Helmet technology may help with concussions

Forbes recently published the following article explaining why current helmets cannot prevent concussions, but that new helmet technology may be able to help.

The veil of denial and misinformation that has clouded awareness of the long term dangers of athletic concussion has started to lift.  As the general public and especially families of collision sports athletes begin to realize the threat to a normal life posed by the heightened risk of Alzheimers, ALS, Parkinson’s, dementia, Chronic Traumatic Encepalopathy and depression that multiple concussions trigger–the search for solution becomes more intense. One focus in prevention is helmets. Athletes in football, baseball, hockey, field hockey, auto and horse racing all wear helmets.

There is a prevalent belief that those helmets play a major role in preventing concussion–they do not. Current helmets are primarily designed to prevent skull fracture. There obviously is some protective benefit–but the energy wave from a collision currently moves through the plastic and the liner of a helmet and enters the athlete’s head. Tate Technology, headed by CEO Jenny Tate Morgan, has devised a solution. Morgan comes from a family background in helmetry. Her grandfather, John Tate Riddell designed the first plastic helmet, and founded Riddell Football. Her father, also CEO of Riddell, co-ventured with Jack Welch and GE Plastics to use new polycarbonate materials on helmets in 1957. Riddell innovated a series of designs also used in military helmets.

Tate Technology assembled a scientific team of industry experts, engineers, PhD’s and MD’s along with a seasoned board of directors from Fortune 500 companies to find better solutions.  ”Advanced Concussion Technology” (ACT) is a solution which has gone through research, development and some testing. It uses a system of coils designed to dissipate energy and attenuate at the first point of impact. This is done through ”compression” instead of the energy flowing into “tension.” The energy wave moves directly into the head. The system of coil and compression in the helmet can reduce the impact of a hit by as much as half. This company is licensing the technology, which can adapt to any of the currently made helmets; it will not manufacture them itself.

I don’t pretend to be an engineer with in-depth knowledge of energy attentuation. But in lay terms, reducing the energy in a hit so it never penetrates the head and the brain, seems like a solution that could revolutionize helmetry. What works on sports helmets, can work on military, bicycle and motorcycle helmets. Tate’s ACT is ready to be installed in helmets now.

Kudos to those inventive individuals and companies that are trying to tackle a problem that is a largely undiagnosed public health epidemic. Otherwise, the number of concussions will continue to rise, and the trauma will manifest earlier than ever before. This is the result of larger, stronger, faster bodies colliding. It will be exciting to see how fast Jenny Morgan’s ACT technology can begin providing relief.I have always felt that once American corporations with engineering capacity worked on the helmet problem, progress would occur. In the same way neutraceutical and pharmaceutical solutions to brain damage have occurred. The race for solution is producing a variety of promising approaches, such as Prevacus nasal spray. In helmetry, Vicis Company has developed a helmet with impact absorbing filaments that also offers hope.

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Depression risk in teens increased by concussions, study claims

A new study claims that concussions in teens makes them three times more likely to suffer from depression.

Teens with a history of concussions are more than three times as likely to suffer from depression as teens who have never had a concussion, finds a new study in the Journal of Adolescent Health.

"What this study suggests is that teens who have had a concussion should be screened for depression," said lead study author Sara Chrisman, M.D., a pediatrician at Seattle Children's Hospital.

Concussion, considered a mild traumatic brain injury, can also have serious psychological effects. Most prior research on these psychological effects has focused on adults. However, many teens experience concussions through sports injuries or accidents, and less is known about long-term complications in adolescents.

The study used data from the 2007-2008 National Survey of Children's Health and included health information from over 36,000 adolescents ages 12 to 17. 2.7 percent of the sample had had a concussion and 3.4 percent had a current depression diagnosis.

Teens who were 15 years or older, lived in poverty or who had a parent with mental health problems were more likely to be depressed than other teens, said Chrisman, "but what was surprising was when we took those factors into consideration, it didn't take away from the association between depression and a history of concussion."

Chrisman also cautioned that it's not known what exactly might account for higher rates of depression in teens with a history of concussion. It could be the brain injury itself, diagnostic bias due to repeated medical visits for concussion, doctors mistaking symptoms of a concussion for depression, or from the social isolation that they may experience while recovering.

Jeffrey Max, M.D., a psychiatrist who specializes in psychiatric outcomes of traumatic brain injury in children and adolescents at the University of California, San Diego noted, "In our research, we've found that about 10 percent of the kids had a full depressive disorder or subclinical depressive disorder 6 months after a concussion." Children who have a history of concussion are more likely to develop attention-deficit/hyperactivity disorder (ADHD) and have difficulties controlling their moods, especially anger, rather than experience depression, Max added.

Unlike Chrisman, however, Max observed that the actual brain injury associated with concussions is probably a major cause of depression in the first few months after injury. "In the clinic, we've certainly seen cases where within hours [of sustaining a concussion], a kid who's never had depression before is suddenly depressed and suicidal. One of our studies found that the brain images in children with traumatic brain injury and depression were actually quite similar to those seen in adults who develop depression as a result of traumatic brain injury."

