The Scary New Finding on Concussions in Young Athletes

The topic of concussions in youth sports is a hot one. As data continue to emerge, the implications for how athletes are treated after suffering an impact could change greatly—and, many say, it’s about time.

The latest finding, from research published in the Journal of Neurotrama, shows that a growing number of high school football players are suffering neurologic injuries that aren’t detected; as a result, they continue to play—a dangerous trend that needs to be reversed.

In the study, post-mortem evidence indicated that repeated head blows may eventually damage the brain, even though individual instances might not provide any clinical symptoms of concussion, said lead author Thomas M. Talavage, PhD, of Purdue University Weldon School of Biomedical Engineering. The detection and characterization of head trauma needs to be improved to minimize future injury risk, the researchers wrote.

Talavage and colleagues examined neurologic performance and health in the presence of head collision events in high school football players, using longitudinal measures of collision events, neurocognitive testing, and functional MRI. Longitudinal assessment was conducted in 11 males ages 15-19 participating on the varsity and junior varsity football teams at one high school. Subjects were observed in two categories: 1) no clinically-diagnosed concussion and no changes in neurological behavior and 2) clinically-diagnosed concussion with changes in neurological behavior.

The investigators also observed athletes in a “previously undiscovered third category who exhibited no clinically-observed symptoms associated with concussion,” but who demonstrated measurable neurocognitive (primarily visual working memory) injuries and neurophysiologic impairments, which included altered activation in dorsolateral prefrontal cortex (DLPFC). This new category, they wrote, “was associated with significantly higher numbers of head collision events to the top-front of the head, directly above DLPFC.”

The implications of this are significant, as it suggests that “more players are suffering neurologic injury than are presently detected via traditional concussion-assessment mechanisms,” wrote the authors. These young athletes are “unlikely to undergo clinical evaluation and thus continue to participate in football-related activities even when changes in brain physiology (and potential brain health) are present, likely increasing risk of future neurologic injury.”

The problem, said Larry Leverenz, one of the authors of the Purdue study, “is that the usual clinical signs of a head injury are not present,” according to an online article. “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.”

The study, which is still ongoing, could determine how many hits are needed to cause impairment, which would help formulate guidelines on how many impacts a player should be limited to each week, said the article.

The subject of concussions has received more attention in recent months due to the long-term damage that studies have found can occur in athletes. According to the Consumer Product Safety Commission, nearly 352,000 sports-related head injuries were treated in hospital emergency rooms in America in 2008. Due to the high incidence of concussion, many experts are cautioning that stricter guidelines are needed in terms of how soon an athlete can return to play after a potential concussion.

For more information:

• Functionally-Detected Cognitive Impairment in High School Football Players without Clinically-Diagnosed Concussion
• Pediatrics: Sport-Related Concussion in Children and Adolescents
• Neurology Today: Managing Patients with Sports Related Concussion

Do you think enough is being done to investigate the impact of concussions in young athletes, and to limit the play of those who have suffered potential brain injury?