ANN ARBOR -- A grant from the NCAA will kick off a groundbreaking, long-term study of concussion and other head injuries among athletes, led by University of Michigan researchers and their colleagues around the country. The NCAA will provide $400,000 to begin to fund a longitudinal study by the National Sport Concussion Outcomes Study Consortium, a new group that includes three founding members from the University of Michigan: Jeffrey Kutcher, M.D., associate professor of neurology; James T. Eckner, M.D., assistant professor in physical medicine and rehabilitation; and Steven Broglio, Ph.D., assistant professor of kinesiology. With the NCAA grant, the Consortium will study more than 1,000 male and female college athletes who compete in 11 sports at three schools. Researchers hope to track those athletes throughout their lifetime to monitor long-term effects of head injuries.But the Consortium has even bigger plans. Kutcher says the group is seeking funding to expand the effort and begin enrolling athletes as early as high school, then follow them through college and even into professional careers. "We're hoping this could become a Framingham heart study for sports concussion," says Kutcher, referring to the study that began in 1948 with more than 5,000 people and has led to the identification of major cardiovascular disease risk factors."This study will be essential to improving our understanding of the risk to brain health for those who play sports. There is no data like this, it's groundbreaking. It will define the landscape." Kutcher and the U-M faculty founded the Consortium with Kevin Guskiewicz, Ph.D., chair of the Department of Exercise and Sport Science at the University of North Carolina; Chris Giza, M.D., of the Department of Neurology at UCLA; and Michael McCrea, Ph.D., professor of neurosurgery and neurology and director of brain injury research at the Medical College of Wisconsin. "There's a tremendous need for data that describe both the short and long-term health consequences of concussions," says Kutcher, who also is director of the Michigan Neurosport Concussion Program at U-M. "There are some hints, and a series of case reports in the literature, but no well-controlled study that addresses the long-term questions. To do that study, and do it correctly, requires following a population of athletes over time and documenting their brain function, while controlling for other variables." David Klossner, the NCAA's director of health and safety, said supporting the consortium's study will aid efforts to promote a safe competitive environment. "The NCAA is seeking to foster innovative research among its member universities to increase knowledge about the short-term and long-term neurological consequences of playing sports," Klossner said. "In addition to monitoring trends in concussions through the Association's injury-surveillance system, this research is another important step to enhance student-athlete safety." In this first phase of the study, the Consortium researchers will study athletes in contact sports ihttps:// football, soccer, basketball, ice hockey, and lacrosse; women's water polo, soccer, basketball, field hockey, and lacrosse. Non-contact sport participants also will be recruited from the track and field and swimming and diving teams. Kutcher believes the data the study collects will provide a more comprehensive understanding of concussions. The short-term effects have been examined for several years, and technological advancements have helped improve the understanding of impacts on the brain by using shock sensors embedded in players' helmets. "There has been https://rable attention paid to concussion recently, by the media and others, spurred by reports of National Football League players, hockey players — people who have had a long history of contact — having a very particular kind of dementing illness," says Kutcher. "But that story is only beginning to be told. We need to do the appropriate research to figure out the scope of the problem." Kutcher also directs the NBA's concussion program, is a consultant to the NHL Players Association and the team neurologist for the University of Michigan Athletic Department. He has been instrumental in crafting the concussion policies of the NCAA, Big Ten and Mid-American Conference. He has testified before U.S. Congress on helmet and equipment safety. For more information and free online courses about recognizing and responding to concussions, go to https://www.michiganneurosport.com/ SOURCE University of Michigan Health System Read more here: https://www.sacbee.com/2012/03/14/4336415/groundbreaking-long-term-study.html#storylink=cpy Photo: Wikimedia Commons

