Footballers continue playing despite undiagnosed brain changes

WASHINGTON - Some high school football players suffer undiagnosed changes in brain function and continue playing even though they are impaired, revealed a study by researchers at Purdue University.

“Our key finding is a previously undiscovered category of cognitive impairment,” said Thomas Talavage, an expert in functional neuroimaging who is an associate professor of biomedical engineering and electrical and computer engineering and co-director of the Purdue MRI Facility.

The findings represent a dilemma because they suggest athletes may suffer a form of injury that is difficult to diagnose.

“The problem is that the usual clinical signs of a head injury are not present. There is no sign or symptom that would indicate a need to pull these players out of a practice or game, so they just keep getting hit,” said Larry Leverenz, an expert in athletic training and a clinical professor of health and kinesiology.

The team of researchers screened and monitored 21 players at Jefferson High School in Lafayette, Ind.

“The athletes wore helmets equipped with six sensors called accelerometers, which relay data wirelessly to equipment on the sidelines during each play,” said Eric Nauman, an associate professor of mechanical engineering and an expert in central nervous system and musculoskeletal trauma.

Impact data from each player were compared with brain-imaging scans and cognitive tests performed before, during and after the season.

The researchers also shot video of each play to record and study how the athletes sustained impacts.

Whereas previous research studying football-related head trauma has focused on players diagnosed with concussions, the Purdue researchers tested all of the players.

They were surprised to find cognitive impairment in players who hadn’t been diagnosed with concussions.

The researchers identified 11 players who either were diagnosed by a physician as having a concussion, received an unusually high number of impacts to the head or received an unusually hard impact.

Of those 11 players, three were diagnosed with concussions during the course of the season, four showed no changes and four showed changes in brain function.

“So half of the players who appeared to be uninjured still showed changes in brain function. These four players showed significant brain deficits. Technically, we aren’t calling the impairment concussions because that term implies very specific clinical symptoms, such as losing consciousness or having trouble walking and speaking. At the same time, our data clearly indicate significant impairment,” said Leverenz.

The findings support anecdotal evidence that football players not diagnosed with concussions often seem to suffer cognitive impairment.

The research could aid efforts to develop more sensitive and accurate methods for detecting cognitive impairment and concussions; more accurately characterize and model cognitive deficits that result from head impacts; determine the cellular basis for cognitive deficits after a single impact or repeated impacts; and develop new interventions to reduce the risk and effects of head impacts.

The ongoing research may help to determine how many blows it takes to cause impairment, which could lead to safety guidelines on limiting the number of hits a player receives per week.

The findings suggest the undiagnosed players suffer a different kind of brain injury than players who are diagnosed with a concussion.

The findings are detailed in a research paper appearing online this week in the Journal of Neurotrauma. (ANI)