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NIH and NFL will research long-term effects of concussions

This article outlines research that will be done on the long-term effects and consequences of concussions. This research will be done as a partnership between the National Institutes of Health (NIH) and the National Football League (NFL).

The U.S. National Institutes of Health is teaming up with the National Football League on research into the long-term effects of repeated head injuries and improving concussion diagnosis.

The projects will be supported largely through a $30 million donation made last year to the Foundation for the National Institutes of Health by the NFL, which is wrestling with the issue of concussions and their impact on current and former players.

There's growing concern about the potential long-term effects of repeated concussions, particularly among those most at risk, including football players and other athletes and members of the military.

Current tests can't reliably diagnosis concussion. And there's no way to predict which patients will recover quickly, suffer long-term symptoms or develop a progressive brain disease called chronic traumatic encephalopathy (CTE), according to an NIH press statement released Monday.

"We need to be able to predict which patterns of injury are rapidly reversible and which are not. This program will help researchers get closer to answering some of the important questions about concussion for our youth who play sports and their parents," Story Landis, director of the National Institute of Neurological Disorders and Stroke (NINDS), said in the news release.

Two of the projects will receive $6 million each and will focus on determining the extent of long-term changes that occur in the brain years after a head injury or after numerous concussions. They will involve researchers from NINDS, the National Institute of Child Health and Human Development and academic medical centers.

One of the projects will attempt to define a clear set of criteria for various stages of CTE. It will also seek to distinguish it from Alzheimer's disease, amyotrophic lateral sclerosis (Lou Gehrig's disease) and other degenerative brain diseases that as of now can only be determined in brain tissue samples collected after death. The objective is to find medical signs of CTE that might eventually be used to diagnose the illness in living people.

The other project will seek to identify the long-term effects of mild, moderate and severe traumatic brain injury (TBI) and compare them with features of CTE. The goal is to identify signs that could be used to diagnose brain degeneration linked to traumatic brain injury in patients.

While the two projects focus on different aspects of traumatic brain injury, "their combined results promise to answer critical questions about the chronic effects of single versus repetitive injuries on the brain, how repetitive TBI (traumatic brain injury) might lead to CTE, how commonly these changes occur in an adult population, and how CTE relates to neurodegenerative disorders like Alzheimer's disease," Landis said.

Six other pilot projects will receive a total of just over $2 million and last up to two years. They will concentrate on improving the diagnosis of concussions and identifying potential medical signs that can be used to assess a patient's recovery. If the early results are promising, these projects may form the basis of more extensive research, the news release said.

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Repeat concussions in children mean longer recovery time

A new study shows that children who receive repeat concussions take longer to recover.

Young people may take longer to recover after their second or third concussion, a new study suggests.

Researchers typically believe the average athlete needs up to two weeks to stop having symptoms - such as headaches and memory problems - after a concussion.

But in the new study, children and young adults who had just suffered their second concussion in the last year took an average of 35 days to get back to normal.

"We have to be cautious in terms of after two weeks, if you still have symptomatic athletes, that you're not trying to hurry them back," said Dr. Paul Comper, a concussion researcher from the University of Toronto.

"The most important piece of information that comes out of this study is, if you've had prior concussions, the 10- to 14-day (recovery) thing may be completely out the window," Comper, who wasn't involved in the new study, told Reuters Health.

"For you, it might be a month."

He said the findings aren't totally surprising - it's clear that multiple head injuries are a bad thing - but they give doctors more information to pass on to their young patients after a concussion.

Studies have been piling up showing the potential harms of concussions among kids (see Reuters Health story of March 4, 2012 here: http://reut.rs/yKlv85).

And the apparent suicides of Junior Seau and other professional football and hockey players, some of whose brains showed damage from multiple head injuries, have raised concerns about depression tied to repeat concussions.

The new study included 280 youth, age 11 to 22, who came to the emergency room within a few days of having a concussion. About two-thirds of them were injured playing sports, most commonly hockey, soccer, football and basketball.

After going home, kids filled out up to six questionnaires about their symptoms over the next 12 weeks, and reported the last day they had any concussion-related problems.

Of the 235 kids who completed the study, 68 had a history of concussion.

On average, participants who had never had a concussion before took 12 days to recover from their head injury. That compared to 24 days among those with at least one past concussion, and 35 days if that prior concussion had been within the last year, the study team reported Monday in Pediatrics.

That finding, the lead author said, gives parents and doctors "even more reason for caution" when deciding how long a child should be kept out of sports or school after a head injury.

"Even after symptoms have improved and even after these neuropsychological tests have returned to normal, there's still a vulnerability that can lead to a much more severe second concussion," Dr. Matthew Eisenberg, from Boston Children's Hospital, told Reuters Health.

The researchers said one limitation to their study was that they relied on kids to report when their symptoms were gone - and some may have had incentives to say they were better to return to sports, or to say they weren't to stay home from school.

Eisenberg said the next goal is to look for something on a blood test, urine test or brain scan that will tell doctors when a child is truly back to normal.

There's also a need for follow-up research on kids with concussions, he said, because what parents want to know most is whether their child will have any lingering issues years down the line.

"The big question that still needs to be answered is, what are the long-term effects of these concussions?"

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