If you want your kids to stay clear of sports injuries, send them out to play.
But don’t sign them up for a club team.
That’s the message from the newest study linking specialized training in young athletes to serious overuse injuries.
“We found a significant relationship between intense training and overuse injuries.
These kids are stressing the same areas of the body without rest while their bodies are still developing,” said lead author Neeru Jayanthi, MD, Medical director of Primary Care Sports Medicine at Loyola University Health System, in an interview.
The new study found that young athletes age 8 to 18 who played more hours per week than their age – for example, an 8-year-old who played more than 8 hours per week – were more likely to be injured.
In addition, those who spend more than twice as much time in organized sports than in free play, whatever their age or sport, were more likely to be injured and have serious overuse injuries.
Typically, these injuries included stress fractures, osteochondral lesions, and low back stress fractures.
Jayanthi presented the results of the study on October 28, 2013, at the American Academy of Pediatrics annual meeting.
The study involved more than 1,200 child and adolescent athletes who came to one of two Chicago hospitals and affiliated clinics for either a sports-related injury or a sports physical.
The injured athletes tended to be slightly older than uninjured athletes, reported a higher average number of hours per week playing organized sports (11.3 vs. 9.4), and higher average hours per week in total sports activity including gym, free play, and organized sports activities (19.7 vs. 17.6).
Parents and coaches need to accept much of the responsibility for putting their children at risk for these overuse injuries, Jayanthi says.
“I believe that much of these injuries are driven by the intensity to improve skills, not just have fun,” he says.
“Kids will play for hours and figure out when enough is enough.
Intense training in a single sport for most of the year teaches skill development, but sets kids up for injury.
Youth sports should be about the kids, not adults.”
The bigger problem is that club teams allow the 10% of elite athletes to stay active, but “the other 90% of kids don’t do much of anything,” says Jayanthi.
“We need to incentivize the others to become more physically active.
We need more, not less, gym classes, and more avenues for free play in the community.”
That means changing the current culture about sports and fitness so there’s a positive, healthy environment for all.
Does screening for minor memory changes wrongly label persons with dementia? Yes, say some experts, who worry there is not enough good evidence yet to screen for pre-dementia.
Minor memory changes, often called pre-dementia or mild cognitive impairment (MCI), are arguably an inevitable consequence of aging.
Although up to 15% of those with MCI will progress to dementia each year, more than half of them will not progress.
Many in whom dementia develops do not meet definitions of MCI before diagnosis.
Pre-dementia was included in a new set of diagnostic guidelines for Alzheimer disease issued in May 2011 by 3 consensus groups organized by the National Institute on Aging and the Alzheimer’s Association.
For the first time, the guidelines included biomarkers — such as functional MRI and PET scans, amyloid imaging, and cerebrospinal fluid analysis — specifically for MCI and preclinical phases of the disease.
“The people with preclinical Alzheimer disease have at most mild impairments in their cognition.
They span a spectrum defined at one end as being cognitively normal to, at the other end, needing more time to do their usual, everyday tasks—and even unable to do some of life’s harder tasks, like tax preparation—but they’re not demented,” said Jason Karlawish, MD, Professor of Medicine and Medical Ethics and Health Policy at the Perelman School of Medicine at the University of Pennsylvania.
Dr Karlawish led a recent survey of Alzheimer researchers who agreed that amyloid test results could be released to research participants, if guidance and counseling were put in place.
“For a person with MCI, the benefits of learning amyloid imaging results include an accurate diagnosis of the cause of cognitive impairment,” said Dr Karlawish.
“This, in turn, can motivate a person to adopt brain-healthy behaviors, trimming a medication list that often includes a host of symptomatic medications for anxiety and depression and cognitive impairment, and planning for the future.”
However, Dr Karlawish thinks that the concept of preclinical Alzheimer disease is not yet ready for practice.
“It remains a diagnosis in the shadows between research and clinical care,” he said.
“For now, someone who is labeled being amyloid positive can enroll in a clinical trial to test a drug that targets brain amyloid.”
One such trial will start later this year.
The Anti-Amyloid in Asymptomatic Alzheimer’s disease Study will assign 1000 cognitively normal, amyloid imaging-positive, older adults to a drug that clears amyloid or a placebo.
Screening for Minor Memory Changes
The drive to screen older persons for minor memory changes is leading to unnecessary investigation and potentially harmful treatment, according to experts from around the world who gathered at the recent “Preventing Overdiagnosis” conference in New Hampshire.