While involvement in school sports is probably one of the healthiest things, physically and mentally, your child can do, the pressure to play harder and practice longer brings an increased risk of head injury. Medical, sports and school communities are all taking a serious new look at how to treat concussions caused by a hit to, or shaking of, the head. Falls during equestrian, cheerleading and gymnastics events are producing concussions at an increasing rate, along with the more obvious contact sports like football and soccer. "A concussion is a type of traumatic brain injury (or TBI) and it is similar to a stroke in that both affect normal brain function and may have similar symptoms," explained Neurologist Frederick Nahm, MD, PhD, and head of the Stroke Center at Greenwich Hospital in Greenwich, Connecticut. Immediate symptoms may include confusion, disorientation and sometimes falling unconscious. Ignoring these symptoms is outright dangerous. "During a game, your adrenaline is going and you're pumped up, so it's easy to brush it off. But whether you bump your head during sports, a car accident, a fall or during military activity, it may not be until that night or a few days later that you get a headache or start to feel dizzy or nauseous," Nahm added. "The most important thing with a head injury, if you feel as though you're having symptoms you have to tell someone and seek evaluation. Taking time to heal makes a lifetime of difference Getting a 14-year-old to take it easy, to stop using the computer, to stop texting, is not easy, but it's very important to get that teenager to understand what happened. Parents need to be involved to get the injured child engaged by allowing the brain to rest as part of the healing process. Dr. Nahm points out that, "a thorough treatment plan focuses on the emotional, psychological, and behavioral issues that can arise following even a mild brain injury." Without proper healing, a student who never worried may develop anxiety about performance at school, and may find that no matter how much effort they put into it, they can't manage to hold the grade point average they had prior to injury. "These secondary complications, like anxiety disorders or a new phobia of tests, memory problems, depression, apathy, inattention and other behaviors are indelible and can be difficult to treat. It's not something the student can control or work harder to 'fix' because It's the result of an injured brain. Only a physician trained in the treatment of concussion or traumatic brain injury (typically a neurologist or neuropsychologist) can do a thorough assessment for a severe brain injury," said Dr. Nahm. Returning to nohttps://tivity without proper healing creates an increased risk of second impact syndrome; repeated head injury, especially injury before total healing has occurred, carries a far more serious threat to long-term complications. If you bang your head, take it seriously, tell someone, and even if you have no immediate symptoms, take the time for an evaluation. Photo: Courtesy College of William and Mary/ (C) Creative Commons Story Source: Science Daily: https://www.sciencedaily.com/releases/2012/09/120912093159.htm The above story is reprinted from materials provided by Greenwich Hospital. Questions/comments? Contact Jean Rickerson at jean@sportsconcussions.org

"Short term memory's not good," Jim McMahon, former Chicago Bears quarterback and two-time Super Bowl champion tells ESPN. "I won't remember a lot about this interview in about 10 minutes." McMahon and his girlfriend give a rare look inside the daily struggles he says were a result of repeated blows to the head incurred during his 15-year NFL career. McMahon and hundreds of other former NFL players are suing the league for allegedly concealing information about the risk of concussions. ESPN Outside the Lines -- Taking Its Toll (8:12)(video) The 52-year-old McMahon says he suffered three documented concussions during his career, impacts significant enough that he was unaware of his surroundings. Now he has good days and bad days according to his girlfriend, Laurie Navon, who has programmed the GPS in his car with their home address in case he gets lost. He repeatedly purchases the same books on his e-reader. The Chicago Bears selected McMahon in the first-round of the 1982 NFL Draft where he won the starting quarterback position as a rookie. McMahon led the Bears to a Super Bowl victory in 1985, where he became the first quarterback in the championship's history to rush for two touchdowns. He returned to win the Super Bowl a second time as a Green Bay Packer in 1996. On Oct. 12, 1988 the Chicago Tribune reported that McMahon had been evaluated by an athletic trainer on the sideline who said, "He had a concussion, but it cleared by halftime." The NFL has much stricter policies and standards regarding head injury today, as more information on concussions has become available. Source: ESPN: Outside the Lines -- Taking Its Toll March 18, 2012 Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

