Cognitive Brain Function in Youth Football Players Can be Impaired by Repetitive “Subconcussive” Head Impacts

Cognitive Brain Function in Youth Football Players Can be Impaired by Repetitive “Subconcussive” Head Impacts

Feb 23, 2022 | news

Brain health study shows cognitive brain function in youth football players can be impaired by repetitive “subconcussive” head impacts

(See this news release on EurekAlert and Medical Xpress.)

Sioux Falls, South Dakota, U.S. and Surrey, British Columbia, Canada (February 23, 2022) – Neuroscience researchers at Sanford Research in Sioux Falls, South Dakota, U.S., Simon Fraser University (SFU), and HealthTech Connex Inc. located at the Health and Technology District in Surrey, British Columbia, Canada, have published the latest results of their ongoing multi-year football study examining subconcussive changes in cognitive brain function in male youth football players.

The findings were recently published in the peer-reviewed journal Brain Communications in the advanced articles section, titled: “Subconcussive changes in youth football players: Objective evidence using brain vital signs and instrumented accelerometers.”

The research team monitored the brain vital signs of 15 male youth football players (age 14 or under) in Sioux Falls, South Dakota, during pre- and post-season play who did not sustain a concussion diagnosis during the season.

“Brain vital signs” translates complex brain waves measured using portable electroencephalography (EEG) into simple, fast, user-friendly and intuitive results that provide an objective evaluation of cognitive brain function. Called the ABCs of brain function, brain vital signs track three well-established neural responses for Auditory sensation (using a response called the N100), Basic attention (using a response called the P300), and Cognitive processing (using a response called the N400).

The study examined this group of male youth football players and reported cognitive processing sensitivity (N400) to subconcussive impairments in those players who did not sustain a concussion diagnosis over the course of the season. In addition, changes in brain vital signs were highly related to the number of head impacts that the players were exposed to during the season.

This youth football study replicated and built on previous Junior-A and Bantam youth ice hockey concussion and subconcussion study results published in Brain: A Journal of Neurology and Brain Communications which resulted in the same findings, confirming significant brain vitals sign changes and concussive/subconcussive impairments in youth contact sport that went undetected using current clinical concussion protocols.

A subconcussive impact is a mechanical force transmitted to the brain below the threshold for a diagnosis of an acute concussive injury. The effects of these low-magnitude impacts may not even be noticeable to the player or to observers on the sideline.

“By monitoring brain vital signs, extracted from complex brain waves measured using portable electroencephalography (EEG), it was possible for us to track three well-established neural responses for auditory sensation, basic attention, and cognitive processing in these youth football players,” says Dr. Thayne Munce, the study’s principal investigator and Assistant Scientist in the Environmental Influences on Health and Disease Group at Sanford Research. “The results of the study show that repetitive subconcussive impacts triggered compounding effects in brain function changes over time. While more research needs to be done in this area, this is the first step in how we can look at youth contact sports in the future.”

The results of this youth football Brain Communications study showed:

  • Significant brain vital sign changes in pre-to-post season cognitive processing speed.
  • A significant relationship between the subconcussive brain vital sign changes and head impact exposures as measured by the total number of head impacts as well as number of games and/or practices over the season.
  • The authors noted that the brain vital sign changes and total number of head impacts for the football players closely related with the results from older, Junior-A, ice hockey players from a previous study.

Canadian collaborators include neuroscientist Dr. Shaun Fickling, lead R&D scientist at HealthTech Connex Inc., SFU PhD graduate and lead author of the study, as well as Dr. Ryan C. N. D’Arcy, an SFU professor and co-founder of HealthTech Connex Inc. and the Health and Technology District in Surrey B.C. HealthTech Connex Inc. is a health technology company developing the NeuroCatch® Platform.

“These findings provide further support that there is a predictive relationship between head impact exposure in contact sport and subtle changes in cognitive brain function” reports Dr. Shaun Fickling, who was the study’s lead author as part of his PhD in Biomedical Engineering at Simon Fraser University.

“The results are really quite positive and optimistic for the future of brain injury prevention and management in sport,” further explains Dr. Thayne Munce. “Now that we can sensitively detect changes associated with subconcussive impacts, it is possible to identify the leading ways to prevent, treat, and manage possible impairments, which is a critical step that is now getting underway.”

