Revealing brain damage from battlefield to playing field
It may not even take such dramatic impacts to impair mental skills. A second study released on Wednesday showed that some college football and hockey players had lower scores on thinking and memory tests after a season of enduring repeated but minor hits to the head.
The players, outfitted with special helmets that measured head impacts, experienced an average of 469 during the season, scientists led by Thomas McAllister of the Geisel School of Medicine at Dartmouth reported in the journal Neurology.
TREATING AND PREVENTING
There are no approved treatments for traumatic brain injury. One experimental drug from BHR Pharma, a subsidiary of Besins Healthcare SA, is in the last stage of human testing.
But the study suggests the military should re-examine soldiers’ protective gear. Heavy helmets that protect against impacts and even bullets “are like putting a bowling ball on top of a match stick,” said Goldstein, exacerbating the destructive acceleration and deceleration from a blast wave.
According to the CDC (Centers for Disease Control and Prevention), USA:
- About one third of injury related American deaths are linked to TBI
- About 230,000 hospitalizations occur annually in the USA as a result of TBI
- 1.1 million Americans are treated for TBI and released from an emergency department
- Almost 2% of the US population lives with TBI-related disabilities
- About 2 million American adults and children suffer from traumatic brain injury annually
- 50,000 patients die annually in America as a result of TBI
- Every 15 seconds one American man, woman or child sustains a significant traumatic brain injury
- The total number of individuals with TBI who are not seen in an emergency department, or who do not receive any care is unknown
- Direct medical costs and indirect costs, such as lost productivity of TBI totaled an estimated $60 billion in the USA in 2000
- Among American children aged up to 14 years, TBI results in an estimated:
- - 2,685 deaths
- - 37,000 hospitalizations
- - 435,000 emergency department visits annually
Scientists have not managed thus far to identify effective medications to improve outcomes for such patients, despite the extent of the problem.
The CDC also reports that the main causes of TBI are falls (28%), motor vehicle traffic crashes (20%), struck by/against events (19%), and assaults (11%).
When the mice’s heads were immobilized, though, an identical blast produced no brain damage. That finding “has invaluable implications for future safety measures,” said psychologist Jennifer Wilde of the University of Oxford, who was not involved in the study. Namely: “special helmets to help keep soldiers heads still during a blast.”
The results also suggest that head trauma should be treated immediately instead of waiting for symptoms. The BU scientists “are working on field-deployable treatments,” Goldstein said, including anti-inflammatory drugs and agents that target leaky blood vessels.
The U.S. military tries “to identify TBI as soon as possible and provide effective treatment,” said Pentagon spokesperson Cynthia Smith. That policy pertains “regardless of whether the injury is obvious and severe, or subtle and hidden.” All service members in a vehicle collision or rollover or within 150 feet of a blast undergo a mandatory medical evaluation.
The new study also confirms the physical reality of psychological illnesses that the military and others have sometimes dismissed. “Post-traumatic stress disorder has been regarded as a purely psychological illness, because we’ve been looking at brains with CT and MRI,” said neuropathologist Bennet Omalu, chief medical examiner of San Joaquin County in California and co-founder of the Brain Injury Research Institute. BIRI hopes to examine Seau’s brain, which the BU lab is also in the running for.
“CT and MRI don’t have the resolution to show the cellular and sub-cellular changes you can get from a concussion or sub-concussive injury,” said Omalu. “Now we can see that PTSD is likely to be a manifestation of traumatic brain damage.”
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By Sharon Begley
NEW YORK