The first of three private screenings was held in Chicago on May 15th for "Head Games," a documentary on the sports concussion crisis. From acclaimed director Steve James (Hoop Dreams, The Interrupters) and award-winning producer Bruce Sheridan, Head Games takes a deeper look at the devastating and long-term effects of concussions in all sports. Inspired by events from the book Head Games written by Christopher Nowinski, the film offers eye-opening insight and cutting-edge science on head trauma from the nation’s leading medical experts. Additional screenings will be held June 6 at the Boston University School of Medicine Albany Street Auditorium and June 7 in Philadelphia at the Translational Research Center (TRC) Rubenstein Auditorium. Watch the trailer Questions/comments? contact Jean Rickerson at Jean@SportsConcussions.org

Collisions. Headers. Goalpost run-ins. Soccer athletes and fans can't help but wonder which elements contribute most to the frequency of concussions in the sport, particularly among young girls. Researchers have been collecting data in helmeted sports for many years using accelerometers embedded in head gear, but non-helmeted sports have presented obvious challenges. Impact data has provided some of the most critical science in the concussion field. As a result, the forces that players sustain in various contact sports are well-documented and found, in some cases, to be alarming. The latest addition to the data bank was the inclusion of an impact study on 7-and 8-year-old football players and the adult-sized forces they incurred during practices. Now the focus is turning to other sports, including soccer. A new study by researchers at Wayne State University, published in the Journal of the American College of Sports Medicine offers insight into head acceleration in girls' youth soccer (U14) during game play. HITS The Head Impact Telemetry System (HITS) used to measure the force impacts, was utilized in this study. Small accelerometers typically mounted inside helmets, transmit data wirelessly to researchers on the sideline. In this case, soccer headbands with the padding removed were outfitted with the instrumentation. Impacts over 10g, or 10x the force of gravity, were recorded and analyzed at a later time alongside corresponding video footage to determine the nature of the hit. For reference, a sneeze might be 3g, a fighter pilot might "pull" 9g during maneuvers, and high school football players regularly sustain hits ranging from 60-100g and higher, many without reporting concussion symptoms. A total of 24 girls participated in the study, conducted during scrimmages on grass fields. Scrimmages lasted 30 to 65 minutes each. None of the players suffered a concussion during the research. Results There were 47 header impacts and 20 non-header impacts observed during the study. Non-header impacts included collisions with another player, player falls, collisions with goalposts, and unintended collisions with the ball. Researchers found: - majority of non-header impacts (40%) were player-to-player collisions - most headers impacted the front of the head; the peak linear acceleration (force) recorded was 4.5g- greatest header force occurred on the right side of the head and was measured at 62.9g - most head impacts players sustained in one scrimmage was four - side headers resulted in greater forces than back headers - player collisions resulted in the highest number of nonheader impacts and had a maximum force of 56.7g - impacts from player falls measured a maximum force of 23.7g - a goalpost collision measured a maximum of 27.1g Researchers hypothesized that non-header impacts would exceed those from heading the ball, but that was not what the case. Many of the players experienced multiple impacts in a single scrimmage, the cumulative effects of such impacts within a short time frame are unknown. Conclusions Concussions can occur in any sport and amending equipment and making rule changes to decrease the frequency and severity of the injury depends on science. Soccer has emerged as the leading cause of sport-related concussions for young girls and researchers are working to unravel the reasons why. Hypotheses range from less neck strength, to hormonal differences to better reporting by females. Source: Medicine & Science in Sports & Exercise: June 2012 - Volume 44 - Issue 6 - p 1102–1108 doi: 10.1249/MSS.0b013e3182444d7d Applied Sciences Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

