Researchers evaluate red wine compound for treating concussions in pro boxers

ScienceDaily (May 27, 2011) — UT Southwestern Medical Center researchers are engaging the help of professional boxers and trainers to study whether a component in red wine and grapes could help reduce the short- and long-term effects of concussions.

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Researchers plan to recruit about two dozen professional boxers to take the neuroprotective compound resveratrol after a fight to see if it reduces damage to the brain after impact and helps restore subtle brain functions and connections via its antioxidant effects. If successful, researchers hope the results may be applicable not only to concussions in other sports such as football and hockey, but also to everyday incidents such as falls, auto accidents and other blows to the head.

"We know from animal studies that if we give the drug immediately after or soon after a brain injury, it can dramatically and significantly reduce the damage you see long term," said Dr. Joshua Gatson, assistant professor of surgery in Burn/Trauma/Critical Care and principal investigator for the study. "There haven't been any completed human studies yet, so this is really the first look at resveratrol's effect on traumatic brain injury."

Resveratrol is already being studied as an agent to lower blood sugar levels, for use against cancer, to protect cardiovascular health, and in stroke and Alzheimer's disease treatments.

"Even though resveratrol is found in red wine, you would need 50 glasses of wine to get the required dose to get the protection you would need," said Dr. Gatson.

He came up with the idea for the trial, called the REPAIR study, while watching ESPN. Being a sports fan, he saw frequent concussion issues in football.

"The only treatment available is rest and light exercise, but there is no drug therapy to protect the brain from consecutive concussions, which are actually a lot worse than the initial one," said Dr. Gatson, who investigates biomarkers and novel therapies for traumatic brain injury. "There's been a lot of work with resveratrol showing that it also protects the brain, so we thought this might be the ideal drug."

In this study, researchers are administering the required oral dose once a day for seven days. Pro boxers will take a supplement form of resveratrol within two hours of their match. Researchers will then use neurocognitive tests and novel MRI protocols to track subtle brain activity, inflammation, and restoration of cells and connections.

"The main goal of our research is to protect the brain after each episode so that we can decrease the cumulative effect of these sports concussions," Dr. Gatson said.

Because boxers can have several fights in a short period of time, the researchers decided to target pro boxers with the help of Joseph Mohmed, the study research coordinator, and a coach for USA Boxing, the governing body for all amateur boxing, including the Olympics. Mr. Mohmed also is a former facilities manager at UT Southwestern.

According to the American Association of Neurological Surgeons, 2009 figures showed that 446,788 sports-related head injuries were treated at U.S. hospital emergency rooms, an increase of nearly 95,000 from the year before, in sports ranging from diving and cycling to baseball, basketball, soccer and football. The annual incidence of football-related concussion in the U.S. is estimated at 300,000, with about 47,000 football-related head injuries treated in hospital emergency rooms. In addition, more than 85,000 people were treated for bicycle-related head injuries; about two-thirds of 600 bicycling deaths a year are attributed to traumatic brain injury.

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Ban bodychecking in youth hockey to prevent concussions, expert argues

ScienceDaily (Apr. 25, 2011) — Bodychecking in youth hockey leagues should be banned to prevent concussions which can cause serious repercussions, states an analysis in CMAJ (Canadian Medical Association Journal).

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Concussions in junior hockey are quite prevalent, with up to 25% of all players in one season sustaining these injuries, according to a recent study. Approximately 500,000 young people in Canada play hockey in organized leagues.

"The fact is that the vast majority of concussions, and hockey injuries overall, at all levels of play, are caused by legal bodychecking," writes Dr. Syd Johnson, Dalhousie University, Halifax, Nova Scotia. "It's safe to say that as long as bodychecking is a part of ice hockey, a high rate of concussions will also be a part of hockey."

Concussions can cause fatigue, poor concentration, headaches and memory loss which can affect academic and athletic performance. Repeat concussions are a risk factor for chronic traumatic encephalopathy (CTE) which can lead to permanent behavioural and personality changes, early dementia and other serious neurological changes.

Bodychecking should be banned from junior hockey to prevent serious injuries such as concussions. "If youth hockey players are not exposed to bodychecking, their chances of experiencing a concussion will decrease considerably," writes Dr. Johnson. "Because the damaging effects of concussion are cumulative, the fewer concussions a youth player has sustained, the better off they'll be in the short and long term."

