Tag Archives: concussions

Researchers surprised by concussion study

Writing for Sports Illustrated, David Epstein tells the story of a small-scale Indiana football concussion study in which in which the youth in the control group unexpectedly became the headliners. The researchers were using functional MRIs and the popular ImPACT test, along with helmet-mounted accelerometers, to figure out what sort of hits cause concussions and how the consequences of such hits vary.


Photo by Les_Stockton via Flickr

Their first discovery? That “no particular magnitude of hit correlated with a concussion.” In fact, the youth they studied were suffering from very few concussions. It wasn’t until they started testing the unconcussed youth, as a sort of control, that they started seeing the results that have come to define their study, the full text of which is available online. Epstein again:

Of those eight [unconcussed youth], four nevertheless showed significant declines in visual memory. In fact, the players with the most impaired visual memory skills were not coming from the concussed group but from a group that in the week preceding the test had taken a large numbers of hits—around 150—mostly in the 40 to 80 G range

If the test scores were accurate, the researchers had inadvertently documented, in real time, a new classification of high school athlete: a player who was never concussed, was not verbally impaired and was asymptomatic even as far as his parents could tell, but whose visual memory was more impaired than his amnesic, headachy, light-sensitive, concussed teammates.

Researchers discovered one other surprise: The players who were asymptomatic but had impaired visual memory had suffered hits to the upper forehead, “which houses the dorsolateral prefrontal cortex – where linemen get hit, play in and play out,” as opposed to the heavy hits to the side of the helmet that most of us associate with concussions.

It’s a very small-scale study – only 21 boys completed the study conducted over one football season – but the researchers are expanding their work this season. Nevertheless, Epstein indulges in some speculation:

Consider this: Concussions as we know them involve a hit that rattles a part of the brain involved in language processing or motor skills. Hits to the forehead that might be every bit as damaging hide their nefarious effects in the frontal lobe, a part of the brain primarily involved in visual memory, planning and cognition, rather than motor or sensory function, and thus not taxed by sideline concussion exams. Indeed, it’s possible that all along, while brain trauma questions have focused on concussions, the real damage is being inflicted by minor impacts that chip away at the brain.

In another piece in Sports Illustrated, Peter King looks at recent violent hits in the National Football League that have attracted attention, the NFL’s attempts to make the game safer and the fans’ and players’ attitudes about the game.

Online guide focuses on covering medical studies

Covering Medical Research

Reporters are inundated with lures to cover the latest medical study or scientific conference paper. And there are some significant milestones being reached in medical research. But, more often, the information reaching the public is way too preliminary or even misleading, say those behind a new AHCJ reporting guide on covering health studies.

The guide will help journalists analyze and write about health and medical research studies. It offers advice on recognizing and reporting the problems, limitations and backstory of a study, as well as publication biases in medical journals and it includes 10 questions you should answer to produce a meaningful and appropriately skeptical report. This guide, supported by the Robert Wood Johnson Foundation, will be a road map to help you do a better job of explaining research results for your audience.


As school starts, so do youth sports injuries

The University of Michigan’s new Michigan NeuroSport Concussion Program seems to be cropping up everywhere, and as far as I can tell, it’s all part of a coordinated effort by the University. They already claim to have one of the only pediatric sport programs in the country, and now they’re expanding it with a clinical and research focus on “neurological sports injuries.”

In related news, the latest CDC Morbidity & Mortality Weekly Report includes an analysis of the numbers for “Heat Illness Among High School Athletes” from 2005 to 2009. The study examined 100 schools and nine sports, and found that heat-related illness was most common in football, and that August was the worst month for such afflictions.

AHCJ has a rich pool of resources for journalists looking to report beyond the press releases on stories like these, including:

Tip sheets
Concussions in young athletes
Reporting on sports injuries in school-age children
Health and education: Two intersecting beats
Health and education: Reporting resources
Blog posts
Tougher concussion rules from high school assn.
GAO evaluates youth concussion databases
Concussion more likely when hit is unexpected (Youth hockey study)
Attention focuses on football’s neurological effects
AP story: Hundreds of PTSD soldiers likely misdiagnosed

Concussion-related trauma masquerades as ALS

The New York TimesAlan Schwarz reports on what he says is “the first firm pathological indications that brain trauma results in motor-neuron degeneration.” The headline behind that conclusion, of course, is that researchers say some  athletes with concussion and impact-induced brain injuries may have been misdiagnosed as ALS victims.