Bronx, NY — Patients vary widely in their response to concussion, but scientists haven’t understood why. Now, using a new technique for analyzing data from brain imaging studies, researchers at Albert Einstein College of Medicine of Yeshiva University andMontefiore Medical Center have found that concussion victims have unique spatial patterns of brain abnormalities that change over time. The new technique could eventually help in assessing concussion patients, predicting which head injuries are likely to have long-lasting neurological consequences, and evaluating the effectiveness of treatments, according to lead author Michael L. Lipton, M.D., Ph.D., associate director of the Gruss Magnetic Resonance Research Center at Einstein and medical director of magnetic resonance imaging (MRI) services at Montefiore. The findings are published today in the online edition of Brain Imaging and Behavior. The Centers for Disease Control and Prevention estimates that more than one million Americans sustain a concussion (also known as mild traumatic brain injury, or mTBI) each year. Concussions in adults result mainly from motor vehicle accidents or falls. At least 300,000 adults and children are affected by sports-related concussions each year. While most people recover from concussions with no lasting ill effects, as many as 30 percent suffer permanent impairment – undergoing a personality change or being unable to plan an event. A 2003 federal study called concussions “a serious public health problem” that costs the U.S. an estimated $80 billion a year. Previous imaging studies found differences between the brains of people who have suffered concussions and normal individuals. But those studies couldn’t assess whether concussion victims differ from one another. “In fact, most researchers have assumed that all people with concussions have abnormalities in the same brain regions,” said Dr. Lipton, who is also associate professor of radiology, ofpsychiatry and behavioral sciences, and in the Dominick P. Purpura Department of Neuroscience at Einstein. “But that doesn’t make sense, since it is more likely that different areas would be affected in each person because of differences in anatomy, vulnerability to injury and mechanism of injury.” In the current study, the Einstein researchers used a recently developed MRI technique called diffusion tensor imaging (DTI) on 34 consecutive patients (19 women and 15 men aged 19 to 64) diagnosed with mTBI at Montefiore in the Bronx and on 30 healthy controls. The patients were imaged within two weeks of injury and again three and six months afterward. The imaging data were then analyzed using a new software tool called Enhanced Z-score Microstructural Assessment Pathology (EZ-MAP), which allows researchers for the first time to examine microstructural abnormalities across the entire brain of individual patients. EZ-MAP was developed by Dr. Lipton and his colleagues at Einstein. DTI detects subtle damage to the brain by measuring the direction of diffusion of water in white matter. The same technology was used by Dr. Lipton and his team in widely publicized research on more than 30 amateur soccer players who had all played the sport since childhood. They found that frequent headers showed brain injury similar to that seen in patients with concussion. The uniformity of diffusion direction – an indicator of whether tissue has maintained its microstructural integrity – is measured on a zero-to-one scale called fractional anisotropy (FA). In the latest study, areas of abnormally low FA (reflecting abnormal brain regions) were observed in concussion patients but not in controls. Each concussion patient had a unique spatial pattern of low FA that evolved over the study period. Surprisingly, each patient also had a unique, evolving pattern of abnormally high FA distinct from the areas of low FA. “We found widespread high FA at every time point, all the way out to six months and even in patients more than one year out from their injury.” said Dr. Lipton. “We suspect that high FA represents a response to the injury. In other words, the brain may be trying to compensate for the injury by developing and enhancing other neural connections. This is a new and unexpected finding.” At present, diagnosis of concussions is based mainly on the nature of the patient’s accident and the presence of symptoms including headache, dizziness and behavioral abnormalities. DTI, combined with EZ-MAP analysis, might offer a more objective tool for diagnosing concussion injuries and for predicting which patients will have persistent and progressive symptoms. The paper is titled “Robust Detection of Traumatic Axonal Injury in Individual Mild Traumatic Brain Injury Patients: Intersubject Variation, Change Over Time and Bidirectional Changes in Anisotropy.” Contributors include Namhee Kim, Ph.D.; Tova M. Gardin, B.A.; Keivan Shifteh, M.D.; Mimi Kim, Sc.D.; Molly E. Zimmerman, Ph.D.; Richard B. Lipton, M.D.; and Craig A. Branch, Ph.D., all of Einstein and Montefiore; and Young Park, M.D., who earned his degree from Einstein; and Miriam Hulkower, a medical student at Einstein. Source: Novel Brain Imaging Technique Explains Why Concussions Affect People Differently Albert Einstein College of Medicine at Yeshiva University -- Newswise; June 9, 2012 Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