The US-Canadian concussion research collaborators are continuing to utilize these brain vital sign advances to evaluate possible leading innovations in prevention and treatment.

The research study was designed and carried out by investigators at Sanford Research, and partially supported by a grant from the T. Denny Sanford Pediatric Collaborative Research Fund. This project was also supported in part by the Simon Fraser University Graduate International Travel and Research Award (GIRTA).

About Sanford Health:

Sanford Health, one of the largest health systems in the United States, is dedicated to the integrated delivery of health care, genomic medicine, senior care and services, global clinics, research and affordable insurance. Headquartered in Sioux Falls, South Dakota, the organization includes 46 hospitals, 1,500 physicians and more than 200 Good Samaritan Society senior care locations in 26 states and 10 countries. Learn more about Sanford Health’s transformative work to improve the human condition at sanfordhealth.org or Sanford Health News.

About Simon Fraser University (SFU):

As Canada’s engaged university, SFU works with communities, organizations and partners to create, share and embrace knowledge that improves life and generates real change. We deliver a world-class education with lifelong value that shapes change-makers, visionaries and problem-solvers. We connect research and innovation to entrepreneurship and industry to deliver sustainable, relevant solutions to today’s problems. With campuses in British Columbia’s three largest cities—Vancouver, Burnaby and Surrey—SFU has eight faculties that deliver 193 undergraduate degree programs and 127 graduate degree programs to more than 37,000 students. The university now boasts more than 165,000 alumni residing in 143 countries. www.sfu.ca

About HealthTech Connex Inc.:

Located in the Health and Technology District, HealthTech Connex Inc. (HTC) is a brain technology company focusing on cutting-edge innovations and services for rapid impact on health improvements and outcomes in neurological performance. With brain vitality as a premier focus, HealthTech Connex provides translational neuroscience innovations to care and community sectors worldwide, bridging the gap between what is capable in the laboratory and what’s available in the real world. www.healthtechconnex.com

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Media contact:

Yvonne Chiang, news@chiangpr.ca

Neuroscience Researchers Find Repetitive Head Impacts Can Result in Functional Brain Impairments in Youth Hockey

Neuroscience Researchers Find Repetitive Head Impacts Can Result in Functional Brain Impairments in Youth Hockey

Apr 22, 2021 | news

Photo: Hockey player gets his brain vital signs checked. Researchers find repetitive head impacts can result in functional brain impairments in youth hockey.

Brain Vital Signs Concussion Study in Bantam and Junior A Ice-Hockey Detects Significant Subconcussive Changes in Cognitive Brain Function

(See this news release on EurekAlert and CNW/Cision.)

Surrey, B.C. Canada and Rochester, Minn., U.S. (April 22, 2021) – Neuroscience researchers at Mayo Clinic Orthopedics and Sports Medicine in Rochester, Minnesota, U.S., the Health and Technology District and Simon Fraser University (SFU) in Surrey, British Columbia, Canada have published the latest results of their ongoing multi-year hockey concussion study examining changes in subconcussive cognitive brain function in male youth ice hockey players.

The research team monitored brain vital signs during pre- and post-season play in 23 Bantam (age 14 or under) and Junior A (age 16 to 20) male ice-hockey players in Rochester, Minnesota.

“Brain vital signs” translates complex brain waves measured using portable electroencephalography (EEG) at the rink-side, into simple, fast, user-friendly and intuitive results that provide an objective evaluation of cognitive brain function. Called the ABCs of brain function, brain vital signs track three well-established neural responses for Auditory sensation (using a response called the N100), Basic attention (using a response called the P300), and Cognitive processing (using a response called the N400).

The study builds on 2019 results published in Brain: A Journal of Neurology that confirmed significant brain vitals sign changes shortly after concussions were diagnosed in Junior A players. Key results of this study showed undetected impairments remained when players were cleared to return to play using current clinical concussion protocols. Notably, the initial study also reported sensitivity to subconcussive impairments in those players who did not sustain a concussion diagnosis over the course of the season.

The current second phase of the study replicated these results and added the Bantam age group. The latest findings were recently published in the peer-reviewed journal Brain Communications in the advanced articles section.

