(Originally published by C2ST, February 3, 2016)
Heaps of presents and family gatherings aside, this holiday season we saw the release of the film ‘Concussion,’ a fact-based, not documentary, account of the clash between pathologist Bennet Omalu and the NFL when Omalu discovered brain trauma in football players and attempted to shed light on this crisis.
Coinciding with this release, we bring you a recap of C2ST’s event When Playing Sports is Bad for Your Brain, a program held in March 2015, which brought together a neuroscientist and orthopedic physician to discuss this hot topic, sports and brain injury. How can sports damage our brains, what can we do to prevent this, and what does science say about treatment?
We all know American culture is rooted in sports. Neuroscientist Dorothy Kozlowski and orthopedic physician Jeff Mjaanes weren’t behind the podium to tell us not to play sports. We should, however, understand what rattling the brain in collisions on the football field or battlefield does to us. We need to be active, but also take care of our brains.
What is traumatic brain injury, really?
Traumatic brain injury is defined as damage to the brain due to any physical blow to the head, including motor vehicle accidents, blasts on the battlefield that shake the head, or sports injuries. Our brain is like the egg white and yolk inside of its shell. When we experience a hit, the brain sloshes around, hitting against the shell, or our skull.
“The brain is the most sensitive, most unique organ that we have, it controls everything; you are only given one brain for your whole life,” says Mjaanes.
And yet kids don’t view concussions as a big deal.
Concussions result in injury to the function of the brain rather than its structure. The cause is a force, which comes in two flavors: linear and rotational. Usually both forces are at play, and helmets are only able to diminish linear but not rotational force.
Concussion is a process, not an event. The trauma is an event, but the concussion is a cascade of events that the brain has to go through on its road to recovery. Part of this cascade happens on a molecular level, when the brain demands energy but has a lack of blood flow, this leads to a toxic chemical imbalance. The amount of time it takes for this imbalance to dissipate varies from person to person.
The brain is also impacted at the level of connections between the cells. A specialized type of cell in our brain, neurons, are shaped like a cable and thus can shear and stretch like rubber bands. Too much shearing and stretching, which happens during concussions, can cause these cable-like structures to break. Breaks in these cables mean severing connections that are essential to brain function. This can happen in areas such as memory, attention, or emotion.
Mending the brain
Symptoms of traumatic brain injury include a long list of maladies, including headache, neck pain, nausea, vision problems, balance problems, difficulty remembering, sleep troubles and emotional change. There is not test or scan for diagnosis, so clinicians need to base their diagnosis solely on symptoms.
Great strides have been achieved in traumatic brain injury rehabilitation.
“My focus has been on trying to come up ways in which our brain can re-organize after brain injury,” says Kozlowski.
Her studies in rats have shown that the brain is less able to re-organize after brain injury than stroke. The animals needed longer, more varied types of physical rehab than after stroke to recover.
Currently, rehabilitation is the only treatment option available to those suffering from a traumatic brain injury. While people can recover well from a single concussion, repeat concussions, which injure an already-injured brain, can lead to longer term deficits. They also potentially increase the propensity for neurodegenerative diseases. Research only has correlative information, which suggests that repeat concussions alter a molecule important for the shape of neurons, which enables them to properly send and receive information.
With high school and college athletes receiving over 1,000 hits to the head, education and research about traumatic brain injury should not be downplayed. Mother nature did not intend for us to be ramming our heads, so let’s work to understand how we can prevent and mitigate the effects.
By Julia Turan, C2ST volunteer and science writer, Communications Assistant for EuroStemCell at the University of Edinburgh