NFL Hall of Famer "Iron Mike" Webster's life ended in 2002 when he suffered a heart attack at age 50. Four Super Bowl rings, nine Pro Bowls, and voted to the NFL's all-time team in 2000, the driven, ultra-competitive Steelers' center drifted into a life of drug use, homelessness, and enormous suffering after retiring in 1988. In 2005, his son Garrett told ESPN that the only way his father could get to sleep was to taser himself into unconsciousness. Former teammates and friends offered assistance over the years but it wasn't enough. After Webster's death, forensic neuropathologist Dr. Bennet Omalu was determined to find neurological reasons for his cognitive decline. Seventeen years in the NFL at a time when safety precautions and concussion awareness were both minimal had resulted in thousands of impacts to his head. Though his brain looked normal at autopsy, Omalu pressed on until he found the abnormalities that we now call Chronic Traumatic Encephalopathy, or CTE. CTE and Alzheimer's CTE and Alzheimer's are both “neurodegenerative diseases.” That is, they are brain diseases that result in the progressive destruction of brain cells, eventually leading to cognitive, behavioral, and other impairments. Both Alzheimer’s and CTE can only be accurately diagnosed postmortem through a neuropathological examination of the brain and their progression has remained elusive. But clues about how Alzheimer's spreads from neuron to neuron are now emerging. Whether the same process of progression applies to CTE is currently unclear. Photo: Alzheimer's infects from neuron to neuron The inexorable spread of Alzheimer’s disease through the brain leaves dead neurons and forgotten thoughts in its wake. Researchers at Linköping University in Sweden are the first to show how toxic proteins are transferred from neuron to neuron. Through experiments on stained neurons, the research team – under the leadership of Martin Hallbeck, associate professor of Pathology – has been able to depict the process of neurons being invaded by diseased proteins that are then passed on to nearby cells. “The spread of Alzheimer’s, which can be studied in the brains of diseased patients, always follows the same pattern. But until now how and why this happens has not been understood,” says Hallbeck, who along with his research group has now published their results in The Journal of Neuroscience. The illness starts in the entorhinal cortex – a part of the cerebral cortex, and then spreads to the hippocampus. Both of these areas are important for memory. Gradually, pathological changes take place in more and more areas of the brain, while the patient becomes even sicker. Two proteins have been identified in connection with Alzheimer’s: beta amyloid and tau. Normally tau is found in the axons – the outgrowths that connect between neurons – where it has a stabilising function, while beta amyloid seems to have a role in the synapses where the neurons transfer signal substances to each other. But in Alzheimer’s patients, something happens with these proteins; autopsies reveal abnormal accumulations of both. Why they become abnormal is still unknown, but what is known is that it’s not the large accumulations, or plaques, that damage the neurons. Instead, smaller groups of beta amyloid – called oligomeres – seem to be the toxic form that gradually destroy the neurons and shrink the brain. “We wanted to investigate whether these oligomeres can spread from neuron to neuron, something many researchers tried earlier but didn’t succeed,” Hallbeck says. The study was inaugurated with an experiment on neuron cultures, where researchers injected oligomeres stained with a phosphorescent red substance called TMR using a very thin needle. The next day the neighbouring, connected neurons were also red, which showed that the oligomeres had spread. To test whether a sick neuron can “infect” others, they conducted a round of experiments with mature human neurons stained green and mixed with others that were red after having taken up stained oligomeres. After a day, approximately half of the green cells had been in contact with a few of the red ones. After two more days, the axons had lost their shape and organelles in the cell nucleus had started to leak. “Gradually more and more of the green cells became sick. Those that hadn’t taken up the oligomeres, on the other hand, weren’t affected,” Hallbeck says. The study is a breakthrough in understanding Alzheimer’s and its progress. If a way of stopping the transfer can be found, it could lead to a more effective inhibitor against the disease. Article: Spreading of neurodegenerative pathology via neuron-to-neuron transmission of beta-amyloid by Sangeeta Nath, Lotta Agholme, Firoz Kurudenkandy, Björn Granseth, Jan Marcusson and Martin Hallbeck. The Journal of Neuroscience, 27 June 2012. Photo: Alzheimer's infects from neuron to neuron: Two nerve cells, each about 10 micrometers large, are visible as shadows in this picture. From the beginning only the right one (yellow arrow) contained the toxic, red stained, oligomeric beta-amyloid. When these sick cells make contacts with the healthy, green labeled cells (black arrow), toxic beta-amyloid will spread through the neuronal projections (white arrow). Subsequently, also the green cell will become sick. Credit: Martin Hallbeck Source: The above story is reprinted from materials provided by Linköping University. Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

