Concussions can occur in sports and in combat, but health experts do not know precisely which awkward head movements pose the greatest risks to the brain.
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To find out, Johns Hopkins engineers have developed a new computer-based process that helps identify the dangerous conditions that lead to concussion-related brain injuries. This approach could lead to new medical treatment options and some sports rule changes to reduce brain trauma among players.
Some kinds of head injuries are difficult to see with standard diagnostic imaging but can have serious long-term consequences. Concussions, once dismissed as a short-term nuisance, have more recently been linked to serious brain disorders.
To help doctors answer this question, K. T. Ramesh, the Alonzo G. Decker Jr. Professor of Science and Engineering who led the research at Johns Hopkins led a team that used a powerful technique called diffusion tensor imaging, together with a computer model of the head, to identify injured axons, which are tiny but important fibers that carry information from one brain cell to another.
These axons are concentrated in a kind of brain tissue known as "white matter," and they appear to be injured during the so-called mild traumatic brain injury associated with concussions. Ramesh's team has shown that the axons are injured most easily by strong rotations of the head, and the researchers' process can calculate which parts of the brain are most likely to be injured during a specific event.
Rika M. Wright played a major role in the research while completing her doctoral studies in Johns Hopkins' Whiting School of Engineering, supervised by Ramesh. Wright is now a postdoctoral research fellow at Carnegie Mellon University. Ramesh is continuing to conduct research using the technique at Johns Hopkins with support from the National Institutes of Health.
Beyond its use in evaluating combat and sports-related injuries, the work could have wider applications, such as detecting axonal damage among patients who have received head injuries in vehicle accidents or serious falls.
Armed with this knowledge, Ramesh and his colleagues want to use their new technology to examine athletes, particularly football and hockey players, who are tackled or struck during games in ways that inflict that violent side-to-side motion on the head.
The authors point out that many professional sports games are recorded in high-definition video from multiple angles. This could allow researchers to reconstruct the motions involved in sport collisions that lead to the most serious head injuries.
The authors also noted that some sports teams equip their players' helmets or mouth guards with instruments that can measure the acceleration of the head during an impact. Such data, entered into the computer model, could help determine the likely location of brain damage.
These results, combined with neuropsychological tests, could be used to guide the athlete's treatment and rehabilitation and to help a sports team decide when an athlete should be allowed to resume playing. This strategy also may help reduce the risk to athletes arising from a degenerative disease linked to repeated concussions. ■