Johns Hopkins’ 2014 study on concussions in former NFL players and the long-term effects was a fine study, not as far as learning about concussions goes, but for testing the usefulness of the newest technology in brain scanning and seeing its limits and advantages.
In the past, chronic traumatic encephalopathy (CTE) was only diagnosed and studied during autopsy. The study also focused on the imaging of traumatic brain injury related damages by targeting the translocator protein (TSPO). A translocator protein (TSPO) is a special protein mainly found on the outer mitochondrial membrane of neurons. It interacts with StAR (steroidogenic acute regulatory protein) to transport cholesterol into the mitochondria of other neurons. In other words, TSPO is an indicator of the brain attempting to repair or patch brain damage. The study helps to support the idea that these new machines and new techniques for neural imaging can really advance our understanding of the brain and increase our medical abilities in providing accurate diagnoses for patients, before their dirt nap.
The primary test used for the study involved a positron emission tomography (PET) scan that used (safe) radioactive chemical injections that bind to specific proteins. In this case, the radiopharmaceutical used was [11C]DPA-713 which binds to TSPO. The idea is that the more prevalent this radio-transmitter is in the PET scan, the more brain damage (TBI) there is in in subject. The PET scan would also show a specific location for the damage. MRI scans were also performed on the participants to check for brain atrophy that may have been caused by TBIs. Along with the imaging tests, there were a few paper-and-pen tests performed on the subjects, including the California Verbal Learning Test-II (CVLT-II), the Rivermead Post-Concussive Symptom Questionnaire (RPQ), and an interview focusing on their past NFL career and past concussions. These tests (in order) covered their ability to learn and remember verbal information, the severity of mood, anxiety, and cognitive long-term symptoms of their concussions, and details of their past concussions (how hard were they hit, how long initial symptoms lasted, etc.). These interviews and written tests help the researchers compare the amount of brain damage they found with their scans to the severity of the side effects the players suffer.
In the results, many of the ex-NFL players who participated in the full study scored fairly highly on the RPQ test, scoring 32, 21, and 20 on a scale of 0-52 with a higher number indicating more severe symptoms. The CVLT-II scores where low as well, with averages ranging from 44% to 54%, indicating a struggle in verbal learning and recall. The article also reports evidence of brain atrophy (shrinkage) in multiple areas, which lines up with the test scores.
The study does have a few flaws, however, including [11C]DPA-173 binding differences between two TSPO genotypes (C/C and C/T) and the fact that the study size was in fact very small. To counter act the genotype flaw, however, the researchers used a GMVT method to correct differences produced by the genotype variation.
The study does a pretty good job of supporting the usability of the new methods in analyzing brain damage in living subjects. The brain scans showed high TSPO activity (through the radioactive injection [11C]DPA-173 binding to the TSPO present in the brain) when compared to a control scan on a person without a concussion (see image below). With this new technology and these new techniques, as supported by the Johns Hopkins study, we can make more accurate, lifesaving decisions for patients who are suffering from a traumatic brain injury.
Coughlin, Jennifer M., Yuchuan Wang, Cynthia A. Munro, Shuangchao Ma, Chen Yue, Shaojie Chen, Raag Airan, Pearl K. Kim, Ashley V. Adams, Cinthya Garcia, Cecilia Higgs, Haris I. Sair, Akira Sawa, Gwenn Smith, Constantine G. Lyketsos, Brian Caffo, Michael Kassiou, Tomas R. Guilarte, and Martin G. Pomper. “Neuroinflammation and Brain Atrophy in Former NFL Players: An in Vivo Multimodal Imaging Pilot Study.” Neurobiology of Disease 74 (2015): 58-65. Web. Mar. 2016.
(I have the article in a Word document i can share via Email, if needed, please let me know and I can send it to you)
Writing this article was actually fairly easy for me. To be honest all I did was edit my scholarly research article a whole lot and provide some more explanations for what things are. I really didn’t need to cut that much information out since my original article was a little over 700 words long, so I easily got everything I wanted into my article. As far as comparisons go, well, I’m still a little unhappy with the first article. The news article I read at the beginning of the semester made the research article sound like it was about studying concussions and how we can catch sports related brain injuries. The title of the article alone is misleading, “Johns Hopkins study of retired NFL players sheds light on concussion-related brain damage” (Hedin, 2015). I think, or at least I hope, that my article more truthfully describes and/or portrays the research article and its intents and findings. I tried to focus on the methods and tests used in the experiment and I hope I explained them and their purposes enough. In my opinion, Maren Hedin’s intentions for her article were probably to make the research look like a more hopeful or productive project to the public masses. I imagine most people would rather hear about research for helping concussion patients than about research on methods of studying the brain in applications like concussions. I understand that sometimes journalists have to decide what is more important and what can be left out so they can stay within their allotted space in there publication. I also see that, depending on what or who a journalist is writing the article for, can change the way they write their article and what they write about. I understand that, while news articles might be shorter, easier, and more convenient to read than original articles, they should not always be completely trusted, however, some might very well be trustworthy. It’s a little confusing, so, I think I’ll stick to trying to find original articles and original statements instead of reading news and other media articles written by journalists whose main interest is usually getting more readers.
Hedin, Marin. “Johns Hopkins Study of Retired NFL Players Sheds Light on Concussion- Related Brain Damage.” The Hub. Johns Hopkins University, 26 Jan. 2015. Web. 21 Feb. 2016. <http://hub.jhu.edu/2015/01/26/nfl-players-concussion-research>.