Promising News On the Concussion Front

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As big a challenge as sports concussions are -- and I think they are the number one contemporary sports issue -- there have been some encouraging developments in the sports concussion field recently.

Let's start with neurofeedback training, a new technology that is designed to retrain the brain after years of blows to the head. It's providing new hope for former players who suffered brain injuries during their playing days.

A pilot study involving the New Hope for the Brain Center in Lakewood, Colorado is showing promise in helping former football players who've been dealing with declining brain function.

Dave Studdard, a former offensive tackle for the Denver Broncos, said the neurofeedback technology has removed "the constant fog" he had been living in. Another former Bronco, Jon Keyworth, said he has experienced significant improvement since beginning the therapy.

Perhaps most promising of all is that the positive results seem to be holding up a year after treatment.

In another development, one that is especially encouraging for youth sports leagues that can't afford to have medical personnel on the sidelines for every game, the Mayo Clinic has endorsed the King-Devick sideline concussion test and will help promote it to youth coaches, parents and athletes.

The King-Devick Test is an inexpensive, quick (approximately two minutes) and accurate test for concussion detection and evaluation on the sidelines of sporting events. Just as importantly, it's easy to administer -- for almost anyone. The test uses flash cards or an app for iPads. You don't have to be a medical professional in order to administer the test to an athlete. Youth coaches and parents can do it after a minimum of instruction.

"Studies have indicated that the King-Devick Test is an effective tool for the real-time evaluation of concussion because it looks at rapid eye movement and attention -- both are affected by concussions," said David Dodick, M.D., Mayo Clinic neurologist and director of Mayo Clinic's concussion program. "Most importantly, the test is affordable and can easily be used by any youth sports league, and administered by non-medical personnel. And youth athletes are at a higher risk for concussion and a longer recovery time than adults."

The test costs between five and ten dollars a year for athletes. The yearly cost is due to the need to establish an annual baseline. Ideally, the King-Devick Test will eventually become part of every young athlete's pre-participation physical.

On the sidelines, the test can identify athletes that not only have suffered a full-blown concussion but sub-concussive brain trauma as well. Thus, the test is an excellent "remove-from-play" tool for trainers, coaches and parents. An effective remove-from-play tool is critical because it can help prevent Second Impact Syndrome, a condition in which a person experiences a second brain injury shortly after the first. Second Impact Syndrome can have devastating effects, both in the short-and-long-term.

The Centers for Disease Control and Prevention estimates that between 1.6 and 3.8 million students have concussions every year. And given that research has shown that up to 50% of athletes don't self-report brain injury symptoms, having a simple, valid and accurate tool for detecting concussions on the sidelines of youth and high school sporting events is a critical societal need.

On another front, a single molecule blood test being developed by Quanterix, a Massachusetts-based company, shows great promise for detecting brain injuries. The highly-sensitive test can detect proteins in the blood that indicate a brain injury

The Quanterix test can signal a concussion, or sub-concussive injury, which will let team personnel know that an effected player shouldn't be allowed back into a game.

The blood test is expected to be available for locker room and/or sideline use in the next year or two.

If the Quanterix blood test could eventually be administered quickly during a game - it currently takes about 45 minutes to get a result -- it could have an advantage over the King-Devick test because it removes the human element. The results are based on biomarkers in the blood.

A potential weakness of the King-Devick test is that an athlete could conceivably establish a false baseline by completing the baseline test slower than they are capable of. Thus, during the season, they could lessen the risk of getting pulled from a game due to a slow response on the test.

"One of my goals is that in the near future this blood test might be administered in doctors' offices around the world as part of a child's yearly physical," says Kevin Hrusovsky, Quanterix's CEO. "This will enable us to get an accurate baseline biomarker read so that if it is suspected that a person has been hit, or has sustained any sort of injury to the brain, it will be easy to determine definitively if an injury did in fact occur and how severe it was."

Finally, a just-released study in the Journal of Clinical and Experimental Neuropsychology, reveals that researchers can accurately predict professional football players eventual cognitive outcomes based on the players' concussion histories, mental abilities (termed "cognitive reserve" in the study), and game-related data.

"While further study is needed, our findings open the door to the possibility that professional football could use individual indices to predict the potential for long-term cognitive losses in determining when, or if, a player should return to the field after suffering a concussion," according to Matthew J. Wright, PhD, lead author of the study.

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