Research making impact on concussions

Neurosurgery Program Manager Jennifer Hill and  Dr. Michael McCrea are collecting concussion data from local high school and college athletes to investigate the best tools for assessing concussion and recovery.

Neurosurgery Program Manager Jennifer Hill and  Dr. Michael McCrea are collecting concussion data from local high school and college athletes to investigate the best tools for assessing concussion and recovery.

Advances in the prevention, diagnosis and treatment of disease and injury result from novel biomedical research in basic, clinical and translational sciences. As the future unlocks new directions for study in emerging fields like genetics, personalized medicine, stem cell biology and imaging, the Medical College of Wisconsin is well-positioned to generate the knowledge that drives improvement in health care and health sciences.

The experiences of soldiers and athletes have made concussions a topic of national discussion in recent years. The condition’s immediate symptoms and long-term deleterious effects make concussion research critical for the present and the future.

An integrated team led by Medical College of Wisconsin neuropsychologist Michael McCrea, PhD, has conducted several large-scale studies over the last 20 years that have significantly advanced the scientific understanding of concussion. Their work has contributed to new standards for concussion management in competitive sports. Their newest project will apply data from athletics to identify the best way to assess concussion and recovery, which could lead to better care for U.S. troops.

Supported by a $2.2 million grant from the Department of Defense’s U.S. Army Medical Research and Material Command, Dr. McCrea’s team seeks to determine which of four concussion screening tools is the most valid and reliable. Accurate testing of cognitive function is important both for measuring an injury’s effect and for guiding clinical decisions about a patient’s readiness to return to duty or activity.

An estimated 3.8 million Americans sustain a traumatic brain injury each year. About three quarters of these are concussions, and many more go unreported. Concussion is common among athletes in contact sports and is recognized as the signature wound of the conflicts in the Middle East. Concussion management research is key to improving outcomes,
particularly because resuming activity too early—on the battlefield, on the game field or in the workplace—is fraught with risk. Short term, there is a greater likelihood of repeat injury with worsening symptoms, longer recovery or even catastrophic injury. Repeat events can lead to post-concussion syndrome, often marked by headaches and cognitive symptoms. Long term, concussions appear to increase risk for depression, mild cognitive impairment, dementia and chronic traumatic encephalopathy.

In the Medical College study, Dr. McCrea’s team aims to conduct baseline tests on 2,100 Milwaukee area high school and college athletes. If and when any of these athletes sustains a sports-related concussion, the group is notified to perform an immediate assessment as well as several follow up tests. This way, results from the four tools can be compared to determine the validity of these tests for assessing concussion and determining recovery. The team will additionally collect data from patients treated for concussion in hospital emergency departments.

Since a comparable study would be nearly impossible to conduct in a military setting, this research offers the best opportunity to inform U.S. military policy regarding the optimal tool for assessing concussion and measuring a soldier’s fitness to return to duty. In turn, the knowledge benefits the public through direct application to sports medicine and civilian care to improve assessment and treatment methods, decrease complications, reduce disability and improve outcomes for individuals affected by concussion.

Dr. McCrea is Professor of Neurosurgery and Neurology and Director of Brain Injury Research.

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