Prospective investigation of sport-related concussion: relationship between biomechanical, neuroanatomical, and clinical factors.

Principle Investigator: Kevin M. Guskiewicz, Ph.D, ATC

Institution: The University of North Carolina at Chapel Hill

Title: Prospective investigation of sport-related concussion: relationship between biomechanical, neuroanatomical, and clinical factors

Abstract: It is estimated that as many as 3.8 million sport-related traumatic brain injuries occur annually in the United States. The center for Disease Control and Prevention reports a high incidence of repeated head injury in several sports, and warns that the likelihood of serious sequelae increases with repeated head injury. One of the most challenging aspects of managing sport-related concussion is recognizing and ultimately grading the injury. Deciding when an athlete can safely return to participation following the injury is equally challenging. Objective assessment tools are very important, a potentially fatal condition known as second impact syndrome (SIS) can occur if a person receives another blow to the head before symptoms from the first injury have resolved.  Sustaining repeated impacts while still symptomatic can result in chronic, cumulative cognitive dysfunction.
Rotational injuries or rotational acceleration-deceleration injuries are believed to be the primary injury mechanism for diffuse brain injuries. Structural diffuse brain injury (diffuse axonal injury) is the most severe type of diffuse injury because axonal damage occurs and can result in functional impairment. Such injuries can result in disruption to centers of the brain responsible for breathing, heart rate, and consciousness, but more typically result in memory loss, cognitive deficits, balance disturbances, and a host of other somatic symptoms. We propose to track symptoms, neuropsychological function, postural stability, and neuroimaging in a group of 100 collegiate football players. These players will be wearing instrumented helmets, allowing our research team to collect biomechanical data in real time.
The uniqueness of this research proposal is the capacity to measure the biomechanical, neuroanatomical, and clinical factors associated with cerebral concussion.
The objectives of this study are to:

  1. Determine how biomechanical factors such as head impact magnitude and location affect the risk of concussion.
  2. Investigate the neuroanatomical relationships and clinical recovery following varying concussive impacts.
  3. Study sub-concussive and concussive impact locations with respect to linear and rotational acceleration.  By measuring head acceleration during normal football maneuvers, and examining the association between acceleration of the head, and the risk of concussion, we will gain new insights about the relationship between these factors, cerebral concussion, and the resulting sequelae. The implications of this research extend well beyond the sport of football. However, by studying a healthy population of football players, we can learn about the effects of head trauma under different impact conditions and extend this knowledge to other populations who may experience similar injuries in other sport settings, or in other types of activities. Ultimately our findings might provide insight regarding potential changes to helmet design and standards.