Tag Archives: McGill University

McGill University study: Detecting long-term concussion in athletes

15 Jul

Kids Health has some great information about concussions at their site:

What Is a Concussion and What Causes It?
The brain is made of soft tissue and is cushioned by spinal fluid. It is encased in the hard, protective skull. When a person gets a head injury, the brain can move around inside the skull and even bang against it. This can lead to bruising of the brain, tearing of blood vessels, and injury to the nerves. When this happens, a person can get a concussion — a temporary loss of normal brain function.
Most people with concussions recover just fine with appropriate treatment. But it’s important to take proper steps if you suspect a concussion because it can be serious.
Concussions and other brain injuries are fairly common. About every 21 seconds, someone in the United States has a serious brain injury. One of the most common reasons people get concussions is through a sports injury. High-contact sports such as football, boxing, and hockey pose a higher risk of head injury, even with the use of protective headgear.
People can also get concussions from falls, car accidents, bike and blading mishaps, and physical violence, such as fighting. Guys are more likely to get concussions than girls. However, in certain sports, like soccer, girls have a higher potential for concussion.
http://kidshealth.org/teen/safety/first_aid/concussions.html#a_What_Is_a_Concussion_and_What_Causes_It_

Dr. Rivara published a study of how serious concussions can be.

Lindsey Tanner of AP reported about concussions in the article, Even mild concussions can cause lingering symptoms:

Children with even relatively mild concussions can have persistent attention and memory problems a year after their injuries, according to a study that helps identify which kids may be most at risk for lingering symptoms.
In most kids with these injuries, symptoms resolve within a few months but the study results suggest that problems may linger for up to about 20 percent, said study author Keith Owen Yeates, a neuropsychologist at Ohio State University’s Center for Biobehaviorial Health.
Problems like forgetfulness were more likely to linger than fatigue, dizziness and other physical complaints, the study found.
Forgetfulness, difficulty paying attention, headaches and fatigue were more common in study children who lost consciousness or who had other mild head trauma that caused brain abnormalities on imaging tests, compared with kids who didn’t get knocked out or who had normal imaging test results.
The study looked at symptoms up to a year after injury so it doesn’t answer whether any kids had longer-lasting or permanent problems.
“What parents want to know is if my kid is going to do OK. Most do OK, but we have to get better at predicting which kids are going to have problems,” Yeates said.
Those who do may need temporary accommodations, including extra time taking school tests, or wearing sunglasses if bright light gives them headaches, he said.
Most children studied had concussions from playing sports or from falls. About 20 percent had less common mild brain trauma from traffic accidents and other causes.
Concussions involve a blow to the head that jostles the brain against the skull, although imaging scans typically show no abnormalities. Other mild brain trauma can cause tissue damage visible on these scans.
The study included 186 children aged 8 to 15 with mild concussions and other mild brain injuries treated at two hospitals, in Cleveland and Columbus, Ohio. The reports are based on parents’ reports of symptoms up to 12 months after the injuries.
The brain injuries studied were considered mild because they involved no more than half an hour of unconsciousness; 60 percent of kids with concussions or other brain trauma — 74 children — had no loss of consciousness.
Overall, 20 percent — 15 children — who lost consciousness had lingering forgetfulness or other non-physical problems a year after their injury; while 20 percent who had abnormal brain scans — six kids — had lingering headaches or other physical problems three months after being injured.
http://www.seattlepi.com/news/article/Even-mild-concussions-can-cause-lingering-symptoms-3383079.php#ixzz1oMUeQVuu

McGill University researched a methodology for detecting long-term concussion,

Science Daily reported in Detecting long-term concussion in athletes:

