Lucas Shapiro
Mrs. Tenly
Independent Research
April 3, 2016
Biotechnology and Increased Safety Precautions
As time progresses, more and more organizations are publicly recognizing the severity of the concussion crisis. The NFL has taken baby steps in addressing the issue by forming an MTBI committee and doing more research to understand how to prevent further injuries. In addition to correcting the players’ behavior on the field, it is also important to develop more effective safety gear. Making a safer helmet, or one that can detect brain activity and impact, would be an incredible help in ending this conflict. Understanding the mechanics behind a brain injury, what parts of the brain are affected, and what physical and technological changes are needed are all important steps to resolving the concussion crisis.
Concussions are considered moderate brain injuries, but there are varying degrees of them that can result in severe damage to the brain. The three types of brain injuries include contusions, axonal injuries, and hematomas. Contusions are bruises to the brain tissue, axonal injuries include damage to the long projections that carry nerve impulses around the body, and hematomas are bleeding in the brain. These outcomes are common in more serious injuries and can have lasting effects that include problems with behavior, communication, and cognitive processes. Participation in contact sports is a notable risk factor for TBIs.
The two causes of TBIs are known as closed- or open- head injuries. Both of these causes can directly impact the brain and lead to increased intracranial pressure (ICP) which inhibits blood supply to brain tissue. Concussions are typically closed-head injuries where the skull is not broken and the brain is jarred from a back and forth motion. The brain is soft and comes into contact with the hard encasing of the skull. Since the frontal and temporal lobes occupy the area of the forehead and temples, these regions are most susceptible to injury. These portions control speech and language, as well as judgment and decision making. This supports the emergence of communication problems after a brain injury. The brain also controls sensation and other cognitive processes such as memory that can be adversely affected from a TBI.
Of all TBIs, 3% of them are known to be from sports injuries. Young people and the elderly are the most susceptible to these injuries. Usually the injury will be to a specific portion of the brain, but more complex injuries can produce diffuse brain trauma. In the case of concussions, symptoms can range from complete unconsciousness to blurry vision and disorientation. About 40% of patients will develop post-concussion symptoms in the days and weeks following an injury. Signs of this condition include headaches, trouble concentrating, problems with sleeping, and irritability.
To lower the risk of TBIs, people are advised to take the necessary precautions to avoid these injuries. Protective headgear has become mandatory for contact sports and other dangerous activity. Helmets for the NFL also go through evaluation before being cleared for play. The issue remains that not all helmets are created the same, so some may have better capabilities of protecting the brain than others, but both meet the minimum requirements for game play (USA Today). To address the variety of dangers related to contact sports, an increasing number of initiatives are being put forth to properly educate coaches and officials on concussions. Safe play and proper steps to attend to any degree of brain injury are now more commonly addressed by coaches to players.
Brain injuries must be monitored for an extended period of time because not all symptoms arise immediately. Some problems may develop days or weeks after injury, and immediate symptoms such as headaches may mask more serious cognitive damage. Due to the stress of these injuries, misattribution of problems is possible and the true degree of damage may not be fully understood until after the initial recuperation period.
Since brain injuries are so specific and must be handled with care, it would be beneficial for sports leagues to utilize technology that could document the severity of an impact. Stefan Duma, director of Virginia Tech’s Center for Injury Biomechanics, has developed a football helmet that helps doctors understand head injuries. Using sensors, brain activity and level of impact can be monitored throughout a game and during contact to better prepare the physician in caring for a patient.
Specifically, CTE has been in the center of neurological research because of its detrimental effects on NFL players. Dr. Bennett Omalu coined the term CTE, and his research is featured in the PBS Frontline documentary NFL: League of Denial. In the film, post mortem evaluations of CTE in NFL players such as Mike Webster and Steve Young are shown, and Omalu reveals his concern about the dedication of the NFL to the safety of its players. Build up of the protein tau in the players’ brains is biological evidence of CTE, and is caused by repetitive concussive or sub-concussive hits that are common in contact sports such as football. It is the job of the NFL to eradicate these dangerous plays, or develop a safety mechanism to protect the players lest the league itself end.
The field of sports medicine is a more recent sector that focuses on preparing and protecting athletes in competition. Diagnosis, treatment, rehabilitation, and prevention of injuries are all important aspects of the field (World of Health). Sports medicine did not become its own entity until the International Assembly on Sports Medicine was formed at a meeting during the St. Moritz, Switzerland Winter Olympics. From then on, physicians have come together to improve the technology that protects athletes, and modify game play to prevent injury. An example of an athlete taking matters into their own hands was hockey goalie Jacques Plante refusing to return to the game until players were required to wear a protective face mask (World of Health).
Students from all around the globe are using advanced knowledge of biology, physics, biochemistry, and engineering to discover new insights into the brain. Edward Boyden, an MIT alumnus, has devoted his time to finding a protein that can be used as a neuronal switch, controlling how neurons interact with one another. Experimenting with rats using this innovation will give researchers further insight into brain function and allow them to attack neurological disorders such as CTE in a new way (Technology Review).
There has also been research conducted on woodpeckers to determine what stops them from sustaining head injuries as they charge their beaks into the bark of trees. Researchers wish to come up with a way to prevent the breakage of the human skull, or better yet counter the impact that causes concussions in general. Since there cannot be human concussion testing, the Head Impact Telemetry System (HITS) has been marketed by Simbex to assess the impact of concussions wirelessly and instantaneously from the sideline. The data that comes from these readings can provide insight as to how to better protect the endangered areas of the brain, and how to improve helmet technology. The Multi-Directional Impact Protection System (MIPS) is a helmet design created by Swedish engineers and neurologists that is meant to rotate with the head as it is impacted, and thus keep the brain and skull in place, thereby avoiding head injury.
Much of the biotechnical research done with the brain is experimental and does not always involve the creation of new technology. It is very important to find numerous ways to evaluate the brain and learn how different factors affect one another in order to come up with a solution to the concussion crisis. No one device is likely to solve the entire problem, therefore many research teams must work together to uncover as much information as possible. In 2011, research on taupathies was conducted in regards to genetic contributions to tau accumulation (Nature Genetics). Although this research is not creating a newer, safer helmet, it is providing information about the cause of CTE and thereby may be a building block to another biomedical initiative.
A combination of educating the players about the dangers of contact sports and doing biomedical research to develop better safety equipment will result in a better athletic environment for future players. It is unlikely that organizations such as the NFL will dissolve, so it is important to work with them to develop compromises that will benefit the majority. As more medical research surfaces regarding the concussion crisis, sports leagues are left with no choice but to address the issue, and their increased attention will lead to improved conditions.