"The way hockey is played by the professionals is imitated in junior hockey," writes the author. "This creates a vicious cycle in which young athletes learn to play in a way that inevitably causes injury and in turn influence the next generation of players. It's time to break that cycle and teach youths to play in a way that emphasizes skill and protects their brains, so they'll be prepared to do the same when they grow up," she concludes.

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Radar shows promise for detecting concussions in athletes and soldiers

ScienceDaily (Apr. 26, 2011) — Walking and thinking at the same time can be especially difficult for persons who've suffered concussions, and scientists hope to use that multitasking challenge -- measured by a simple radar system -- to quickly screen individuals who may have suffered brain injuries.

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By asking an individual to walk a short distance while saying the months of the year in reverse order, researchers at the Georgia Tech Research Institute (GTRI) can determine if that person is impaired and possibly suffering from a concussion. This simple test, which could be performed on the sideline of a sporting event or on a battlefield, has the potential to help coaches and commanders decide if athletes and soldiers are ready to engage in activity again.

"When a person with a concussion performs cognitive and motor skill tasks simultaneously, they have a different gait pattern than a healthy individual, and we can identify those anomalies in a person's walk with radar," said GTRI research engineer Jennifer Palmer.

More than 1 million concussions and other mild traumatic brain injuries are reported each year in the United States and catching them right after they happen can improve treatment and prevent further injury or other long-term health issues. Diagnosing concussions can be difficult, though, because the symptoms of concussions are not always easily visible or detectable, even though they last for weeks or months following the incident. Methods exist for detecting concussions, but most focus purely on cognitive impairment and do not assess accompanying motor skill deterioration.

Details of GTRI's technique, which simultaneously examines a person's cognitive and motor skills, will be presented on April 26 at the SPIE Defense, Security and Sensing conference in Orlando. GTRI research engineers Kristin Bing and Amy Sharma, principal research scientist (ret) Eugene Greneker, and research scientist Teresa Selee also worked on this project, which is supported by the GTRI Independent Research and Development (IRAD) program.

Several studies have shown that measuring changes in gait could be used to diagnose concussions, but measuring a person's gait typically requires wearing special clothing with reflective markers or sensors so that movements can be captured with motion analysis cameras. Using radar for gait analysis would be faster and less intrusive than these existing techniques. The assessment would be done with radar systems similar to those used by police for measuring the speed of vehicles.

For their study, the GTRI research team compared how 10 healthy individuals walked normally and when impaired. For the impairment scenario, individuals wore goggles that simulated alcohol impairment. Past research has shown that concussion impairment is equivalent to having a blood alcohol level of 0.05 percent.

During the trials, each individual performed four 30-second walking tasks: a normal walk, walk while saying the months of the year in reverse order, walk while wearing the goggles, and walk while wearing the goggles and performing the cognitive task. For each task, the subjects walked away from the radar system, turned around and walked back toward the radar system.

"We're using a 10.5 gigahertz continuous wave radar, which is similar to a police officer's radar gun that measures the speed of a car," explained Bing. "The data we collect tells us the velocity of everything that's in the field of view of the radar at that time, including a person's foot kicks, and head and torso movements."

The researchers analyzed the radar data using information-theoretic techniques, which detected similarities and differences in the information without having to identify and align specific body parts. In addition, these techniques could recognize a gait anomaly without requiring that an individual's normal gait be measured before the person became impaired.

"By looking for differences in the gait patterns of normal and impaired individuals, we found that healthy individuals could be distinguished from impaired individuals wearing the goggles," explained Palmer. "Healthy individuals demonstrated a more periodic gait with regular and higher velocity foot kicks and faster torso and head movement than impaired individuals when completing a cognitive task."

The results also indicated that if no cognitive task was performed, a healthy individual's gait pattern was not statistically different when wearing and not wearing the goggles.

"We found that we needed to examine a person's physical and mental capabilities at the same time to see a change in gait and detect impairment," said Bing. "It's easy for a person to concentrate on one task, but when that person has to multitask we can begin to discriminate between someone who is impaired and someone who is not."

In the future, the researchers plan to collect additional data from healthy individuals of different heights and weights, and from individuals exhibiting concussion symptoms according to neuropsychological screening tests performed at a hospital. They also plan to reduce the size of the system so that it becomes more practical to use.

"For the military, we envision the system could fit into a tough box so that commanders can have it in the field," added Bing. "They could simply press a button, connect the radar system to a laptop, and an easy-to-use interface would display the results and tell them whether their soldier is exhibiting signs of a concussion."

Approval from the Food and Drug Administration will be required before this system can be used to diagnose concussions.

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