Tags: nfl | concussion | guidelines | violence | domestic | dementia | cte

NFL Needs Better Concussion Guidelines: Top Doc

By    |   Friday, 03 October 2014 05:41 PM

The Ray Rice affair is the latest in a string of cases to raise questions about whether sports-related brain injuries predispose some athletes to mental health disorders or to commit violent acts. The NFL has adopted new protocols for dealing with head injuries, but one of the nation’s leading concussion specialists says more needs to be done.
 
Teena Shetty, M.D., a New York-based neurologist at Hospital for Special Surgery and NFL consultant, tells Newsmax Health’s Meet the Doctors that the NFL and other sports organizations need better guidelines and treatments for traumatic head injuries, in light of continuing research into the potential links between injury-related brain disorders, mental health issues, and domestic violence.
 
“In terms of advising the NFL, I think better guidelines, better management [are needed] — and I think they’re very much trying to do that — [and] its’ very important to educate the trainers and the coaches and have everybody collaborate and to advance research in science,” says Dr. Shetty, a triple-board certified specialist in sports neurology and a consultant for the New York Mets and an independent team neurologist for the New York Giants.
 
“That’s really where the answer lies. We do not yet fully understand the long-term implications of multiple sub-concussive blows we don’t understand the complications that may or may not happen from long-term effects of concussions. So we’re still very much trying to get clarity on that and the answer really lies in the science of this.”
 
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Dr. Shetty is among the nation’s leading health specialists whose research is examining the long-term effects of brain trauma in athletes. Her research involves brain imaging after repeated concussions or traumatic brain injuries, with the goal of developing biomarkers that can measure the degree of injury to help guide treatment and establish guidelines for leagues to follow.
 
“We’re looking at acute concussions and we’re trying to track those over time,” Dr. Shetty says. “So understanding the effects of concussions on the brain is very important to understanding whether or not violence can be a consequence of traumatic brain injury.
 
“That’s certainly something that is not yet well understood; we cannot make any conclusions about that at this time. However we recognize what the acute symptoms of a concussion are and we’re trying to see how concussions evolve over time and we’re trying to capture biomarkers of concussions over time.”
 
NFL players suffer repeated blows to the head as part of the game. And there is ample, conclusive evidence that all those hits increase the risks for a variety of brain disorders, including dementia, Parkinson’s, and Lou Gehrig’s disease.
 
But there’s a growing body of research also suggests brain injuries may increase some players’ propensity to commit domestic violence, as well. Studies by the University of Pennsylvania and Boston University have found football players and other athletes who engage in contact sports often have certain types of brain damage that have been linked to aggressive behavior and violence.
 
That could explain, at least in part, why crime statistics indicate domestic violence arrests are up to four times higher among NFL players than in the general population.
 
Experts note that brain injuries are not an excuse for the dozens of NFL players who’ve been arrested for domestic violence in recent years. Pro athletes are trained to be aggressive and are rewarded financially for it, which may also contribute to a culture of violence and ego-boosting that may spill over from the field into personal lives, specialists say.
 
But researchers at the University of Pennsylvania have found that brain scans of men arrested for domestic abuse tend to have differences in what’s called the prefontal cortex of the brain — the region that controls impulses and aggressive behavior. They also determined that such men were much more likely to violently lash out when provoked by something minor, possibly because that prefrontal cortex is just not working as well.
 
Football players are also at risk for a disease called CTE (chronic traumatic encephalopathy), in which the brain deteriorates over time, Boston University researchers have found. Symptoms typically include impulsivity, explosive tempers, and aggression.
Experts note that it’s possible some of those problems are congenital, which begs the question: Do brain injuries cause the problems or are individuals with such brain abnormalities or aggressive tendencies drawn to violent contact sports like football?
 
But there is little debate that playing football, as well as soccer and boxing, can cause brain damage that increases the risk for Alzheimer’s and other brain disorders that can alter personality. The NFL has increasingly acknowledged such links, projecting last month that one in three NFL players will suffer from some brain disorder.
 
In response to the Ray Rice fallout, mental health experts are calling on the NFL to protect players’ partners and families, and actively screen and treat players for mental health problems. Many are also suggesting that more must be done to improve safety standards, helmets, and protective equipment for athletes, including kids who participate in youth sports, including football, soccer, and boxing.
 
Better helmets and equipment, and changes in the game, could offer better protections from head injuries, specialists say.
 
Dr. Shetty says she hopes growing awareness of the problems will lead to more action — for the players as well as their families.
 
“I think there’s a great deal of awareness now,” she notes. “I think for a long time this was something that was unnoticed and unrecognized and that was a big problem. And I think it’s great that people recognize the importance now of both detecting and diagnosing these injuries and also managing them correctly and I believe that’s been brought to the attention of professional athletes…
 
“I think the best approach is to really try to manage them very safely, as cautiously as possible, and to better understand the science.”

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The Ray Rice affair is the latest in a string of cases to raise questions about whether sports-related brain injuries predispose some athletes to mental health disorders or to commit violent acts.
nfl, concussion, guidelines, violence, domestic, dementia, cte
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Friday, 03 October 2014 05:41 PM
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