A team of specialists from Australia and the United Kingdom said that an expansion of the diagnosis of dementia will end up including up to two-thirds of persons older than 80 years and up to one-fourth of non-demented older persons being labeled with dementia.
With no drugs available to prevent the progression of dementia or to treat MCI, once patients are labeled, they may be vulnerable to untested therapies, say the specialists.
Perhaps our aging population has become a commercial opportunity to develop screening, early diagnostic tests, and medicines marketed to maintain cognition for a condition that is just part of the normal aging process.
Most patients with rotator cuff injuries respond well to physical therapy and don’t need surgery, according to new research into repairing shoulders.
Treatments to repair the rotator cuff include anti-inflammatory agents, steroid injections, surgery, physical therapy, or a combination of the above.
The best option may simply be physical therapy, says John E. Kuhn, MD, Chief of Shoulder Surgery at Vanderbilt University Medical Center.
After surgery “it usually takes people about four months before they can even think to get back to any kind of labor-type work and it usually takes a year to get a full recovery,” says Kuhn, who is the director of the Moon Shoulder Group, a network of doctors researching the best options for repairing shoulders.
“We found exercise programs were effective at treating rotator cuff disease and we consolidated them into one physical therapy program,” says Kuhn.
The program focuses on range of motion, flexibility, and strengthening.
The therapy program doesn’t necessarily heal the rotator cuff, but it does take the pain away, he says.
Kuhn led a new study of 452 rotator cuff tear patients and found the exercise program helped 85% avoid surgery.
The study appeared in the May issue of the Journal of Shoulder and Elbow Surgery.
The effect lasted for 2 years, and only 2% of the patients opted for surgery.
The study also suggests that pain may be a less suitable indication for surgery than weakness or loss of function.
The entire rotator cuff home exercise program is available for free online.
Kuhn suggests you talk to your physician before starting it.
When to see your doctor
Here are some indications you may need to see your doctor for a rotator cuff problem, says Jeffrey H. Yormak, MD, a board-certified orthopaedic surgeon with Somers Orthopaedic Surgery & Sports Medicine Group:
• Pain in the front of your shoulder that radiates down the side of your arm.
• Weakness in your arm and difficulty with routine activities.
• Difficulty with routine activities, including combing your hair or reaching behind your back.
“If you’ve injured your shoulder or experience chronic, lasting shoulder and arm pain, it’s best to see an orthopedic surgeon,” Yormak says.
“Only then can you receive a definitive diagnosis and begin treatment.
Early diagnosis and treatment of a rotator cuff tear may stop symptoms, such as loss of strength and motion, from setting in.”
The slippery grass courts at Wimbledon led to injuries and the withdrawal of 7 top tennis players on Day 3 from the prestigious tournament last Wednesday.
Four players injured their knees – Victoria Azarenka, John Isner, Marin Cilic, and Jo-Wilfried Tsonga.
Prominent players, such as Maria Sharapova and Caroline Wozniacki, who both lost their matches, criticized the condition of the courts.
But it’s more likely that the rigors of the game, rather than the courts, were to blame.
No matter what the surface, knee injuries are quite common in tennis players because of the sharp side-to-side movements required.
Azarenka hurt her right knee on Monday when she slipped on Court One.
Tsonga, Isner, and Cilic mostly blamed pre-existing physical problems or one-off injuries that were not caused specifically by slipping on the grass.
Most of us never get a chance to play tennis on grass courts and so will never know how slick the courts can be.
I once played on a grass court on vacation in Hawaii, and didn’t find it particularly slippery, although the skidding ball made me bend me knees more than usual.
Knee Cartilage Tears
One of the most prevalent knee injuries among players in their 40s and 50s is a knee cartilage tear, particularly among those who play intensely.
The basic problem is that the aging knee cartilage loses some of its water content and elasticity and, consequently, some internal strength.
These changes make tears more likely.
Tears occur when you land, anchor your foot, and then attempt an inward or outward pivoting motion.
Most players experience some pain and may feel tearing within the knee, although some feel no tearing and have relatively little, if any pain.
A swollen knee on the day following a painful episode is a good indication that you have damaged your knee.
Medial cartilage tears, on the inside of the knee, are more common than lateral cartilage tears, on the outside of the knee.
Many tennis players simply live with a cartilage tear that does not bother them too much.
Even a highly active player, who is much more likely to have symptoms, may only feel intermittent pain.
