In football, "We need to start monitoring more than the appearance of concussions," said Constantine Lyketsos, a psychiatrist at Johns Hopkins University in Baltimore, Maryland, speaking to the press yesterday after a meeting of head injuries in sports. He and other experts in a closed program in Washington, sponsored by the national Football League examined the risk and frequency of brain damage. "We are concerned that they are underestimated," said Lyketsos, who led the session one day.
The event, entitled "Traumatic Brain Injury in Professional Football. An Evidence-Based Perspective," was primarily continuing education for doctors of the NFL team defense clinicians Department also attended the hearing on topics such as brain damage biomarkers and potential long-term effects, including depression, dementia, and chronic traumatic encephalopathy, a disease of dementia as first identified in boxers.
Lyketsos described to reporters a video presented earlier in the day. in the middle of a game, a load of barrels football player in an opponent on his helmet an accelerometer measures a whopping 100 billion, enough for him give a concussion. But he continues to play. it was a powerful illustration, Lyketsos said, the way players are adversely affected without symptoms for the flag to doctors.
Lyketsos said researchers were "worried" that an injury to the relatively soft head, repeated hundreds of times, could add up to a serious injury over time. He cited research in 07 by Kevin Guskiewicz, a sports concussion researcher at the University of North Carolina, Chapel Hill, where Guskiewicz helmets Tarheel players with accelerometers and recorded impacts equipped five seasons. Lyketsos said that an average player 950 visits per season "could be cause for concern," while the "vast majority [resulted in] any symptoms."
Get a handle on these invisible wounds is possible using electroencephalography and imaging, said Robert Stevens, a doctor of intensive care at Johns Hopkins. "[In] many people who appear clinically normal when we make batteries extensive neuropsychological and cognitive tests when we use these biomarker tests, we see brain damage," he said. But the most sensitive techniques, such as diffusion tensor imaging, which measures the directional preference of the water molecules in the white matter, "are very complex and require technical expertise," he said. Team doctors need a simple but powerful test such as checking blood for specific proteins in brain injury --- they can "to implement bedside or the key."
Curiously, Lyketsos downplayed the link between head injuries on several occasions and the long-term effects such as depression, drug use, and dementia, a position reiterated in the program brochure and recently criticized by the president of the NFL concussion committee. "There have been a handful of evidence, but it is not very strong," said Lyketsos. an earlier study commissioned by the NFL and conducted by researchers from the University of Michigan found that former NFL players proportion who had been diagnosed with dementia-related disorder (according to their own accounts) was five times higher than in the general population for players aged 50 and more, and 19 times higher for players aged between 30 and 49 (for an overview of research on dementia and NFL players, see this recent article science ).
However, larger samples and more studies are needed, Lyketsos said, adding that among the doctors in the NFL, "there is a strong will to achieve ongoing studies."
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