurological and psychiatric examinations of all age groups so much easier. Patient access and management will be enhanced without compromising image quality or scanner performance.”

GE Healthcare has already created specialized MRI scanners that allow hospitals to scan arms and legs without patients having to undergo a complete body scan.

Last year, GE Global Research announced that GE Healthcare and Mayo Clinic had received a grant from the National Institute of Neurological Disorders to be able to create a prototype of a dedicated brain MRI scanner; not only to be used for brain trauma, but also to advance treatment for patients with neurological diseases. “A head only MRI system will make neurological and psychiatric examinations of all age groups so much easier,” said Steve Williams, Professor of Imaging Sciences and Head of Neuroimaging at the Institute of Psychiatry in Kings College, London.

These advances could also help improve patient care in emergency rooms. Knowing what kind of impact a trauma might have will help professionals identify the best possible course of action. Having specialized equipment that permits a concise evaluation of head injuries may revolutionize the diagnosis and treatment of patients and may save countless lives.

*Trademark General Electric Company