Lawyers representing both sides in concussion lawsuits against sports leagues may eventually have a new tool at their disposal: a diagnostic signature that uses artificial intelligence to detect brain trauma years after it has occurred.
While the short-term effects of head trauma can be devastating, the long-term effects can be equally hard for patients. The symptoms may linger years after the concussion happened. The problem is it is often hard to say whether their symptoms are being caused by a concussion or other factors like another neurological condition or the normal aging process.
The only way to prove the presence of brain damage caused by concussion years after it occurred was through post-mortem examination. A means of diagnosing concussion in living patients, however, remained elusive.
A research team from Université de Montreal, The Montreal Neurological Institute and Hospital (The Neuro), and the Ludmer Center for NeuroInformatics recruited former university athletes between the ages of 51 and 75 who played contact sports such as ice hockey and American football. From that group, the researchers formed a cohort of 15 athletes who reported being concussed in their athletic careers, and a control group of 15 athletes who had not been concussed.
The researchers performed a battery of tests on both groups, including neuropsychological testing, genotyping, structural neuroimaging, magnetic resonance spectroscopy, and diffusion weighted imaging. They then pooled the data and fed it to computers that use artificial intelligence software to “learn” the differences between the brain of a healthy athlete versus the brain of a previously concussed athlete. They found that white matter connections between several brain regions of concussed individuals showed abnormal connectivity that might reflect both degeneration and the brain’s method of compensating for damage. Using the data, the computers were able to detect concussion with up to 90-per-cent accuracy….
Dr. Sebastien Tremblay, the paper’s first author, says they need to validate the signature on a larger sample size, using various magnetic resonance imaging (MRI) scanners, before it becomes an effective means to diagnose concussion. When perfected, the signature could also aid treatment of concussion by providing doctors with an accurate picture of what is causing their patients’ symptoms…..https://www.sciencedaily.com/releases/2017/07/170712145611.htm

Citation:

Detecting long-term concussion in athletes
Researchers develop method that could one day be used in brain trauma lawsuits
Date: July 12, 2017
Source: McGill University
Summary:
representing both sides in concussion lawsuits against sports leagues may eventually have a new tool at their disposal: a diagnostic signature that uses artificial intelligence to detect brain trauma years after it has occurred.

Journal Reference:
1. Sébastien Tremblay, Yasser Iturria-Medina, José María Mateos-Pérez, Alan C. Evans, Louis De Beaumont. Defining a multimodal signature of remote sports concussions. European Journal of Neuroscience, 2017; DOI: 10.1111/ejn.13583

Here is the press release from McGill University:

