Conquering Concussion

Summer 2014

Numerous former athletes have shown signs of a once rare but increasingly common condition known as chronic traumatic encephalopathy (CTE). CTE is a serious degenerative brain disease caused by repeated concussions, like those suffered over a lengthy football career. The lifelong and often debilitating symptoms include irritability, memory loss, and confusion, among many others.

CTE can only be diagnosed posthumously, but it is turning up in an alarming number of autopsies performed on retired players from virtually every professional sport today, from football, baseball, and soccer to horse racing.

In an effort to address the growing concerns for the safety of the athletes, the National Football League, General Electric, and Under Armour have sponsored the Head Health Initiative, a $20 million effort to advance the development of technologies that can detect early stage concussions and improve brain protection.

The first of two challenges set out by the Head Health Initiative is focused on discovering imaging technologies and algorithms to better detect and analyze the changes in the brain from head trauma. The second challenge is to find new materials and technologies that protect the brain and track head impacts in real time.

To help fulfill these goals, Ramesh and Daphalapurkar envision a biomechanics-based digital head that could help to better identify traumatic injuries in real-time and to design systems able to protect players from injury. Such models might someday be used for in-game evaluations of players involved in sports accidents.

“Professional sports are being documented like never before, in high-definition and from multiple angles,” Ramesh says. “We can use this footage to reconstruct the specific forces in a collision and determine, on the spot, what level and type of force a player has sustained.”

Down the road, Ramesh can foresee a day when football helmets, mouth guards, and other equipment are fitted with sensors that might feed real-time data into the digital head to determine the presence and extent of injury. This information might also be used to build better equipment. But the problem is larger than gear alone can solve.

“We’re hoping to use that information to provide guidance not only to the doctors and to the people who make equipment but also to those who make the rules of the game,” says Ramesh.

Yes, No, Maybe: The Basics of Brain Trauma

conquering-concussion_body3

Using real-world acceleration data, Professor K.T. Ramesh has created a computer model that anticipates where axonal damage is likely to occur during concussion and to map those injuries to cognitive impairments that might result.

His model tells him many things, but one of the most surprising is that the direction of a blow is often as important to injury as the amount of force applied. Determining which type of hits is the most risky is as easy as yes, no, and maybe.

The forward-and-back motion of an affirmative nod (y) is the least likely to cause injury. The researchers describe this as a “yes” motion. The shoulder-to-shoulder motion (x) of indecision, known as “maybe,” tends to cause more damage. The left-right twist (z) of a negative response also induces the rotational motion that is most harmful to the brain. This is referred to as the “no” motion.

Ramesh believes that these disparities are the result of underlying structural differences in the orientation of the tissue-level fibers in the white matter that make the brain tissue more resilient in certain directions than others.

“Using head models, we think we will be able to tell players when they have been injured and perhaps even when they can return to the game safely,” says Ramesh.