If you have a cartilage tear and it remains painful even after conservative treatment with anti-inflammatory agents, decreased activity, and quadriceps-strengthening exercises, then arthroscopic surgery can remove the torn portion of cartilage.
Then you should rehabilitate your leg muscles to help regain full range of motion in the knee.
Like most tennis players, if you have torn cartilage you can likely return to play at the same level, even if you need surgery more than once for tearing knee cartilage.
If you’re out in the sun playing tennis or golf, jogging or cycling, you need to protect your skin from the damaging ultraviolet rays.
Newly revised sunscreen labels should make it easier for you to make a smart choice on which products to use.
The Food and Drug Administration (FDA) now requires that labels must provide information about whether a sunscreen will protect against skin cancer in addition to sunburn, and will also have to indicate whether a sunscreen is water-resistant, which is what you want if you’re exercising outside.
To reduce your risk of skin cancer and early aging, the American Academy of Dermatology recommends using a sunscreen with the following features listed on the label:
– Broad spectrum, which means the sunscreen protects against ultraviolet B (UVB) and ultraviolet A (UVA) rays.
– A sun protection factor (SPF) of 30 or higher.
SPF 15 is the FDA’s minimum recommendation for protection, but the academy recommends an SPF of at least 30.
– Water-resistant for up to either 40 or 80 minutes.
This means the sunscreen provides protection while swimming or sweating for the length of time listed on the label.
Available sunscreen options include lotions, creams, gels, ointments, wax sticks, and sprays.
– Creams are best for dry skin and the face.
– Gels are good for hairy areas, such as the scalp or male chest.
– Sticks are good to use around the eyes.
Sunscreen should be applied liberally, and should be reapplied every 2 hours and after swimming or excessive sweating, according to the National Council on Skin Cancer Prevention.
Dermatologists recommend the equivalent of a shot glass full of sunscreen per application.
Sunscreens that are not water resistant must include a direction instructing consumers to use a water resistant sunscreen if swimming or sweating.
Karthik Krishnamurthy, DO, chief dermatology consultant with the Melanoma Program at Montefiore Einstein Center for Cancer Care, offers the following tips for the summer season:
• Give skin the once-over.
Just one full-body skin check by a physician can be a lifesaver.
Additionally, monthly self-exams from the top of the head to the soles of the feet are highly effective in detecting early warning signs of melanoma, such as a mole that looks different.
“I remind patients of the ‘ABCDE’ rule to detect changes in a mole: A is for asymmetry, B is for border, C is for color, D is for diameter, and E is for evolving,” says Krishnamurthy.
“Any suspicious-looking moles or moles that have changed shape or color should be looked at by a physician as soon as possible.”
• Know your risk.
Just one blistering sunburn, even in childhood, is enough to substantially increase your lifelong risk for melanoma.
Other risks include frequent sunbathing or indoor tanning, and a family history of melanoma.
“Fair-skinned individuals with red or blond hair and light-colored eyes are also at higher risk,” says Krishnamurthy.
• Don’t assume darker skin makes you immune.
A survey of 1,000 Hispanic adults in New York and Miami conducted by Krishnamurthy showed alarming misconceptions about perceived risk.
Nearly half believed those with darker skin cannot get skin cancer.
“This is very concerning because although melanoma is less common in darker-skinned individuals, there is a higher risk of late diagnosis with advanced melanomas and lower survival rates,” he says.
Another way to prevent skin cancer is to wear protective clothing, such as a broad-brimmed hat to protect the back of the neck and ears, which are highly susceptible areas.
Darker clothes and hats block more dangerous ultraviolet rays than light-colored ones, but you have to balance out heat problems.
A light-colored cotton shirt has an SPF of about 8.
The bottom line: choose the best sunscreen for you and use it early and often to protect your skin before you head out to play your chosen sport.
I have been asked to write Commentaries for ConsultantLive, an online publication that reaches about 70,000 unique visitors every month, most of them primary care physicians, for which I am a regular contributor.
Here’s my first one on what’s happening in Alzheimer research.
Researchers around the world have devoted themselves to devising ways of blocking the production or accumulation of beta-amyloid, the protein that accumulates as plaques in the brains of persons with Alzheimer disease.
Now scientists are studying other protein targets, including tau, which accumulates in Alzheimer brains and disrupts the activity of brain networks, and the regulator protein CD33.
Last month, Dan Skovronsky, MD, PhD, Eli Lilly & Company vice president of tailored therapeutics, announced that the drug company was pursuing several potential treatments targeting the neurofibrillary tangles caused by tau and had just bought the rights to 2 tests for measuring tangles in the brain.
