New study reveals young, concussed hockey players still impaired after being cleared to play
Young ice-hockey players who have had concussions continue to exhibit some brain impairment after being cleared to play, according to a new study by researchers from Simon Fraser University, the Surrey Health and Technology District and the Mayo Clinic.
SFU professor Ryan D’Arcy, founder of Surrey’s Health and Technology District, led a research and development team that has developed a new set of objective physiological measures for tracking the brain’s “vital signs.”
The researchers used this technology, which is a breakthrough for analyzing complex brainwave data, to track brain function in Junior A male hockey players over two seasons.
The researchers detected neurophysiological impairments, such as attention and cognitive processing deficits, in players who had been diagnosed with concussions and were cleared for return-to-play using routine clinical concussion-management protocols. Surprisingly, players who were not diagnosed with concussions during the season were also tested and found to have significant delays in cognitive processing. The study’s lead author, SFU PhD student Shaun Fickling, says this is thought to be due to repetitive ‘subconcussive impacts’.
The research results appear in the February issue of Brain: A Journal of Neurology published by Oxford University Press.
Collaboration drives improvements in concussion management
The research is the result of a collaboration between neuroscientists in Surrey’s Health and Technology District and the Mayo Clinic Sports Medicine Center in Rochester, Minnesota. Through a consortium of initiatives and technologies known as BrainNET, the Health and Technology District has designed a clinical-academic-innovation network dedicated to bringing advances in neurotechnologies to individual improvements in brain health.
D’Arcy, the study’s senior author, describes the collaborative research as a significant step forward in evaluating and managing concussion treatment. He says the new, brain vital signs technology provides a simple, practical and objective physiological evaluation of brain function. It translates complex brain wave recordings from electroencephalography (EEG), which is measurable at rinkside, into a fast, user-friendly and intuitive index of an individual’s brain function.
“Sports-related concussion is a major topic of discussion amongst scientists, clinicians, the medical community, the sports industry and various governmental agencies, says D’Arcy.
“There is growing concern that concussions may be associated with an increased risk of persistent cognitive and mental health impairments later in life.”
Major gap in measuring brain function
Despite dozens of clinical studies examining sports-related concussions, D’Arcy says a major gap remains in terms of objective, physiological measures of brain function that can be easily deployed and readily used at point-of-care.
Aynsley Smith, a sport and exercise psychologist and concussion investigator at Mayo Clinic Sports Medicine, says the Mayo Clinic has been on the forefront of research into preventing, diagnosing and managing concussions from ice hockey.
"We recognized the need to move beyond subjective concussion diagnoses that relied on questions—that players could deny or exaggerate— to more objective measurements. This is why we were pleased to collaborate in this study.”
Physician Dr. Michael Stuart, a professor of orthopedic surgery and the co-director of Mayo Clinic Sports Medicine, says, “Concussion in sports, especially in ice-hockey, is a global public health issue with an estimated 1.6 million to 3.8 million sport-related concussions occurring per year in the United States alone. There is a growing urgency to develop practical approaches that use objective, physiological measures, which are also rapidly and easily deployable in sport and clinical settings so medical staff can better diagnose and treat concussions.”
The research study was designed and carried out by the Mayo Clinic Sports Medicine Ice Hockey Research team, partially funded by USA Hockey and the Johannson-Gund Endowment.