Monday, March 9, 2015

Protect Your Head: New Research Regarding Sports-Related Concussions

The National Institute of Health discovered that more than one million mild traumatic brain injuries occur each year within the United States. Professionals take these cases seriously because the human brain is the command center of the body. Although it is surrounded by a protective, bony shell and fluid that has the ability to absorb impact, the brain is composed of soft, sensitive tissues. Of the one million mild traumatic brain injuries, more than half occur in children participating in organized athletic events.  Common symptoms of concussions, a form of mild traumatic brain injury, include: loss of consciousness, headaches, amnesia, nausea, dizziness, confusion, balance and memory impairment, and light sensitivity, along with many others. With a recent dramatic increase in diagnosed concussions in athletes, researchers have set out to understand the effects of repeated head trauma, while also discovering potential biomarkers to properly detect brain injury.

Neurological Testing for Concussions. Digital Image.

            Bernick et al. gathered two-hundred and twenty-four fighters and twenty-two controls to participate in the Professional Fighters Brain Health Study (PRBHS). After gathering how many years each participant had engaged in fighting and how many fights per year, they underwent computerized cognitive testing and volumetric brain MRI. Cognitive testing examined memory, finger tapping, and symbol digit coding skills, while the MRI acquired the volumes of each structure in the brain. The goal of this experiment was to study the relationship between exposure to repeated head trauma and measurements of brain structure and function, along with cognitive performance.
            They discovered that repetitive head trauma is associated with lower brain volumes and lower processing speeds among the studied professional fighters. The MRI showed lower volumes in various structures within the cortical and subcortical area, particularly the thalamus and caudate. Therefore, brain function is vulnerable to volumetric loss. The thalamus relays sensory and motor signals to the cerebral cortex, therefore if affected, neurological functions may be diminished. A blow to the head also results in axonal injury in white matter tracts, which can lead to possible neuronal loss in subcortical grey matter structures. In other words, if signals are unable to travel down an axon of a neuron, then the cell all together is almost incapable of sending information.
            In terms of the cognitive aspect of this study, processing speed was correlated with reduced volume in brain structures. Also, processing speed was lower in participants who obtained higher Fight Exposure Scores (FES). FES accounts for cumulative number of fights and intensity of exposure (number of fights per year). It is possible that this test will provide a useful means when determining future cognitive impairment and/or future retirement plans regarding neurological damage in sports. One important future implication Bernick et al. suggested was potential biomarkers of brain injury, which could provide advances in detecting head trauma in athletes and all humans.
            Pham et al. recently discovered plasma soluble cellular prion protein (PrPC) as a potential reliable biomarker in rodents. A biomarker has the ability to assist in detection of brain injuries, especially when no obvious physical injury is noticeable. This scientific advancement has the potential to properly diagnose humans who have experienced a form of head trauma.
            Athletes and non-athletic students between the ages of eighteen and thirty year-olds were recruited and evaluated. Normal values for the plasma soluble PrPC were recorded in both gendered participants. Pham et al. determined plasma soluble PrPC were significantly higher in students who were confirmed to have experienced a concussion than the normal values in young adults.
            With that being said, the study proposed that this biomarker could potentially be used for neuroinflammation and encephalitis, also known as acute inflammation of the brain. Although it is prominently found in the central nervous system, which includes the brain and spinal cord, recent evidence indicates that PrPC has that ability to cross the blood brain barrier in a bidirectional manner. Therefore, soluble PrPC concentrations can be determined in multiple locations within the central nervous system. The study also noted that there were no significance between genders and different age groups of young adults. This means there is no gender and age variation in human plasma PrPC concentrations, which supports the conclusion that it is indeed an ideal biomarker for brain trauma.
            The future of sports medicine is focused on head trauma in athletes as high-contact sports experience an increase in sports-related concussions each year. Bernick discovered the association between repeated head trauma among professional fighters and the result of smaller thalamic volumes and slower processing speed. Pham et al. then revealed a potential biomarker in determining sports-related concussions, plasma soluble cellular prion protein (PrPC). Both studies have further developed a clinical diagnostic tool to assist clinicians in diagnosing concussions and return-to-play decision making among athletes.


