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Figure 5: NFL Logo (Source: http://www.sportslogos.net/teams/list_by_lea gue/7) It’s just a concussion right? A report exposing the future consequences of repetitively sustained head injuries in sports By: Akhil Ramaswamy What is a TBI? More info on CTE: • Traumatic Brain Injuries are basically concussions and can range in severity Controversies: Mike Webster (Patient zero): • • Former Center for the Pittsburgh Steelers • Chronic Traumatic Encephalopathy issued by many • • First football player to be diagnosed with CTE • Concussions can cause two different types of damage to the brain • A neurodegenerative disorder that can lead to death caused by TBI’s • Occur when a biomechanical force is applied to the head • Known as “Punch-Drunk Syndrome” in boxing • Structural (skeletal) Damage • Very common in athletes • Had trouble sleeping as a result of injuries sustained to the brain in his playing career • Pathology synonymous with that of ALS and Alzheimer's • Body and brain was in a deteriorated state • Diagnosed after death • Suffered from severe memory loss • Affects physical brain regions • Functional damage • • Caused by hook like and rotational forces Accumulation of Tau protein in brain Could not remember family members Several other factors effect CTE development • Demographics (Age, gender) • Suffered from serious Dementia and loss of cognitive function throughout his life • Correlation does not prove causation statement • A Protein E gene mutatoin present in all cases What’s being done!: • New Concussion protocol by the NFL • Concussion education and awareness training • Causes axonal damage thus disrupting communication of neurons within the brain • Better helmets that provide impact force protection • The axon is the part of the neuron that is responsible for relaying signals across the brain, after a direct hit on the head the axons may swell causing functional damage to the brain • New sensor technology that players can wear that monitors and quantifies impact force data when a collision occurs (Triax sensor) • Can cause neural cell death • Most cases of structural and functional damages arise from lower CBF to the brain (Cerebral Blood Flow) and increase in glucose usage causes a energy crises that puts a lot of stress on the brain • Can lead to a variety of disorders and problems Figure 4: Mike Webster (Source: http://articles.latimes.com/2014/mar/21/sports/la-sp-sn-mikewebster-nfl-concussions-lawsuit-20140321) Figure 6: Triax Sensor (Source: http://urbanwearables.technology/triax-smartimpact-monitor-for-team-sports-and-individuals/ Work Cited: Figure 2: Neuropathology of CTE (Source: http://www.sciencedirect.com/science/article/pii/S104474311500041X ) Where’s the proof?: Figure 1: Graphic of neuron of cell (Source: http://www.wikiwand.com/en/Neuron) • TBI has negative consequences in all sports from football and boxing to soccer What does it cause?: • Majority of brain autopsies of athletes with repetitive forms of brain trauma show damage to specific brain regions • Dementia • Steady decline of motor and cognition functions • CTE • Secondary impact syndrome • occurs when a player has not recovered from a • Dementia and memory loss are common symptoms in all case studies Figure 3.2: Tau Protein stained images (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945234/) • Majority of the athletes who have dementia also have CTE concussion and gets hurt again where he/she might go into a coma • Juvenile Head Trauma Syndrome: • TBI in children and youth athletes • Subdural Hematoma • Most common case of TBI related death • Usually found in boxers Figure 3.2: Frontal Cortex of damaged vs normal (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945234/) Figure 3.2: Damaged Hippocampus of athletes(Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945234/) •Webster, P., Omalu, B., M.D., Otto, J., & Young, S. (2014, September 29). Mike Websters Legacy [Interview]. Retrieved February 27, 2017, from http://www.pbs.org/wgbh/pages/frontline/oral-history/leagueof-denial/mike-webster-s-legacy/ • •Ling, H., Morris, H. R., Neal, J. W., Lees, A. J., Hardy, J., Holton, J. L., . . . Williams, D. D. (2017). Mixed pathologies including chronic traumatic encephalopathy account for dementia in retired association football (soccer) players. Acta Neuropathologica,133(3), 337-352. doi:10.1007/s00401-017-1680-3 • •Garber, G. (2005, January 24). A tormented soul. Retrieved February 18, 2017, from http://www.espn.com/nfl/news/story?id=1972285 • •Ling, H., Hardy, J., & Zetterberg, H. (2015). Neurological consequences of traumatic brain injuries in sports. Molecular and Cellular Neuroscience, 66, 114-122. DOI: 10.1016/j.mcn.2015.03.012 • •Mckee, A. C., MD, Cantu, R. C., MD, Nowinski, C. J., AB, HedleyWhyte, E., MD, Gavett, B. E., PHD, Budson, A. E., MD, . . . Stern, R. A., PHD. (2009). Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy After Repetitive Head Injury . Journal of neuropathology and experimental neurology,68(7), 709-735. doi:10.1097/NEN.0b013e3181a9d503 • •Giza, C. C., MD, & Hovda, D. A., PhD. (2014). The New Neurometabolic Cascade of Concussion. Neurosurgery,75(4), 2433. doi:10.1227/NEU.0000000000000505 • •Castillo, %. (2014, March 20). Basketball and the brain: Concussions aren't just a risk in football. CBS News. Retrieved February 27, 2017, from http://www.cbsnews.com/news/basketball-concussions-a-riskin-contact-sports-not-just-football/