“The whole field has been amyloid-centric, amyloid-driven, but we need more than that.
That’s why we’re investing in tau,” Dr Skovronsky told The Wall Street Journal. “The most meaningful impact in Alzheimer’s might involve targeting multiple pathways and using combinations of drugs.”
Targeting a reduction in levels of the tau protein is likely to be a useful therapeutic approach in Alzheimer disease in parallel with efforts to target beta-amyloid levels, according to research that has identified a new set of genetic markers for the disease.
“We identified several genes that modulate tau levels in the cerebrospinal fluid.
These genes may be useful therapeutic targets for Alzheimer disease,” senior investigator Alison M. Goate, DPhil, Professor of Genetics in Psychiatry at Washington University School of Medicine in St Louis, told ConsultantLive.
Higher levels of tau and a phosphorylated version of tau (p-tau) in the cerebrospinal fluid are thought to reflect both tangle formation and neuronal cell death.
Because tau levels are proportional to the cell death, higher tau levels are associated with more severe dementia, Goate noted.
In the April 24 online edition of Neuron, Goate and colleagues reported that they had identified several genes that are associated with tau levels, and “thus targeting these pathways may provide a more specific means of reducing tau or p-tau levels,” she said.
If drugs could be developed to target tau, they might prevent much of the neurodegeneration that characterizes Alzheimer disease and, in that way, help prevent or delay dementia, Goate suggested.
Blocking CD33 Activity
Another potential strategy for developing treatments to stem the disease process is based on unclogging removal of toxic debris that accumulates in patients’ brains by blocking activity of CD33.
“Too much CD33 appears to promote late-onset Alzheimer’s by preventing support cells from clearing out toxic plaques, key risk factors for the disease,” said Rudolph Tanzi, PhD, of Massachusetts General Hospital and Harvard University, in an NIH statement.
“Future medications that impede CD33 activity in the brain might help prevent or treat the disorder.”
Tanzi and colleagues have found overexpression of CD33 in support cells, called microglia, in postmortem brains from patients who had late-onset Alzheimer disease.
What’s more, they found reduced amounts of CD33 on the surface of microglia and less beta-amyloid in the brains of persons who inherited a version of the CD33 gene that protected them from Alzheimer disease.
There also is evidence to suggest that CD33 works along with another Alzheimer risk gene in microglia to regulate inflammation in the brain.
Early detection of Alzheimer disease is critical to give persons at risk a better chance of receiving effective treatment.
Perhaps studies of proteins other than beta-amyloid will lead to useful therapeutic targets.
If you’re a man who exercises mostly on the weekend, a so-called “Weekend Warrior,” you have a higher risk of rupturing your Achilles tendon while playing sports than other Americans.
Basketball leads to about 1/3 of all Achilles ruptures in the US, followed by tennis (9%) and football (8%), report researchers in the April issue of Foot & Ankle International.
They reviewed 406 records from patients diagnosed with Achilles tendon injuries from August 2000 to December 2010.
On average, the patients who ruptured their Achilles tendon were 46 years old, mostly men (83%), and were injured playing sports (more than 2/3rds).
Older patients (over age 55) and those whose body mass index (BMI) was greater than 30 (considered obese) were more likely to have non-sports related causes and were more likely to not have been diagnosed correctly until more than one month after the injury.
More than 1/3 of the tendon ruptures not caused by sports occurred at work.
When the diagnosis was missed, it was usually because the initial diagnosis was an ankle sprain.
“Delayed diagnosis and treatment have been shown to result in poorer outcomes,” says lead author Steven Raikin, MD, of the Rothman Institute in Philadelphia, PA.
“Older individuals, and those with a higher BMI, should be evaluated carefully if they have lower leg pain or swelling in the Achilles tendon region.”
Re-rupture of the same tendon occurred in 5% of the group, and 6% of the study’s population had previously ruptured the other leg’s tendon.
The study supports previous findings that an Achilles tendon rupture on one leg increases the likelihood of a rupture on the other leg.
When the same tendon was re-ruptured, 85% of those injuries had not been treated surgically earlier.
Signs of an Achilles Rupture
One sign of an Achilles rupture is the inability to stand on your toes.
However, this test is not completely reliable.
Also, when you walk, your foot may turn out to the side.
A ruptured Achilles tendon can be confused with a partial rupture because it may cause little pain at first.
