Archive for August, 2009
Science Daily reports that researchers at the Sahlgrenska Academy and the Ericyes University Medical School in Turkey published a study revealing elevated levels of the protein NSE in blood samples taken from amateur boxers after a two-month break from boxing. The NSE levels were higher in the blood samples of 44 boxers than in a healthy control group of the same size. The team of scientists concluded from these results that receiving multiple blows to the head and face can lead to nerve-cell deterioration, which persists for months, even after the blows have ceased.
The study, published in the current issue of the journal Brain Injury, demonstrates that when boxers are punched in the head repeatedly, harmful processes are set in motion, which continue long after the initial injuries took place. Earlier research by the same team of scientists showed heightened levels of brain injury markers in the spinal fluid of boxers, further demonstrating the potential for serious injury that fighters may not be fully aware of.
Doctors and scientists have expressed concern that boxers and children who aspire to boxing and martial arts may not be fully informed about the serious risk of long-term chronic brain injury from taking multiple traumatic punches and kicks to the head.
The team of researchers hopes their most recent study will help boxers, trainers, and parents make more informed and better decisions about when athletes should avoid further training and competition in order to avert serious traumatic brain injuries.
The Turkish scientists expressed plans to expand their study to encompass more boxers at different times of their training and boxing careers. The scientists will continue to monitor variations in the NSE levels of boxers before and after matches, after knockouts, and over much longer periods of time to determine more specifically the serious potential for brain damage in boxing and other sports in which athletes take repeated blows to the head.
While the debate continues over whether or not amateur boxers are at serious risk for traumatic and chronic brain injury, scientists have finally demonstrated proof that taking blow after blow to the head really does lead to damage in the fragile gray matter inside the skull.
Many boxers will likely choose to continue with their sport, and children will still aspire to become boxers. At least with this and other studies on the detrimental effects of boxing on the human brain, parents and trainers will be able to make better-informed decisions before sending their athletes and youth into the ring.
Doctors and researchers at the Albert Einstein College of Medicine of Yeshiva University recently made novel use of diffusion tensor imaging (DTI) in order to scan the brains of 20 concussion patients to determine once and for all whether or not concussions involve traumatic injury to the brain. The DTI scans revealed subtle brain damage in 15 of the 20 patients. The team of researchers reported their results in the August 26, 2009 issue of the journal Radiology.
The results of the DTI study hold much promise for the over 1 million Americans who get concussions each year. Most concussion patients experience a full recovery and return to full mental functioning over time, but upwards of 30% of concussion patients suffer long term symptoms such as personality change and inability to perform complex planning and organizational tasks.
Doctors currently diagnose concussions by examining patients’ accident histories and checking for the most common symptoms, which include headaches, shifts in behavior and personality, and dizziness. This approach has proven ineffective since it does not allow doctors to distinguish between which patients will recover fully, and which patients will exhibit long-term symptoms.
DTI scanning may now provide more objective diagnosis of concussion and allow doctors to more accurately diagnose actual brain injury following a concussion. The DTI scans may also give doctors the ability to predict whether or not concussion patients will suffer from a loss of the ability to make decisions, organize complex tasks, and efficient management of their time. In the Radiology study, the 15 patients whose brains showed actual damage also performed more poorly than the control group and the 5 non-brain-damaged patients on executive function tests.
Researchers hope that DTI diagnosis will allow doctors to begin treating more severe concussion-based brain injuries immediately following the injury, which could decrease the chances of long term loss of executive functioning. By initiating cognitive rehabilitation therapy early in the brain injury treatment process, doctors may be able to reduce the amount of sustained long-term damage.
Doctors have long suspected, but have never before been able to objectively demonstrate, a link between concussions and actual brain tissue damage. Now that this link has been clearly demonstrated and understood, researchers can focus on developing more efficient and useful treatments for serious concussions.
