Researchers to monitor UCLA, high school athletes in NCAA-funded study on concussions

In 1948, more than 5,000 residents of Framingham, Mass., enrolled in a long-term study on heart disease, consenting to be monitored throughout their lives.

Many of the now widely accepted risk factors for cardiovascular disease such as smoking and obesity were first identified in the Framingham Heart Study.

A similar long-term study focusing on sports-related concussions is a project envisioned by Dr. Christopher Giza, an assistant professor of pediatric neurology and neuroscience.

The study, which would follow athletes in various sports through high school, college and eventually professional leagues, could provide valuable answers about the long-term consequences of repeated concussions and multiple impacts.

The NCAA showed its support for the ambitious project in early April, awarding a $400,000 grant to the National Sport Concussion Outcomes Study Consortium, which consists of researchers from UCLA’s Brain Injury Research Center, the University of North Carolina at Chapel Hill, the University Michigan and the Medical College of Wisconsin. All the universities involved in the consortium are large public institutions with elite athletic programs. The study will start in the summer.

The grant will provide funding to monitor consenting UCLA athletes throughout their collegiate careers. Researchers from Chapel Hill and Wisconsin will monitor players from local high schools.

Giza, the study’s lead investigator at UCLA, plans to apply for additional grants from the NFL and the National Institutes of Health to continue monitoring select athletes throughout their respective professional careers.

“What are the lasting effects of concussions? … What if you don’t have a concussion or symptoms, and you are still out there getting hit? Does that add up in some way?” Giza said, listing questions that he hopes a long-term study may answer.

The NCAA grant gives the consortium an opportunity to monitor a large sample size of athletes from different sports over four years and to compile the results into a database.

Baseline data will first be collected for all UCLA athletes enrolled in the study, using protocols such as cognitive testing, neurological and balance exams and taking medical histories. These evaluations are similar to the preseason tests the UCLA sports medicine department performs on every athlete in the fall.

Since previous research has found a strong link between concussions and impaired cognitive function, computerized tests will evaluate a player’s cognitive ability after sustaining a concussion.

“They test attention, attention span, which is also working memory, and visual and verbal skills,” said Talin Babikian, the neuropsychologist who will monitor the protocols that measure cognitive testing for the NCAA grant study.

In addition to the tests, the NCAA grant provides funding for mouthguard accelerometers, cutting-edge devices that record how many times a player feels an impact, the direction and force with which they are hit and the time of the collision.

The sophisticated mouthguards would allow athletes in many different sports to participate in the study, and are slated for a summer release by Seattle-based developer X2Impact.

Previously, concussion data could only be measured with accelerometers placed in helmets, limiting brain injury studies to helmeted, high-contact sports such as football, lacrosse and hockey.

Giza is especially excited about the opportunity to compare concussion data between sports such as basketball and soccer in which men and women tend to have similar amounts of exposure to impact.

“The only way you can actually study the difference between men and women is to use non-helmet-based accelerometers,” he said of comparing concussion rates between men and women.

Preliminary studies suggest that although concussions are more common in male athletes, female athletes may have a higher concussion rate.

Continually monitoring players will allow researchers to evaluate whether intermediate cognitive impairment can occur without concussions and simply through participation in contact sports.

“There has to be an amount of force that the head has to be exposed to before the brain begins to show a concussion. As the force increases, all of a sudden you have an absolute response, and then you get a concussion,” said David Hovda, director of the Brain Injury Research Center.

“One of the things this study is going to help us do is to determine whether that happens a lot and if there is such a thing as a sub-concussive blow that we don’t know about.”

As evidence demonstrating that repeated concussions and sub-concussions lead to long-term repercussions such as impaired cognitive ability, behavioral changes and possibly degenerative neurological disease increases, some scientists believe contact sports should be banned for children younger than 14 or 15.

Hovda, who played football and basketball in high school and a year of collegiate golf at the University of New Mexico, believes that advocating in favor of eliminating contact sports is unreasonable and premature.

“Before we start getting hysterical about everything and claim that we need to ban sports, we need to first figure out what type of problem we have, because organized sports play a huge role in our society,” said Hovda, a sports fan who said he wished he had been talented enough to have played collegiate football or basketball.

Before choosing to make any widespread claims on banning or limiting contact sports, Giza cautions about the importance of putting the issue into perspective.

The number of people at risk for obesity easily outweighs the likelihood of developing a degenerative disease such as chronic traumatic encephalopathy. Contact sports play an important role in motivating children to exercise.

“You don’t have to play contact sports, but you have to do some type of sport, and most have some type of risk. There are a lot of physical benefits from participating in those activities,” Giza said.