Neuroscience of Sports: Concussions

When Babe Ruth was knocked unconscious for five minutes
after crashing
into an outfield wall
in 1924, he was examined in much the same way he
would be today. The protocol immediately following a concussion hasn’t changed
much over the years. The major difference today is what happens next: The Babe
returned to the game and even played in the second game of a double header
later that day. Someone who sustains a similar injury in 2013 won’t be
returning to the field that day.

The first two sessions of the adult course, “The
Neuroscience of Sports: Your Brain in Action
,” have dealt with concussions.
Several neurology experts have spoken about the causes and treatment of
concussions. Here are some of the things I have learned:

  • Fans tend to notice the impacts between two
    players, but concussions can be sustained when players make contact with the
    ground as well.
  • There is a difference between men and women in
    response to concussions. Women show more post-concussive symptoms and are
    slower to recover than men.
  • A concussion is a functional disturbance to the
    brain and doesn’t involve any structural damage (as would be the case for
    traumatic brain injury).
  • There are problems involved with assessing high
    school athletes who may have suffered a concussion, such as: (1) they may deny
    any symptoms in an attempt to get back on the field or (2) they may exaggerate
    symptoms to get out of school or even in the hopes of strengthening their case
    should they sue the school.
  • After a concussion, there should be a gradual
    increase in activity, not weeks of complete inactivity or bed rest, as is
    sometimes recommended. So maybe a student should start with a half-day of
    school or not take any graded exams but he or she shouldn’t stay out of school
  • Who is going to develop Alzheimer’s among the concussion
    population? The APOE gene may hold the answer. Depending on which variant of
    the gene you have, you may be more or less at risk for long-term brain
    degeneration. In the future, perhaps people with a particular (higher risk)
    variant would be advised not to play contact sports.
  • A comparison was made between Junior Seau and
    Troy Aikman. Seau, a former NFL linebacker who committed suicide last year, had
    no documented concussions (though it’s reasonable to assume he had several) but
    his brain did show signs of CTE. Aikman, a former quarterback, had 10
    documented concussions but has experienced no problems in his post-football
    life. Perhaps Seau had the “bad” variant of the APOE gene and Aikman doesn’t.
  • Looking at brains is, according to one expert,
    “phenomenally confusing.” It’s hard to figure out what’s going on. Knowing the
    patient’s clinical history is very important.
  • Every big collision may reduce the number of
    axons in the brain. Over time, losing axons adds up.
  • Media coverage may be heaviest with the NFL, but
    traumatic brain injury extends beyond professional football, not just to kids
    playing sports, but the military and even victims of domestic violence.

Some of the experts who spoke work with college or
professional teams. It seems like teams are doing a good job of assessing and
managing head injuries, establishing baseline tests and taking decisions about
returning to the field out of coaches’ hands. While a sport like football
remains inherently dangerous, medical experts can help players get the care
they need.

In upcoming classes, I’ll be learning about (and reporting
on) what happens in the brains of athletes and the fans watching them.

–Andrew Kahn

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