The results of this new Brain Communications study showed:

  • Significant brain vital sign changes in N100 Auditory sensation and N400 Cognitive processing responses for the pre-to-post season comparison across both groups.
  • Differences between the Bantam and Junior A ice hockey players showed more changes in the Junior A group.
  • Importantly, the subconcussive changes were significantly correlated with the number of head impacts over the season across both age groups and consequently showed more subconcussive changes in brain vital signs.

A subconcussive impact is a mechanical force transmitted to the brain below the threshold for a diagnosis of an acute concussive injury. The effects of these low-magnitude impacts may not even be noticeable to the player or to observers on the sideline. Head impacts in the sport of ice hockey typically result from player-to-player or player-to-boards contact due to body checking, collisions and fighting[i]. Some of these impacts are the consequence of foul play, but many of these events also result from routine, legal on-ice behavior.

“Concussion in sports is a major concern for many and our research has shown that having an objective physiological measure of brain function at rink-side is key to detection and managing concussive impacts,” says Dr. Aynsley Smith, principal investigator of the study and Associate Professor of Orthopedics at Mayo Clinic in Rochester, Minnesota.

The study, funded in part by USA Hockey, was co-led by Dr. Michael Stuart, Professor of Orthopedics at Mayo Clinic in Rochester, Minnesota. It is also part of a larger concussion research team within Mayo Clinic that includes neurology research leadership from Dr. David Dodick, Professor of Neurology at Mayo Clinic in Phoenix, Arizona, U.S.

Canadian collaborators include neuroscientist Dr. Ryan C. N. D’Arcy, an SFU professor and co-founder of the Health and Technology District in Surrey B.C. and Dr. Shaun Fickling, a biomedical engineer, a recent SFU PhD graduate and lead author of the study.

“Our research has shown that repetitive subconcussive impacts triggered compounding effects in brain function changes, which underscores the importance of shifting our thinking and understanding of concussions as a singular acute-injury model to a spectrum of head-impact exposure and effects over time,” says Dr. Fickling.

The US-Canadian concussion research team is continuing to advance their collaborative effort.

Says Dr. D’Arcy, “In medicine: you can’t treat what you can’t measure. With breakthroughs on measurement challenges, we hope to now accelerate treatment innovations for prevention, acute care and extended care concussion management – for all people across a range of different applications. Our partnership is moving into incredibly exciting future steps – stay tuned.”

The research study was designed and carried out by the Mayo Clinic Sports Medicine Ice Hockey Research team, partially funded by USA Hockey Foundation and the Johannson-Gund Endowment. Financial support was also provided by the Mathematics of Information Technology and Complex Systems (MITACS), Natural Sciences and Engineering Council Canada (NSERC) and the Canadian Institutes for Health Research (CIHR).

About Mayo Clinic

Mayo Clinic is a nonprofit organization committed to innovation in clinical practice, education and research, and providing compassion, expertise and answers to everyone who needs healing. Visit the Mayo Clinic News Network for additional Mayo Clinic news. For information on COVID-19, including Mayo Clinic’s Coronavirus Map tracking tool, which has 14-day forecasting on COVID-19 trends, visit the Mayo Clinic COVID-19 Resource Center.

About Simon Fraser University (SFU)

As Canada’s engaged university, SFU works with communities, organizations and partners to create, share and embrace knowledge that improves life and generates real change. We deliver a world-class education with lifelong value that shapes change-makers, visionaries and problem-solvers. We connect research and innovation to entrepreneurship and industry to deliver sustainable, relevant solutions to today’s problems. With campuses in British Columbia’s three largest cities—Vancouver, Burnaby and Surrey—SFU has eight faculties that deliver 193 undergraduate degree programs and 127 graduate degree programs to more than 37,000 students. The university now boasts more than 165,000 alumni residing in 143 countries. www.sfu.ca

About the Health and Technology District (the DISTRICT)

The Health and Technology District in Surrey, B.C., is a rapidly expanding ecosystem of innovators and entrepreneurs collaborating with tech companies, scientists, educators and health professionals; each representing a range of business, technologies and research fields. The series of high-tech buildings located and under expansion strategically across from Surrey Memorial Hospital, offers a dynamic community where disruptive impacts are generated through the translation of research, science and technology into global innovations. Within this, the current research is a result of the BrainNET initiative to translate neuroscience knowledge directly into clinical advances in care. www.HealthandTechnologyDistrict.com

[i] Smith AM, Farrell KJ, Roberts WO, Moris MR, Stuart MJ. Eliminating Fighting and Head Hits from Hockey: Opportunities and Barriers. Curr Sports Med Rep 2019; 18: 35–40.