In fact, an Achilles rupture is quite often misdiagnosed.
The only foolproof way to know if you have ruptured this tendon is to lie on your stomach with your foot off the end of a bed, toes pointing down, and have someone squeeze your calf.
The front of the foot normally will move down.
If there is no flex in the foot, then the tendon is torn.
You can also compare the two legs.
Squeeze the uninjured leg first to observe the flexing movement, and then squeeze the injured leg to see whether it moves.
As this new study shows, if you injure your Achilles tendon, getting to a doctor sooner than later will speed your recovery.
When my sister-in-law Carol Peerce died suddenly at age 49 exactly three years ago, it was discovered that radiation-induced heart disease likely led to her heart attack and eventual death.
It turns out the radiation therapy to treat her Hodgkin’s lymphoma 30 years previously had damaged Carol’s heart.
At my wife Margie’s suggestion, I looked into this condition and sure enough found medical evidence that radiation, and chemotherapy, given to Hodgkin’s lymphoma patients put them at risk for later heart problems.
Pat had been diagnosed with Hodgkin’s lymphoma at age 29 and received multiple sessions of radiation therapy and chemotherapy that included heart-toxic anthracyclines.
Little did he know that the radiation therapy and chemotherapy he received to cure his cancer would scar his heart and lead him to have several silent, near-deadly heart attacks and a stroke 20 years later.
Pat’s story, and the heart risks of cancer therapies, are the basis of the cover story for the just released May 2013 issue of Heart Insight magazine.
Heart Risks from Radiation Therapy
Among Hodgkin’s lymphoma patients who have received radiation, cardiovascular disease is one of the most common causes of death.
Studies have shown that these patients have an increased risk for coronary artery disease, heart valve disease, congestive heart failure, pericardial disease (disease of the heart lining), and sudden death.
The basic mechanism appears to be radiation-induced damage to the lining of blood vessels.
Compared to the general population, Hodgkin’s lymphoma patients have higher heart risks if they were treated before age 21 or had radiation to the central part of the chest, which increases the risk of death from a fatal heart attack by 1.5 to 3 times.
In addition, a woman who received chest radiation therapy for breast cancer has a 63% increased risk of cardiac death.
With improvements in radiation techniques, including smaller amounts of radiation aimed at specific body areas, the risk of cardiovascular complications has declined.
But patients treated through the mid-1980s have a higher risk of congestive heart failure and heart valve problems.
Pat’s cardiologist, Ronald Drusin, MD, Professor of Clinical Medicine at New York-Presbyterian Hospital, says: “If you had chest radiation for lymphoma in the central part of the chest and have chest pains or tightness and shortness of breath, you should be evaluated by a cardiologist.”
Road to Recovery
For Pat, Dr. Drusin decided that stents to reopen the blocked coronary arteries in his heart were a better choice than bypass surgery because of radiation-induced scarring in Pat’s heart.
Pat felt better after the procedure, although his recovery was complicated by a stroke.
Today, Pat’s prognosis is fine, says Dr. Drusin “as long as he takes good care of himself, which he does.”
Pat is back to work and now pays close attention to his exercise and diet.
As the family chef, he cooks heart-healthy meals containing more whole grains and vegetables, no salt and fewer processed foods.
He checks his blood pressure regularly and takes daily medications, a beta-blocker and baby aspirin, to keep his heart healthy.
On weekends he stays busy with his three sons’ lacrosse games and other activities, including his favorite hobby, building bird houses.
Pat has some simple advice to anyone with symptoms of heart disease:
“As soon as you are not feeling well, get to a doctor,” he says.
“You have to be proactive.
You are in charge of your own heart.”
That’s particularly true if you had radiation or chemotherapy to treat a cancer when you were younger.
It’s official! The Harvard Medical School Guide to Tai Chi:12 Weeks to a Healthy Body, Strong Heart & Sharp Mind is now available in book stores and online book sellers, including Amazon.com and Barnes&Noble.com.
Conventional medical science on the Chinese art of Tai Chi now shows what Tai Chi masters have known for centuries: regular practice leads to more vigor and flexibility, better balance and mobility, and a sense of well-being.
Cutting-edge research from Harvard Medical School also supports the long-standing claims that Tai Chi also has a beneficial impact on the health of the heart, bones, nerves and muscles, immune system, and the mind.
This research provides fascinating insight into the underlying physiological mechanisms that explain how Tai Chi actually works.