Detecting long-term concussion in athletes
News
Researchers develop method that could one day be used in brain trauma lawsuits
Published: 12Jul2017
Lawyers representing both sides in concussion lawsuits against sports leagues may eventually have a new tool at their disposal: a diagnostic signature that uses artificial intelligence to detect brain trauma years after it has occurred.
While the short-term effects of head trauma can be devastating, the long-term effects can be equally hard for patients. The symptoms may linger years after the concussion happened. The problem is it is often hard to say whether their symptoms are being caused by a concussion or other factors like another neurological condition or the normal aging process.
The only way to prove the presence of brain damage caused by concussion years after it occurred was through post-mortem examination. A means of diagnosing concussion in living patients, however, remained elusive.
A research team from Université de Montreal, The Montreal Neurological Institute and Hospital (The Neuro), and the Ludmer Center for NeuroInformatics recruited former university athletes between the ages of 51 and 75 who played contact sports such as ice hockey and American football. From that group, the researchers formed a cohort of 15 athletes who reported being concussed in their athletic careers, and a control group of 15 athletes who had not been concussed.
The researchers performed a battery of tests on both groups, including neuropsychological testing, genotyping, structural neuroimaging, magnetic resonance spectroscopy, and diffusion weighted imaging. They then pooled the data and fed it to computers that use artificial intelligence software to “learn” the differences between the brain of a healthy athlete versus the brain of a previously concussed athlete. They found that white matter connections between several brain regions of concussed individuals showed abnormal connectivity that might reflect both degeneration and the brain’s method of compensating for damage. Using the data, the computers were able to detect concussion with up to 90-per-cent accuracy.
The study’s results were published in the European Journal of Neuroscience on May 16, 2017. Their work, once more thoroughly tested and refined, could have implications for current and future concussion lawsuits. The National Football League, for example, faced a decade-long lawsuit by former players who claimed it did not do enough to protect them from concussion. The lawsuit was complicated by the fact there was no objective way to determine if the neurological symptoms they experienced were caused by the concussions they received as players. The National Hockey League is currently facing a similar lawsuit by former players.
Dr. Sebastien Tremblay, the paper’s first author, says they need to validate the signature on a larger sample size, using various magnetic resonance imaging (MRI) scanners, before it becomes an effective means to diagnose concussion. When perfected, the signature could also aid treatment of concussion by providing doctors with an accurate picture of what is causing their patients’ symptoms.
The need for such tools is greater than ever. According to the federal government, reported concussions have increased 40 per cent between 2004 and 2014 among young football, soccer and hockey players.
“With 1.6 to 3.8 million concussions per year in the US alone, the prevalence of this injury is alarming,” says Tremblay, a postdoctoral researcher at The Neuro. “It is unacceptable that no objective tools or techniques yet exist to diagnose them, not to mention the sheer lack of scientifically valid treatment options. With our work, we hope to provide help to the vast population of former athletes who experience neurological issues after retiring from contact sport.”
“Future studies, including systematic comparisons with patient groups presenting with other age-related neurological conditions, together with identifying new biomarkers of concussion, would help refine the developed, computer-assisted model of the remote effects of concussion on the aging brain,” says Dr. Louis de Beaumont, a researcher at Université de Montreal and the paper’s senior author.
This study was funded by the Canadian Institutes of Health Research (CIHR).
Université de Montréal
Deeply rooted in Montreal and dedicated to its international mission, Université de Montréal ranks among the top 1% of the world’s best universities and is considered the top comprehensive university in the Francophonie. Founded in 1878, UdeM today has 15 faculties and schools, and together with its two affiliated schools, HEC Montréal and Polytechnique Montréal, constitutes the largest centre of higher education and research in Quebec and one of the most important in North America. It has 2,800 professors and researchers and more than 66,000 students. For more information, please visit http://www.umontreal.ca/en
The Montreal Neurological Institute and Hospital
The Montreal Neurological Institute and Hospital – The Neuro – is a world-leading destination for brain research and advanced patient care. Since its founding in 1934 by renowned neurosurgeon Dr. Wilder Penfield, The Neuro has grown to be the largest specialized neuroscience research and clinical centre in Canada, and one of the largest in the world. The seamless integration of research, patient care, and training of the world’s top minds make The Neuro uniquely positioned to have a significant impact on the understanding and treatment of nervous system disorders. In 2016, The Neuro became the first institute in the world to fully embrace the Open Science philosophy, creating the Tanenbaum Open Science Institute. The Montreal Neurological Institute is a McGill University research and teaching institute. The Montreal Neurological Hospital is part of the Neuroscience Mission of the McGill University Health Centre. For more information, please visit http://www.theneuro.ca
Contact Information
Contact:
Shawn Hayward
Organization:
Communications Officer, Montreal Neurological Institute
Email:
shawn.hayward@mcgill.ca
Office Phone:
514 893 3376
Secondary Contact Information
Contact:
Jeff Heinrich
Organization:
International Press Attaché, Université de Montreal
Secondary Email:
jeff.heinrich@umontreal.ca
Office Phone:
514 343 7593

WebMD has a good description of what a concussion is and the signs of concussion

A concussion is a brain injury that is caused by a sudden blow to the head or to the body. The blow shakes the brain inside the skull, which temporarily prevents the brain from working normally….
Symptoms of a concussion include:
· Passing out.
· Not being able to remember what happened after the injury.
· Acting confused, asking the same question over and over, slurring words, or not being able to concentrate.
· Feeling lightheaded, seeing “stars,” having blurry vision, or experiencing ringing in the ears.
· Not being able to stand or walk; or having coordination and balance problems.
· Feeling nauseous or throwing up.
Sometimes it can be hard to tell if a small child has a concussion. If your child has had a head injury, call your doctor for advice on what to do.
Occasionally a person who has a more serious concussion develops new symptoms over time and feels worse than he or she did before the injury. This is called post-concussive syndrome. If you have symptoms of post-concussive syndrome, call your doctor. Symptoms of post-concussive syndrome include:
· Changes in your ability to think, concentrate, or remember.
· Headaches or blurry vision.
· Changes in your sleep patterns, such as not being able to sleep or sleeping all the time.
· Changes in your personality such as becoming angry or anxious for no clear reason.
· Lack of interest in your usual activities.
· Changes in your sex drive.
· Dizziness, lightheadedness, or unsteadiness that makes standing or walking difficult.

Parents must be alert to what is happening with the children when they participate in athletic events and activities.

Resources:

Concussions http://kidshealth.org/teen/safety/first_aid/concussions.html#a_What_Is_a_Concussion_and_What_Causes_It_
Concussion
http://www.emedicinehealth.com/concussion/article_em.htm

Concussion – Overview
http://www.webmd.com/brain/tc/traumatic-brain-injury-concussion-overview

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