Starting in 2012, helmet reconditioners will no longer accept helmets 10 years or older. Leagues that have depended on reconditioning their helmets every year and cannot afford replacement gear will be most affected. Although helmets do not prevent concussions, most experts agree that newer ones are preferable to used, and an older, unreconditioned helmet might increase the risk of injury. Many leagues ask their booster clubs for assistance with fundraising as this issue has now reached a critical phase. Limited grants for replacement helmets by leading manufacturers are now available for eligible youth leagues in several areas around the country. Applications are now being accepted for youth football programs seeking to replace their league's helmets before the start of the 2012 season. The Centers for Disease Control and Prevention, USA Football and partnering organizations have introduced a helmet replacement program for youth in underserved communities. It is estimated the program will provide almost 13,000 new helmets to athletes in low-income communities beginning in July 2012. To qualify a league must meet the following criteria: - Operate a youth football league (no middle or high school programs) - Live in one of the following areas: Cleveland, New Orleans, New York, or the San Francisco Bay area - Serve an economically disadvantaged area The application process requires registration at USA Football, the governing body for youth football under the NFL. The application is accessible only after viewing a concussion awareness video and pledging to utilize USA Football's resources to educate members of your league before the 2012 season. A visit from an official to verify the ages and number of helmets exceeding 10 years of age in your inventory will occur by mid-June, with new helmets arriving prior to the beginning of the 2012 season. Participating helmet manufacturers include Rawlings, Xenith, Riddell and Schutt. Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

Concern over longevity issues stemming from a string of injuries including back-to-back concussions, may have contributed to Chris Owusu's omission from the first seven rounds of the NFL draft this weekend. But Stanford's talented receiver, who turned in one of the fastest times in the 40-yard dash at the NFL Combine in February and was considered a possible top 100 prospect during his senior year, was signed by the San Francisco 49ers shortly after the draft concluded on Saturday. Owusu, one of Andrew Luck's go-to receivers missed the end of his senior season including two Bowl games after suffering two concussions in three weeks, his third in a little more than a year. Admitting to frustration because his symptoms cleared rapidly after each injury, he was not authorized by Cardinal physicians to return. Considered a third-round talent, Sports Illustrated's Jim Trotter spoke to several general managers about Owusu. "He's off our board," says one general manager. "He was from the start. It wouldn't matter if he was RG3, he'd still be off our board. With that kind of history it's not worth the risk of him being seriously injured, especially with all the attention you're going to receive. If you draft him you're going to be under the microscope the whole time. Every time he gets hit it's going to be magnified tenfold." For the 49ers, Owushttps://oo good to pass up. "Chris wasn't wiped off our board," 49ers general manager Trent Baalke said Saturday when he met the media at the conclusion of the draft. "You've got to remember, he was cleared to play by the same group of doctors that work with us on a regular basis. He certainly was not off our board," according to NBC SportsGroup. Owusu was taking part in a Stanford School of Medicine research project when he suffered at least one of his concussions. Researchers recorded impact data from players wearing high-tech mouthguards in an effort to gain a better understanding of the forces that cause the injury. Source: Read more: https://sportsillustrated.cnn.com/2012/writers/jim_trotter/04/25/draft.concussions/index.html#ixzz1tSyGvhE8 Questions/comments? contact Jean Rickerson at Jean@SportsConcussions.org Photo: (c) Maveric2003@creativecommons