Dr. Peter M. Wayne, a longtime Tai Chi teacher and a researcher at Harvard Medical School, developed and tested protocols similar to the simplified program he includes in this book, which is suited to people of all ages, and can be done in just a few minutes a day.
This book includes:
• The basic program, illustrated by more than 50 photographs
• Practical tips for integrating Tai Chi into everyday activities
• An introduction to the traditional principles of Tai Chi
• Up-to-date summaries of the research literature on the health benefits of Tai Chi
• How Tai Chi can enhance work productivity, creativity, and sports performance
Peter M. Wayne, PhD, is Assistant Professor of Medicine at Harvard Medical School and the Director of Research for the Osher Center for Integrative Medicine, jointly based at Harvard Medical School and Brigham and Women’s Hospital.
Prior to this appointment, Dr. Wayne served as the Director of Tai Chi and Mind-Body Research Programs at the Osher Research Center and Founding Research Director at the New England School of Acupuncture.
He has more than thirty-five years of training experience in Tai Chi and Qigong and is an internationally recognized teacher of these practices.
It was an honor to work with such a renowned Tai Chi teacher and researcher to put together this new book.
I can honestly say my life is richer, and my mind and body certainly more relaxed, from having practiced Tai Chi over the past 3 1/2 years as I worked with Dr. Wayne on the book.
A simple blood test may be able to identify football players who have suffered brain damage from hits to the head, even if they don’t have a concussion.
No single test can reliably diagnose a concussion, said Jeffrey Kutcher, MD, of the University of Michigan in Ann Arbor, at a recent press conference to announce the just-released, newly updated guidelines on sports concussions by the American Academy of Neurology.
Concussions can be difficult to diagnose, relying on player symptoms, cognitive tests, or very costly brain scans.
A $40 blood test for a protein, called S100B, normally found only in the brain may offer an objective measure of whether a player has endured head trauma.
Researchers at the Cleveland Clinic and University of Rochester have found that elevated blood levels of the S100B protein directly correlate to the number and severity of hits to the head during college football games.
Body contact or simply playing in a football game did not affect S100B levels in the players.
In an interview with the lead author, Damir Janigro, Ph.D., professor of molecular medicine and the director of cerebrovascular research group at Cleveland Clinic, he gave me
a scenario of how the blood test may be used.
“In a situation where a player is suspected of having a concussion, we could validate that by a blood test the following day,” says Janigro.
“If the test is positive for S100B, we can assume the player had some concussive event.
If the blood test is normal, we can assume the player did not have a concussion.”
In effect, the blood test could tell whether the player needs medical attention as a result of the in-game hits to the head.
In a study of 67 college football players, Janigro and colleagues found that the more hits to the head a player absorbed, the higher the levels of S100B leaked into the bloodstream after a head injury.
Typically, S100B is found only in the brain, says Janigro.
Finding it in the blood indicates damage to the layer of cells that prevent materials from the blood from entering the brain, the so-called blood-brain barrier.
Once in the bloodstream, S100B is seen by the immune system as a foreign invader, triggering an autoimmune response that releases auto-antibodies against it.
Those antibodies then seep back into the brain through the damaged blood-brain barrier, attacking brain tissue and leading to long-term brain damage.
Four of the football players tested showed signs of an autoimmune response to S100B.
Brain scans confirmed that the presence of S100B antibodies in the players’ blood correlated with brain tissue damage.
“To our surprise, even when players don’t have a concussion, the blood-brain barrier opens,” says Janigro, adding that many European countries do blood tests for S100B to diagnose mild traumatic brain injury.
Janigro and colleagues Nicola Marchi, Ph.D., of the Cleveland Clinic and Jeffrey Bazarian, M.D., M.P.H., of the Clinical and Translational Science Institute at the University of Rochester Medical Center, published their research on March 6, 2013, in the online journal PLOS ONE.
“And to our surprise a few of the non-concussed players had changes in brain scans and balance tests after the season,” says Janigro, noting that these players had the most openings in the blood-brain barrier.
With further tests, Janigro says he plans to figure out at what blood level of S100B players should stop playing to prevent further brain damage.
He also plans to look at former college football players and retired National Football League players to see whether they have S100B autoantibodies in the brain.
“It’s a matter of brain health,” says Janigro. “We don’t have a good experimental design to look at brain health, other than scans.”
He hopes to use the blood test to point out the risk factors associated with hits to the head as well as a pre-screening tool to narrow down those who may need to go for a brain scan to confirm a brain injury.