Talks with impact

The Canadian Association for Neuroscience held Public Lectures at the 10th Annual Canadian Neuroscience Meeting

Talks with impact

Rowan Stringer, a high school student from Ottawa, got her first concussion on a Friday in 2013. On the following Monday, she got her second concussion, and on the Wednesday, her third. On the following Sunday, these head injuries ended the life of the 17-year-old rugby player.

Dr. Charles Tator shared Rowan’s story with the audience members of the 2016 Canadian Association for Neuroscience (CAN) Public Lectures. As the first of several events, these lectures heralded the 10th Annual Canadian Neuroscience Meeting, a symposium showcasing the top Canadian research in this field.

Leading neuroscientists Dr. Margot Taylor, Director of Functional Neuroimaging and Diagnostic Imaging at The Hospital for Sick Children, and Dr. Charles Tator, a neurosurgeon at Toronto Western Hospital, were invited to the Peter Gilgan Centre for Research and Learning to speak about their work with innate and acquired brain injury, respectively.

Dr. Taylor introduced the magnetic resonance imaging (MRI) and magnetoencephalography (MEG) brain imaging techniques currently being used in her studies. Her work centres on developmental differences in the pediatric population, comparing typically developing (TD) children with children born preterm or who have Autism Spectrum Disorder (ASD).

“MEG and fMRI are complementary in understanding the neural mechanism of cognitive function,” explained Dr. Taylor. “The main advantage of MEG is that it gives timing information,” whereas fMRI allows the researcher to “determine what brain regions are involved with cognitive ability.” Using these neuroimaging methods, she found that atypical working memory brain processes are found in the ASD group.

In addition to investigating working memory, a component of short-term memory that allows information storage during mental activity, Dr. Taylor explored a concept called theory of mind (ToM) in children with ASD. ToM is the ability to understand that other people have different perspectives from oneself. “People have to inhibit their own belief to understand what others believe,” said Dr. Taylor. “It is considered a key deficit in autism and is called ‘mind-blindness.’”

ASD is an innate disorder of brain development. On the flip side of the coin, Dr. Tator spoke about his research, activism, and experience with acquired brain injuries as a neurosurgeon.

“A concussion is a brain injury. In fact, it is the most common brain injury,” said Dr. Tator. Although the exact mechanism is unknown, experts believe that rotational head acceleration — rather than the tearing or bruising of the brain — causes concussions. The brain moves within the skull. “That’s why helmets don’t work. Helmets do prevent other types of brain injury but they don’t prevent concussions.”

Another concern with concussions is in its diagnosis. “We do not have a good biomarker,” said Dr. Tator. Concussions today are still diagnosed clinically, meaning they are dependent on the amalgamation of a clinician’s judgement with a patient’s self-reported symptoms. This requires the patient to be compliant and truthful. “Imagine having a major disorder that can only be diagnosed with autopsy,” Dr. Tator posited. A purposeful effort to hide the injury can fool the examiner. “We still witness this regularly in professional sports,” said Dr. Tator, recalling hockey player Sidney Crosby’s melee with concussions.

Beyond the NHL, this issue has blighted many lives, including Rowan Stringer’s. She lost her life after ignoring several symptoms of concussion. “This case alone indicates that concussion is a public health concern,” said Dr. Tator. “We are playing catch-up in this field. It’s been a completely neglected field for a long time, but not anymore.”

As a prelude to the 10th Annual Canadian Neuroscience Meeting, these lectures sparked discussion of current research by the neuroscience community.

A dangerous blow

U of T conducts the first study on the incidence of all-cause injury in the NFL

A dangerous blow

According to a new survey, nearly 1 in 5 Canadians have suffered a concussion from sports.

Recently, the effects of concussions have been in the media due to the release of the new blockbuster Concussion. The film stars will smith as Bennet Omalu, a Nigerian-American forensic pathologist faced with the challenge of proving that concussions from professional football may be more serious than was previously believed.

In the film, Omalu attempts to convince the NFL — and the many Americans who love professional football — that concussions from professional football may be linked to long-term depression and mental health issues.

Here in Toronto, research on the effects of concussions are ongoing and productive. Assistant Professor Michael Hutchison of the faculty of kinesiology and physical education is the director of the concussion program at U of T’s David l. Macintosh sport medicine clinic, and a prominent concussion researcher.

His most recent publication, “descriptive epidemiology of musculoskeletal injuries and concussions in the NFL, 2012-2014,” published in collaboration with Dr. David w. Lawrence and Dr. Paul Comper studies the effect of american football on concussions.

The paper, published in the Orthopeadic Journal of Sports Medicine, utilizes the weekly injury reports from the NFL to understand the epidemiology and frequency of concussions in the NFL. The paper found that head injuries or concussions accounted for nearly 7 per cent of all injuries by anatomical location in nfl players. It also determined that wide receivers suffered from the greatest rate of injury, while quarterbacks and kickers had the lowest. Equally startling is the fact that the incidence rate of concussions in the NFL in 2012-2014 has increased 1.61 times since 2002-2007. The paper also suggests that the incidence of concussions in american football is nearly three times as high as the incidence seen in professional rugby union.

Although the relatively high prevalence of concussions in football has been known for some time, it was the work of Bennet Omalu that inextricably linked the high prevalence of concussions in football to a disorder he named chronic traumatic encephalopathy, abbreviated as CTE. In linking the two, he discovered a link between the frequent brain trauma of football to depression and issues of mental health in a number of former professional football players. However, because CTE cannot be detected using traditional methods (such as cat scans), proving its existence was a challenge for Omalu, who initially faced ridicule for making the links that were later proven. The connection between concussions and repeated brain trauma and CTE is now nearly universally accepted. Furthermore, thanks to research at U of T, the relative prevalence of concussions in american football is being uncovered. In the future, we may be able to find safer ways to play the game that millions love without threatening the mental health of  its players.