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Media contact:

Yvonne Chiang, 604-880-5090, news@chiangpr.ca

New scientific study shows brain injuries can be unbroken by innovative neuro-technologies

New scientific study shows brain injuries can be unbroken by innovative neuro-technologies

Oct 14, 2020 | news

Photo: Capt. Trevor Greene continues his recovery from brain injury using innovative brain technologies.

Canadian veteran Capt. Trevor Greene pushes the limits of physical, cognitive and PTSD recovery from Afghanistan axe attack

Surrey, British Columbia, Canada (October 14, 2020) – A recently published scientific study led by the Centre for Neurology Studies at HealthTech Connex and a research team from Simon Fraser University (SFU) reports the latest breakthroughs from Project Iron Soldier. Captain (retired) Trevor Greene, who was attacked with an axe to the head while serving in Afghanistan, continues to disrupt conventional limits in recovery after brain injury. The internationally renowned research, led by neuroscientist Dr. Ryan C. N. D’Arcy, involves tracking Capt. Greene’s neuroplasticity as he rewires his brain using the latest and most advanced brain technologies.

Just a month before a global pandemic was declared, Capt. Greene and Dr. D’Arcy recounted their remarkable progress and showcased their mission to lead scientific breakthroughs in neuroplasticity through a recent TEDx talk. In a time when COVID-19 is increasingly being linked to brain health, the scientific results from Project Iron Soldier brings hope and optimism in the form of a peer reviewed study, published in Frontiers of Human Neuroscience, on Capt. Greene’s physical, cognitive and PTSD improvements.

In 2006, retired Canadian soldier Capt. Greene survived a severe, open-traumatic brain injury when he was attacked with an axe to the head, during his combat tour in Afghanistan. He spent years in various therapies and rehabilitation, and in 2009, he started working with Dr. D’Arcy to track his progress. In 2015, the B.C. and Yukon Command of the Royal Canadian Legion helped outfit Trevor with a robotic exoskeleton, which helped him continue re-learning to walk. Called Project Iron Soldier, this exciting initiative was the inspiration to develop the Legion Veterans Village, a $312M Centre of Excellence for PTSD, mental health and rehabilitation dedicated to veterans and first responders (currently under construction in Surrey).

Capt. Greene and the Project Iron Soldier research team have continued with intensive daily rehabilitation, but the team experienced an extended plateau in progress using conventional therapy alone. To break through the plateau, the Centre for Neurology Studies launched an intensive 14-week study using the Portable Neuromodulation Stimulator (or PoNS™) in combination with physical therapy to safely stimulate novel neuroplasticity and tracked brain vital sign improvements using NeuroCatch® Platform (or NeuroCatch®).

The PoNS is a neuromodulation technology that sends a series of small electrical impulses to the brain by stimulating the tongue (known as translingual neurostimulation). NeuroCatch is a rapid objective measure of cognitive brain function. A number of published clinical studies demonstrate applications for both the PoNS and NeuroCatch for brain injury, with the current case study highlighting the real-world application to push the limits of recovery in physical abilities, cognitive processing, and PTSD symptoms.

“Our team has been leading clinical research to develop and validate advanced brain technologies like the PoNS and NeuroCatch Platform for a few years and have seen incredible results in terms of improved brain health and well-being,” says Dr. D’Arcy, co-founder of HealthTech Connex, which operates the Centre for Neurology Studies, and an SFU professor. “When Trevor experienced a plateau in his rehabilitation, we tried intensive conventional treatment approaches, but to no avail. It was only after combining stimulation with the PoNS device with his rehabilitation therapy that we could break through these barriers and demonstrate significant clinical improvements.”

Results of the study: The newly published results demonstrate that PoNS neurostimulation, paired with intensive rehabilitation, may stimulate neuroplasticity to overcome an extended recovery plateau in this case as objectively measured by NeuroCatch and other brain scanning technologies. The main findings were:

  • Capt. Greene showed significant gains in clinical outcome measures for physical therapy. It is noteworthy that these improvements occurred more than 14 years after the axe attack. Capt. Greene and his wife Debbie Greene also reported notable and lasting improvements in cognition and PTSD symptoms.
  • Capt. Greene showed significant brain vital sign improvements in cognitive function, particularly in auditory sensation (as measured by the N100 response), basic attention (as measured by P300 response), and cognitive processing (as measured by N400 response). The study results are published in Frontiers in Human Neuroscience.