Photo by peterjr1961 via Flickr

In interviews, the study’s authors even speculate that Lou Gherig, who gave the disease its popular name, may have instead suffered from a similar disease caused in part by brain injuries.

The finding was not unexpected, given that ALS seemed to occur at much higher rates in concussion-heavy populations like athletes and soldiers.

Schwarz’s summary of the study:

Doctors at the Veterans Affairs Medical Center in Bedford, Mass., and the Boston University School of Medicine, the primary researchers of brain damage among deceased National Football League players, said that markings in the spinal cords of two players and one boxer who also received a diagnosis of A.L.S. indicate that those men did not have A.L.S. at all. They had a different fatal disease, doctors said, caused by concussionlike trauma, that erodes the central nervous system in similar ways.

It’s in the emergence of that second disease that really seems to have attracted Schwarz’ attention. It behaves similarly to ALS, but shows a distinct protein pattern that only seemed to emerge in patients with a history of head injury. There is not, however, a 1:1 relationship. Other factors seem to also be at play, Schwarz writes.

Gary Schwitzer of HealthNewsReview.org examines the story more closely and concludes that, while this is an “important and fascinating area of research,” the story “did not exhibit the best of health/medical/science journalism.” He lists seven points of criticism and includes comments from one of the site’s medical editors.

John Gever of MedPage Today offers more scientific coverage of the study and points out that there was no mention of Gehrig in the study but that “a New York Times reporter coaxed McKee into suggesting that Gehrig may have been among those misdiagnosed – even though, as a first baseman, he did not routinely experience violent collisions. (He was, however, beaned at least twice during his 14-year career with the New York Yankees.)”

Tougher concussion rules from high school assn.

The National Federation of State High School Associations has released tougher rules about removing players with potential concussions from the field. The initial release outlines the changes:


Photo by Les_Stockton via Flickr

The previous rule directed officials to remove an athlete from play if “unconscious or apparently unconscious.” The previous rule also allowed for return to play based on written authorization by a medical doctor. Now, officials are charged with removing any player who shows signs, symptoms or behaviors consistent with a concussion, such as loss of consciousness, headache, dizziness, confusion or balance problems, and shall not return to play until cleared by an appropriate health-care professional.

The Tampa Tribune‘s Mary Shedden and Katherine Smith reported on how the change would affect Florida high school football and on how implementations of the new rule vary from district to district.

Language in the new rule is vague, stating a player can’t return until cleared by a “health-care representative.” In Hillsborough and Pinellas counties, players will need a doctor’s clearance, but Pasco officials may interpret the rule to include medical officials who were at the game, said Phil Bell, Pasco’s supervisor of athletic programs and facilities.

The best-known guidelines for returning to the game come from a sports medicine expert consortium in Zurich. It recommends athletes gradually return to activities, from light aerobic activity to noncontact drills to game day. Each step takes a minimum of 24 hours, and if symptoms return, an athlete must revert to the previous step.

Texas, Oregon and Washington have state laws mandating when players should be taken off the field; many other states rely on their athletic associations to format such rules. With the school year and football season getting under way, this would be a good time for reporters to check on the policies at local schools. Read more about concussions, including some recent reports and Congressional testimony.

NFL to post concussion warning in locker rooms

In The New York Times, football concussion reporter Alan Schwarz examines the content and ramifications of a new warning poster the NFL will be putting in every locker room. An image of the poster can be seen here.

high school tackle

Photo by Eagle102.net via Flickr

The poster lists symptoms that players should look out for, including headaches, confusion, memory problems and feeling more emotional, and warns them not to ignore symptoms.

In addition to strictly medical information — including the most starkly worded warnings yet from the league — the poster reminds players that concussions can also have long-term negative impacts on their families and on the health of those youngsters who idolize pro athletes.

Greg Aiello, a league spokesman, said in an e-mail message that the poster, spearheaded by the league’s new head, neck and spine medical committee and written in collaboration with the players union and the Centers for Disease Control and Prevention, “is intended to present the most current and objective medical information on concussions and will be distributed to the players and clubs in the near future.”