Monthly Archives: October 2013
Pro Football Talk‘s Mike Florio is reporting this morning that today’s hearing on the proposed NFL concussion settlement, which Federal Judge Anita Brody was expected to oversee, has been postponed.
Quoting a source “with knowledge of the situation, Florio said he was “told the hearing was bumped principally because the financial experts assessing the ability of the $765 million settlement to provide compensation to all retired NFL players who have or may have severe cognitive impairment need some extra time to prepare their reports.”
While a new date has not been set, Florio is reporting that the “delay, which reflects the complexity of implementing the agreements, isn’t expected to be more than a few weeks.”
Steve Shaw had a lot to say about the targeting rule when he spoke to the Gulf Coast Athletic Club earlier this week. And the coordinator of football officials for the Southeastern Conference didn’t mince words, calling it the “the most significant rule change” since his involvement in the early 1990s.
“Our game is absolutely under attack, there’s no question about that. Even the president of the United States said: ‘If I had a son, I’m not sure I’d let him play football.’ We may pass that off, but those are impactful words. There’re a lot of people out there with lawsuits. The NFL has just settled a lawsuit, but it’s not over. That’s just the first stage.
“From my perspective, I believe targeting – where you target a defenseless player above the shoulders, is what the rule says, or you use the crown or top of your helmet to deliver a blow — those are dangerous acts. You get concussions and, when you use the crown or top of your helmet, that’s when you get catastrophic injuries.
“I’m just going to tell you our game is under attack, and I believe that coaches, players and officials have to make a change in our game or we’re going to have people changing our game that we don’t want changing our game. We have got to make some changes with our game or people are going to change it for us.”
And those changes should be made before the season starts, according to Shaw.
“We’ve never had more conversations with coaches and players about proper technique,” he said. “I go to every school in the summer, and I talk to the players, and they ask, ‘What am I supposed to do?’ And we give them three pieces of advice. No. 1, keep your head up. See what you hit. Lower your target is No. 2. And then No. 3 is wrap your arms up.”
Accurately diagnosing traumatic brain injuries (TBI) and concussions is difficult, as standard CT or MRI scans can’t see most changes to the brain caused by these injuries.
Clinicians must rely on patients accurately and candidly describing their symptoms, which many patients – such as soldiers and athletes – are hesitant to do for fear of being removed from action with their unit or team.
Borrowing a tactic used to identify lung infections, University of Virginia School of Medicine researchers have discovered a potential method to identify TBI that uses positron emission tomography (PET) scans and the body’s immune response to a brain injury.
Backed by funding from the U.S. military’s Defense Health Program, the UVA researchers – radiologist and neuroscientist James Stone, MD, PhD, and radiology researchers Stuart Berr, PhD, Jiang He, PhD, and Dongfeng Pan, PhD – presented their initial findings at the recent Military Health System Research Symposium.
Why imaging misses most TBI and concussions
Existing clinical methods for imaging TBI are only able to identify alterations to the brain’s structure at a macroscopic level, such as bruising, tissue tears or blood accumulation. However, most changes to the brain that result in TBI symptoms are typically only visible microscopically, either at the cellular or molecular level.
“Most people with concussions and TBI will have negative CT and MRI scans,” Berr said.
Without imaging that can identify brain injury at the microscopic level, clinicians largely have to diagnose concussions and TBI based on patients’ description of their symptoms.
Identifying TBI with a “Trojan Horse” tracer
To identify TBI, UVA researchers attached a compound similar to the radioactive tracers used to identify lung infections to the surface of neutrophils, a white blood cell that is part of the immune response to an injury. Previous research has shown that when TBI occurs, neutrophils target the injured area of the brain by passing through blood vessels that access cerebral spinal fluid.
The compound hitchhikes on the neutrophils and travels with these cells to sites of injury, allowing researchers to see and identify brain injury on a PET scan. “It’s like a Trojan horse kind of approach,” Stone said.
“Neutrophils identify early inflammation in TBI, which could one day allow researchers to identify patients that might benefit from therapies targeting TBI-related inflammation,” Stone added.
The researchers are planning additional tests to ensure the safety of the compound, followed by clinical trials to examine the effectiveness of this technique for diagnosing TBI.