Bernick, C., Banks S.J., Shin W., Obuchowski N., Butler, S., Noback M., Phillips M., Lowe M., Jones S., Modic M. Repeated head trauma is associated with smaller thalamic volumes and slower processing speed: the Professional Fighters’ Brain Health Study. Br J Sports Med 0:1-6 (2015).

NIH News in Health. A bang to the brain: what we know about concussions. National Institute of Health. (May 2013).

Pham N., Akonasu H., Shishkin R., Taghibiglou C. Plasma soluble prion protein, a potential biomarker for sport-related concussions: a pilot study. PLoS ONE 10(2): e0117286 (2015).


  1. I thoroughly enjoyed this blog entry as it covered a topic that I and many others are interested in. Only recently have repeated concussions and their consequences come to the forefront of discussion in organzied sports. With all the findings about how detrimental repeated head trauama and concussions are, it still seems like not a lot is being done to help the cause. Many professional athletes, especially boxers, football players and hockey players have severe depression because of the numerous concussions that went undiagnosed or rushed back in to competing to soon.
    The biomarkers you mentioned in your blog is new information to me and I'm happy to hear about the progression. However, I still feel as though the real progression will be coming when people understand, raise awareness and not rush kids and athletes back into their sport too soon.

  2. I think this is a really great post and particularly relevant to Colgate and our division I athletes. I think recently people have begun to take concussions and their consequences more seriously. I think symptoms of brain trauma are not as obvious as other injuries, such as a broken ankle, and it is important to have some marker to assess potential injury. I wonder if screening this biomarker could be implemented in yearly physicals for athletes to determine whether they are safe to play a contact sport.

  3. I think this post is really interesting and has important implications for student athletes! One thing I am wondering is whether the levels of PrPc stay high for a long period of time after a concussion or if they go back to normal after the injuries have improved. It would be interesting to see if this biomarker could be used to determine if an athlete has recovered from a concussion and is well enough to play again.

  4. With concussions being a very popular injuries in sports, I am glad to learn new information on the topic especially being an athlete. It makes me wonder how college students who have unfortunately received multiple concussions are able to perform as well as they could. It is important that people are continuing to research concussions because those who receive concussions could have severe long term problems if it is not taken care of properly.

  5. All of the negative consequences tied to concussions are certainly a pressing issue in contact sports. Many retired football players report greater rates of depression suicide than regular people, especially offensive and defensive lineman who sustain both major concussions and frequent minor concussions created by the repeated head trauma that comes from ramming into other peoples helmets. I wonder if the helmets worn by football players actually further the rates of concussions because of how strong they are. It would be interesting to see a comparison study between the rates of concussion among football players and players of a similar high contact sport that doesn't require helmets, such as rugby.

  6. I liked how this article focused on a potential bio marker for brain injury. As someone who tries to keep up on brain injuries and how to prevent them it is fascinating that there is a possible ideal bio marker for brain injury that would make it easy to diagnose and treat future brain injuries.

  7. I think the recent focus on concussions in athletes is very interesting and also very scary for those who have played sports for many years. This research has helped shaped policies that ensure athletes recover from head injuries before playing again. I often hear about new studies focusing on how detrimental concussions are, so it is scary to think only a few years ago an athlete could get a concussion and be told it was fine to keep playing the next day. This research is very important in the lives of children who are currently playing contact sports because it may help shape new rules in order to better protect the athletes. Although it may be too late to reverse the damage done to long time fighters, we can still use it to prevent future generations from being exposed to these types of preventable injuries.

  8. While organized sports have many clear benefits for children and young adults, more research seems to be surfacing about the harm of how competitive these sports are coming. Student athletes are frequently injured, not only with concussions, but with a whole host of other injuries, and like others have mentioned, these student athletes and their coaches are eager to get them back into competition and proper recovery does not always occur. While sports keep students fit and encourage many positive traits such as cooperation and good sportsmanship, are sports becoming more harmful as they become more competitive. What are the long term effects of youth constantly pushing themselves to their physical and mental limits?