Medical professionals, high school officials, parents, coaches, and student athletes in communities west of Boston, Massachusetts are working together to bring more awareness to concussions in high school sports such as hockey, football, and cheerleading. According to a Boston Globe article, late last year, the Massachusetts Association of School Committees reported that multiple concussions can lead to catastrophic brain injury and swelling, as well as prolonged post-concussion syndrome.
The group issued recommendations for safety and prevention of concussions, and they propose computerized cognitive testing both before each season begins and after a concussion to monitor the healing process on a more subtle level.
While some schools have implemented a form of computerized testing, other schools use handwritten methods of measuring and tracking student’s cognitive functioning after concussions. Schools and parents have reason to be concerned due to the severe nature of any brain injury, including concussions, which are common enough that they are often not taken seriously.
A spokeswoman for the Brain Injury Association of Massachusetts in Westborough wants to challenge the tradition of cheering on players who join in the game immediately after getting a serious head injury. She believes that current policies on concussions do not do enough to educate and protect students who are at risk of traumatic brain and spinal cord injury in addition to concussion.
High school athletes in Massachusetts are currently required to have their doctor’s or a trainer’s permission before resuming activity in contact sports after having a concussion. Some medical professionals recommend staying out of any sports activity for at least a week after a concussion or head injury.
A spokesman for the Massachusetts Interscholastic Athletic Association said that an attentive coach and a well trained medical staff can prove just as effective in preventing serious long-term harm in student concussions. The MIAA and the Brain Injury Association of Massachusetts push for a well rounded plan of action including coaches, medical staff, parents, teachers, fellow students, and lawmakers.
Coaches must be able to react immediately when a head injury occurs in the field. A well trained medical staff must be alerted to take over from there. Finally, fellow students, parents, and teachers must pay attention to students who have had concussions to observe any differences in behavior.
A combination of high tech computerized cognitive testing programs and preventative measures such as safety policy and public education will likely improve the chances of a successful outcome for high school athletes who suffer concussions and brain injuries.
A team of scientists from the University of California San Diego (UCSD), UCLA and the San Diego Veterans Affairs Medical Center reported in the journal Nature Neuroscience that they had partial success in restoring damaged nerve connections in lab rats. This was based on earlier research in which scientists discovered a method to regenerate axons.
Axons are the fibers that connect neurons and carry signals between them, allowing communication between the brain and the nervous system. Axons are damaged or destroyed in spinal cord injuries, causing communication between neurons to be interrupted, which can mean sensory loss and paralysis.
Scientists used a three-part therapy in their study. First, they injected a harmless virus with a chemical growth hormone into the injury site. The growth hormone draws growing axons to the site. Next, they placed a cell graft across the injury site to encourage the young axons to grow. Finally, they stimulated genes in the injured neurons to amplify axon growth.
While the therapy practiced by the team is far from perfect, and will require much more study before being tested on humans, it offers hope to the more than 5.6 million Americans suffering some form of paralysis, 23% of them due to a spinal cord injury.
The team’s success was only partial because, although the axons found their way to the precise spinal injury site and formed connections with other nerve cells, the new neural connections did not have a myelin sheath. The myelin sheath is a fatty sheath that acts as a sort of electrical insulator to assist in the passing of electrical signals between the brain and the body’s nervous system. Since the new connections lacked a myelin sheath, they proved effectively inactive.
Further research is being planned by the same team of scientists to add another step to the already complex therapeutic process in which they hope to encourage the formation of myelin sheaths at the injury site. Although the translation from rats to humans may prove difficult, the creation of the myelin sheath will bring scientists one step closer to fully repairing nerve damage and potentially reversing paralysis.
In Menlo Park, California, the biotech company Geron has plans underway to conduct clinical studies on humans with spinal cord injuries. They will inject embryonic stem cells into spinal cord injury patients in the hopes that the cells will form oligodendrocytes, which in turn assist in the formation of myelin sheaths.
This combination of research inches ever closer to the possibility of full spinal regeneration after a severe injury. While it is nowhere near perfect yet, the promising research continues.
