‘When the Game Hits Back’ talk explores science behind brain injuries
Concussions should be taken seriously. But concerns about brain injuries don’t need to sideline athletes from the sports they love, experts told a standing-room-only crowd on Nov. 18 at Highland Park High School.
UT Southwestern Medical Center professors Dr. Jennifer Coughlin, who is director of molecular imaging in the psychiatry program, and Dr. C. Munro Cullum, who is vice chair and chief of the division of psychology in the department of psychiatry, unraveled mysteries of concussions during their presentation in the MAPS Makerspace.
They assuaged some concerns about the brain injuries’ long-term impact and corrected outdated advice about how to treat them.
You don’t have to lose consciousness, or even hit your head, to have a concussion. A body blow that rocks your brain back and forth could be enough. But the force that produces a concussion in one individual won’t necessarily cause a brain injury in another, explained Cullum, who spent about two decades treating Cowboys players as the team’s neuropsychologist.
The most dangerous concussions are those that occur in quick succession, but there’s no magic number that means an athlete should quit their sport. No two brains are alike, and neither are two concussions.
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“It’s really highly variable, and that’s one of the things we’re actually studying,” he said. “We’re very interested in why some people continue to have symptoms weeks later. Most people recover within about a week.”
Concussions are often diagnosed based on symptoms — conventional medical imaging typically doesn’t detect them, explained Coughlin.
She and other researchers at UT Southwestern are using positron emission tomography — the PET scans that help doctors diagnose cancer — to capture images of cells that turn on when there’s a brain injury and work to heal it.
“The technology’s there now,” said Coughlin, a former field hockey player who quit the sport after suffering concussions. “Scientists are working hard to figure out whose brain is healing for what reasons.”
Chronic Traumatic Encephalopathy (CTE), damage found post-mortem in the brain tissue of people with a history of multiple head traumas, seems to be a rare condition, Cullum said, and behavioral problems correlated with CTE may not have been caused by it.
An oft-cited 2017 study that found CTE in 99% of brains obtained from former NFL players involved just 111 subjects. Those brains had been solicited from family members and did not represent a random sample, he said.
“That was kind of overblown, and got people really worried about this entity,” Cullum remarked. “If you look at the current scientific literature on CTE, there’s still so much we don’t know.”
As for treating concussions, even though it’s not necessary to cocoon an athlete, brain injuries are serious and should be treated and evaluated. In the first few days after the injury, sufferers should dial back overstimulating activities before progressively returning to their routine.
The researchers advised parents to educate themselves on their children’s sports and the teams they train with, as well as to consider which options are good fits for their child. But fear of concussions doesn’t need to bench an athlete who enjoys their sport.
“People who love their game should play their game,” Coughlin said. “But with the caveat that they’re getting data and input from all of their loved ones and the people around them, and they’ve got educated trainers right there working with educated coaches, and the community’s coming together to make this sport as safe as we can make it.”
