SfN2016: “Complex and controversial”, Neuroscience 2016 discusses concussion

Written by Hannah Wilson

Chaired by Candace Floyd (Virginia Commonwealth University, VA, USA), this session aimed to encourage discussion and debate on the controversial and growing field of concussion, with a particular focus on sports and military settings.
The scene was set by Harvey Levin (Baylor College of Medicine, TX, USA), who highlighted incidence data from a number of studies in high school and college athletes. Levin continued by discussing recovery in this population, stating that 10–15% of concussed collegiate athletes are slow to recover (taking more than 7 days). In high school athletes this proportion is even more pronounced, with one study observing approximately 20% of subjects to not have reached full recovery 30 days post-injury. Levin concluded by questioning recovery protocols, in particular the role of rest and how it should be defined.

Considering psychological aspects of concussion, the next speaker was director of Veterans Integrated Service Network Lisa Brenner (University of Colorado, CO, USA). Brenner focused on veterans who had experienced traumatic brain injuries (TBI) and those who had been diagnosed with post-traumatic stress disorder. Using a powerful selection of quotes from veterans recalling their experiences, Brenner emphasized the crossover in symptoms in these two conditions and encouraged those in the room to look beyond just TBI history to both TBI and combat experiences when considering veteran patients.

The final scientific speaker on the panel was Robert Stern (Boston University, MA, USA). Known for his work on chronic traumatic encephalopathy (CTE), Stern opened by emphasizing his experience in neurodegenerative disease as opposed to neurotrauma. The overarching question of whether concussive and subconcussive impacts cause neurodegeneration was addressed, starting with a brief tour of our current understanding of CTE. Stern highlighted two key questions that remain unanswered: is it common and what are the risk factors? The presentation concluded with promising news of a new NIH-funded, 7-year collaborative biomarker study entitled DIAGNOSE-CTE.

This social issues round table concluded with an emotive talk from former NFL player Kevin Drake. Drake discussed his personal experience of repeated concussive injuries over his career, giving a breakdown of his ongoing symptoms related to these events. The subject of pituitary gland damage was also discussed when Drake revealed that endocrine testing had revealed deficits in his pituitary. Drake concluded by advocating for an overhaul in coaching of American football in youths, expressing a desire to remove full-contact practice or play before age 14.

Overall, while this event presented no new data, the bringing together of experts from different backgrounds emphasized the importance of collaborative work in neuroscience in general and the field of concussion research in particular.