Dr. D’Arcy describes the study results: “We were fascinated to see that, while the focus was physical therapy, NeuroCatch scans detected cognitive improvements and Trevor and his wife Debbie reported greatly reduced PTSD symptoms. My favorite line in this published paper was when Debbie closed the study by saying, ‘I got my superman back.’ In our COVID-19 era, when we are all concerned about the recent links to brain health, it is breakthroughs like this that bring continued hope for science and technology advances.”

Says Capt. Greene, “I first saw the power of neuroplasticity in the early days of the first study involving the MRI. I was blown away when Ryan showed me images of my brain with coloured splotches showing where my healthy brain tissue was taking over for the damaged bits. Later on, I saw the full power of the PoNS device when I got demonstrably stronger, steadier and more coordinated after using it regularly for just a few weeks. It’s really been a game changer for me and my family.”

“Trevor’s amazing progress is no doubt pushing the frontiers of medical science by overcoming perceived limits of brain recovery,” says Dr. Shaun Fickling, the study’s lead author who completed his PhD at Simon Fraser University. “These brain imaging results provide valuable insight into the importance of unleashing the power of neuroplasticity to inspire countless people impacted by brain and mental health conditions.”

Dr. D’Arcy concludes, “These neuro-technology breakthroughs have considerable impacts to inspire many of us to push beyond conventional limits in neurological and mental health recovery. For our veterans and first responders, who remain resilient in the face of frequent exposure to trauma, this research and science underpins the inspiration for our newly developed Legion Veterans Village, to give back through a Centre of Excellence in PTSD, mental health, and rehabilitation.”

About HealthTech Connex Inc.:

Located in the Health and Technology District, HealthTech Connex Inc. (HTC) is a brain technology company focusing on cutting-edge innovations and services for rapid impact on health improvements and outcomes in neurological performance. With brain vitality as a premier focus, HealthTech Connex provides translational neuroscience innovations to care and community sectors worldwide, bridging the gap between what is capable in the laboratory and what’s available in the real world. www.healthtechconnex.com

About the Centre for Neurology Studies (CNS):

The Centre for Neurology Studies is a boutique clinical research site that administers clinical trials and consulting services, specializing in neuroscience. Clinically embedded at HealthTech Connex Inc., a brain technology company focusing on cutting-edge neuro-tech innovations located within the Health and Technology District ecosystem, CNS offers high-quality evaluation and delivery of neuro-technology innovations while integrating scientific evidence and real-world clinical practices. www.centreforneurologystudies.com.

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Media contact:

Yvonne Chiang, news@chiangpr.ca

Studies’ References:

Fickling, S.D., Greene, T., Greene, D., Frehlick, Z., Campbell, N., Etheridge, T., Smith, C., Bollinger, F., Danilov, Y., Rizzotti, R., Livingstone, A., Lakhani, B., & D’Arcy, R.C.N. (2020). Brain vital signs detect cognitive improvements during combined physical therapy and neuromodulation in rehabilitation from severe traumatic brain injury: Case report. Frontiers in Human Neuroscience. 14,347.

D’Arcy, R.C.N., Greene, T., Greene, D., Etheridge, T., Frehlick, Z. Fickling, S.D., Campbell, N., Smith, S., Bollinger, F., Danilov, Y., Livingstone, A., Tannouri, P., Martin, P., & Lakhani, B. (2020). Portable neuromodulation induces neuroplasticity to re-activate motor function recovery from brain injury: A high-density MEG case study. Journal of Neuroengineering and Rehabilitation. In press.

D’Arcy, R.C.N., Lindsay, D.S., Song, X., Gawryluk, J.R., Greene, D., Mayo, C., Ghosh Hajra, S., Mandziuk, L., Mathieson, J., & Greene T. (2016). Functional recovery in severe traumatic brain injury beyond established limits. Journal of Head Trauma Rehabilitation, 31(5), 50-58.

See below for photos of the Project Iron Solidier video: