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Ask yourself if you have ever: • Blacked out for a few seconds? • Seen stars? or Have you ever: • Played football, baseball, basketball, lacrosse, soccer, rugby or hockey? • Fallen out of a tree, down the stairs, off a horse, a bike or a skateboard, or crashed while skiing or snowboarding? • Been in a motor vehicle accident (even a simple “fender-bender”) or physically assaulted? If you answered “yes” to any of these, you may actually have injured your brain—even if you didn’t get diagnosed with a concussion.

So how can you find out?

In a helpful demonstration of the usefulness of SPECT imaging for identifying brain-based disorders, a new study shows that current and former NFL players experience low blood flow to the brain, compared to a healthy group. The researchers examined the brains of the largest group of retired and current NFL players investigated to date; a total of 161 individuals with an average age of 52. The results of the study, recently published in the Journal of Alzheimer’s Disease, may help physicians to provide better treatment to people with head injury. “Without functional imaging studies like SPECT, it is very difficult to know if brain trauma is present and which areas are affected,” points out lead author Daniel G. Amen, MD. “Structural studies often appear normal but what we can do better with functional neuroimaging with SPECT is not only pinpoint specific areas of the brain that are unhealthy with low blood flow, but also demonstrate their improvement with successful brain rehabilitation treatments in persons like football players.” This study further supports that fact that brain SPECT imaging is one of the best tools available to identify areas of the brain hurt by an injury. A CT (“CAT”) scan or MRI will tell you if there is any damage to the anatomy or structure of your brain, but these scans cannot tell how your brain is functioning. In fact, many times a CT or MRI will be normal after a head injury, when there is actually functional damage to the brain that can be detected with SPECT. Co-author Dr. Bennet Omalu, who discovered Chronic Traumatic Encephalopathy (CTE) in former football players as portrayed in the movie Concussion, added, “What our current work is doing, in addition to other imaging modalities, builds the foundation for identifying the negative effects of head trauma on the brain while the patient is still alive so that we can intervene with better treatments.” CTE is a progressive degenerative disease of the brain found in athletes (and others) thought to result from repeated hits to the head. It is important to note that undiagnosed sub-concussive blows may also contribute to CTE. However, the actual diagnosis of CTE can be confirmed only with an autopsy. According to Dr. Amen, The two big takeaways from the study are:

1) You don’t have to wait until you’re dead to be diagnosed with a brain injury. With SPECT, we were able to see traumatic brain injuries in virtually all of the football players we studied, and some are recently retired.

2) We determined that you’re not stuck with the damage you have, you can get treated.

Dr. Amen and the physicians at Amen Clinics are very knowledgeable about the consequences of repetitive blows to the head, including how to identify them and heal the brain. If you are concerned that you or a loved may have a head injury, a call to our Care Center can answer your questions and provide you with valuable information that can lead you to a better brain and a better life. Find out how. Call 888-288-9834 or schedule a visit today. This past year, the research team at Amen Clinics, in collaboration with scientists from UCLA, Thomas Jefferson University, and the University of British Columbia, completed two research studies on the differentiation of traumatic brain injury (TBI) from posttraumatic stress disorder (PTSD). They were both accepted into peer-reviewed journals. The first study, entitled Functional Neuroimaging with Default Mode Network Regions Distinguishes PTSD from TBI in a Military Veteran Population was published in April 2015 in Brain Imaging and Behavior. The second study, Functional Neuroimaging Distinguishes Posttraumatic Stress Disorder from Traumatic Brain Injury in Focused and Large Community Datasets was published in PLOS ONE in July 2015. The latter is the world’s largest functional brain imaging study on more than 21,000 patients that demonstrated the ability to distinguish between PTSD and TBI using brain SPECT imaging with high accuracy. We were very pleased to be published in these two excellent medical journals; however, we were really honored when we received the acknowledgment from Discover Magazine about the relevance of our studies to the scientific community. The pioneering research we did on differentiating TBI from PTSD has been highlighted in Discover Magazine as #19 of the top 100 stories in all of science for 2015! Our research was sandwiched between Tesla’s new entry into renewable energy at #18 and the discovery of a new dinosaur species at #20.

Brain SPECT imaging reveals the differences we cannot know just from talking about the patients’ symptoms.

With SPECT (single photon emission computed tomography) we are able to do an overall evaluation of a person’s brain function. The tracer, HMPAO-Tc99, is distributed proportionally to blood flow in the brain. Areas that have lower activity, such as with TBI, draw less blood to them, whereas areas of overactivity, as seen in PTSD, draw more blood. This allows us to differentiate high and low activity from the patient’s normal blood flow. In our study, we were able to distinguish PTSD from TBI with 80% – 100% accuracy.

Using SPECT to Guide Treatment

Because PTSD and TBI have several overlapping symptoms, this capability is particularly important when trying to differentiate between them since the treatments for each are different. Below is a list of symptoms that are among those that can confound the diagnosis for even very experienced clinicians: Typically, treatment for PTSD and emotional trauma is psychological in nature and the goal is to try to calm down the brain. Conversely, treatment for TBI is more physiological in nature and focuses on increasing activity in the injured areas of the brain. Knowing which condition a patient has is critical to helping them heal. For example, if someone is feeling depressed and has difficulty concentrating, a doctor may presume it is TBI and prescribe a stimulant. Unfortunately, if the diagnosis is actually PTSD, the patient’s symptoms will be exacerbated. By using SPECT to help differentiate between PTSD and TBI, it is our hope that the findings from our study and the acknowledgment by Discover Magazine will help millions of people suffering from one or both of these devastating conditions to be correctly diagnosed and more effectively treated. If you have been working with patients who have PTSD or TBI but they aren’t responding well to treatment, consider referring them for a SPECT evaluation at one of our clinics. By doing so you will obtain the data on the underlying biology of their condition which can improve your treatment decisions and help the patients feel better more quickly. Call us today at 888-288-9834 or schedule a visit today. At Amen Clinics, we knew about the NFL concussion problem 25 years ago, simply because we were looking at brains. We quickly learned these tragic facts: even mild traumatic brain injury (TBI) can ruin someone’s life, and the underlying impact of TBI on mental health problems is missed because most doctors don’t look at the brain.

Undiagnosed concussions and TBIs are a very serious problem.

They are a major cause of psychiatric disorders including anxiety, depression, substance abuse, and panic disorder along with homelessness, domestic violence, divorce, and suicide. Furthermore, untreated brain injuries can lead to Alzheimer’s disease and other dementias. Although we have heard about the NFL concussion crisis in the media over the past several years, this issue was brought into the spotlight when the movie, Concussion, starring Will Smith, was released. The story features the work of Dr. Bennet Omalu, who more than a decade ago, identified the physical brain pathology of Chronic Traumatic Encephalopathy (CTE). Dr. Daniel Amen was a consultant on this very important film and highly recommends seeing it because it will really help you understand the devastating, long-term impact that head trauma has on the individuals who suffer from its consequences.

How Do You Know Unless You Look?

Because we look at the brain using brain SPECT imaging, many people with a history of TBI come to Amen Clinics for evaluation, including professional athletes. In fact, Dr. Amen is the lead researcher on the first and largest brain imaging and rehabilitation study on NFL players. This research not only demonstrated high levels of brain damage in players, but also showed the possibility of significant recovery for many of them using the principles that underlie our work, including nutrition, supplementation, and exercise. We apply these same principles for brain health to all patients with TBI. As inferred above, one of the most prevalent conditions we identify with SPECT is previously undiagnosed TBI. All too often concussions are not taken very seriously unless a person has noticeable symptoms shortly after one occurs. Many times, clinicians do not know to ask their patients about a past history of head injuries. However, we think it is very important to ask them multiple times in multiple ways because people often forget or dismiss such incidents as inconsequential, but they all matter – even sub-concussive events. If you don’t already have your own set of questions for assessing a history of head injury, consider using ones like these: Given the magnitude of people suffering from known TBIs as well as undiagnosed concussions, it is really important to take the time to assess for them. With the proper treatment, people can get better and live more balanced and productive lives. Contact us today at 888-288-9834 to see how we may help, or schedule a visit today. We are so excited that the pioneering research at Amen Clinics was just highlighted in Discover Magazine as number 19 of the top 100 stories in all of science for 2015! Our research was sandwiched between Tesla’s new entry into renewable energy at #18 and the discovery of a new dinosaur species at #20. The research team at Amen Clinics, in collaboration with scientists from UCLA, Thomas Jefferson University, and the University of British Columbia, published the world’s largest functional brain imaging study on more than 21,000 patients that demonstrated we can distinguish between posttraumatic stress disorder (PTSD) and traumatic brain injury (TBI) using brain SPECT imaging with high accuracy. Our study was published in the prestigious journal, PLOS ONE in July 2015. With SPECT, We Can See the Difference SPECT (single photon emission computed tomography) is the type of advanced brain imaging we use at Amen Clinics. It allows us to do an overall evaluation of a person’s brain function and identify areas of the brain that are normal, as well as areas that are overactive or underactive. This capability is particularly important when trying to differentiate between PTSD and TBI, because these two conditions have several overlapping symptoms, including: However, even though some of the symptoms are the same, PTSD and TBI present with very different patterns on SPECT images. Most commonly, PTSD reveals areas of overactivity, while TBI has areas of decreased activity in the brain. Our study found that with brain SPECT imaging, we were able to distinguish PTSD from TBI with 80% – 100% accuracy. Using SPECT to Guide Treatment The ability to differentiate these disorders from each other is critical for determining the most effective treatment for each individual. Without knowing the underlying biological issue, it is easy to mistake one condition from the other – and the problem is that the treatments for each are very different. Typically, treatment for PTSD and emotional trauma is psychological in nature and the goal is to try to calm down the brain. Conversely, treatment for TBI is more physiological in nature and focuses on increasing activity in the injured areas of the brain. So, for example, if a doctor diagnoses someone with PTSD (but it’s really TBI), a sedating medication might be prescribed. Unfortunately this is not what someone with a TBI needs because the activity in the brain is already suppressed as a result of the injury, thus this type of treatment will not likely be of any help and may actually cause further harm. Why This Study is So Important Now There are approximately 1.7 million emergency room visits in the U.S. each year for head trauma along with hundreds of thousands of undiagnosed concussions primarily from sports, recreational accidents and falls. It is also estimated that 1 out of 30 adults in the U.S. has PTSD. When we add the numbers of impacted veterans to this— more than 300,000 have been diagnosed with TBI and 125,000 with PTSD—these conditions are significant health problems. By using SPECT to help differentiate between PTSD and TBI, it is our hope that the findings from our study and the acknowledgement by Discover Magazine will help millions of people suffering with one or both of these devastating conditions to be correctly diagnosed. By being able to identify the underlying brain problem, people are given the best possible opportunity to receive the correct diagnosis and treatment so they can feel better and have more healthy and productive lives. If you know people who suffer from PTSD or TBI, referring them one of our clinics may be very helpful in their care. Traumatic Brain Injuries (TBI) — including mild ones — can dramatically alter a person’s personality, negatively affecting memory, mood and aggression levels. One population with many brain-related behavioral problems is the homeless. So, does that mean that many of them have had a TBI? YES, says a St. Michael’s (Canada) Hospital study.

What They Found

The researchers found that out of 111 homeless men studied: almost half of them had suffered at least one TBI episode in their life, and 87% of these took place before they became homeless.

When asked what type of head injury had been sustained:

• 66% reported at least one from assault • 44% reported at least one from sports or another recreational activity • 42% reported at least one from motor vehicle collision • 42% reported at least one from a fall Furthermore, a positive TBI screening result was significantly associated with a lifetime history of arrest or mental illness and a parental history of substance abuse. Findings from a separate study done at St. Michael’s Hospital Centre for Research on Inner City Health underscored the TBI-homeless link, showing that as much as 61% of those who are homeless or “vulnerably housed” have suffered a TBI, a figure seven times higher than the general population.

So, what can be done to heal a traumatic brain injury that has already occurred?

• Rest and rejuvenate with at least 7-8 hours of sleep each night. • Refrain from using alcohol and drugs. • Eat LOTS of colorful fruits and vegetables, which contain cell-supportive antioxidants and critical nutrients. • PROTECT and LOVE your brain — do all that you can to prevent more brain injuries in the future.

How Can Brain SPECT Imaging Help?

• Help identify if there has been brain trauma • Show brain blood flow deficits NOT visible in anatomical studies, such as CT or MRI • Identify affected brain systems • Help determine if there could be co-occurring conditions that need treatment • Increase treatment compliance by showing pictures of results • Provide scientific documentation that may help with special services or legal issues

Imaging Changes Everything

At Amen Clinics, we want to help you and your loved ones heal brain injuries before they affect your life. Call us today at 1-888-288-9834 or tell us more to schedule an appointment. We have found that depression can arise months or even years after sustaining a traumatic brain injury (TBI) that was not deemed severe enough for a trip to a doctor or hospital.

How Many Suffer from TBI?

According to the Brain Trauma Foundation: • At least 5.3 million Americans, or 2% of US population live with TBI-related disabilities • 30% of soldiers admitted to Walter Reed Army Medical Center have been diagnosed as having had a TBI • It is believed that 10-20% of Iraq veterans (150,000-300,000 service members) have some level of TBI A study from 2011 found that 30% of adult TBI patients—about 360,000 people annually—suffer depression after a brain injury. Of course, depression may lead to suicidal thoughts if left untreated. According to Suicide Awareness Voices of Education(SAVE), an astounding 15% of people who are clinically depressed commit suicide.

Transcranial Magnetic Stimulation (TMS)

One highly effective non-medication treatment used for TBI and depression is a form of “brain stimulation” called transcranial magnetic stimulation, or TMS, in which a pulsed magnetic field is focused on areas of the brain that control mood.
Transcranial_Magnetic_Stimulation-TMS_Brain-Injury_Depression
Transcranial Magnetic Stimulation (TMS)

What We Know

Now comes a study published in the journal Brain Stimulation, in which researchers enrolled 41 adult inpatients who had been admitted to a hospital in “suicidal crisis” [All participants had co-existing PTSD and/or mild traumatic brain injury]. They were then randomly divided into two groups: one group received three 30-minute TMS sessions daily for three consecutive days, and the other group a sham treatment. Scientists found that the patients who got the TMS treatment experienced rapid decreases in suicidal thoughts. After the first day, the active treatment group showed a greater than 50% decrease in suicide ideation scores. Furthermore, the high dose TMS sessions were also found to be safe and free of adverse side effects.

Imaging Changes Everything

At Amen Clinics, we can help you and your loved ones overcome the stigma and suffering associated with ADD/ADHD, anxiety, depression, brain injury, weight loss, addictions, memory issues, brain fog, and other emotional and cognitive issues. If you are ready to regain control over your life or help a loved one do the same, call us at 1-888-288-9834 or click here to ask a question. Your brain is very delicate like the consistency of soft butter – and is protected by a hard skull with multiple sharp bony ridges. Even minor blows to the head that can be classified as a Traumatic Brain Injury (TBI), without loss of consciousness, may result in brain injuries that cause serious consequences for the rest of life.

The Traumatic Brain Injury Effect

Traumatic brain injury is the leading cause of death and disability for people between the ages of 1 and 44, and an often-overlooked cause of emotional, thinking, and behavioral problems. People who have experienced TBI have a higher risk of depression, anxiety, suicidality, drug and alcohol abuse, job and marital failure, incarceration, homelessness, and dementia.

Can SPECT Help?

One of the first lessons we learned was that undiagnosed brain injuries were a major cause of learning, emotional and behavior problems that were often misdiagnosed as “personality disorders” or people who just didn’t care enough to act right. In a world literature review done by our colleagues from the U.S. and Canada, we reviewed 1,600 research studies published over the last 30 years. Of these papers, 71 studies – involving 2,634 patients – were of the highest of quality and were included in the review. Nineteen studies followed TBI patients over time and 5 looked at the effects of treatment interventions.

What Research Tells Us

• SPECT is more sensitive than any other study, showing TBI abnormalities not seen on CT and MRI in all 10 of the studies that investigated such sensitivity – 100%. • SPECT findings correlate with the psychological and neurological symptoms of TBI. • SPECT is effective for helping to direct TBI treatment interventions. These same patients may have recurring psychiatric symptoms such as depression, attention problems, and impulse control issues. Commonly, they are referred to psychiatrists who generally do not use neuroimaging to diagnose and treat brain disorders. Ultimately, how would physicians ever know if the TBI was significant unless they ordered a functional imaging study like SPECT? Brain SPECT imaging can provide answers that may guide diagnosis and treatment of patients with TBI.

We Can Help

We believe that millions of Americans are still being forced to live in the “dark ages” of psychiatric care; treated with often times harmful psychiatric drugs and given the diagnosis of having a “mental illness” when in fact there is a treatable physiological cause for their problems. This is truly a tragedy for everyone: patients, families and society as a whole. At Amen Clinics, we can help you feel like yourself once again. We offer biomedical testing as part of our Integrative Medicine program; combining conventional medicine with complementary and alternative therapies. If you would like to explore physiologic issues that may be misdiagnosed as psychiatric disorders, connect with us online or call 888-288-9834 today. If you’ve suffered a stroke, taking steps to improve your brain health and mood are critical. A study has found that people who become depressed after a stroke may have a tripled risk of dying early and four times the risk of death from stroke compared to people who have not experienced a stroke or depression. “Up to one in three people who have a stroke develop depression,” said study author Amytis Towfighi, MD, with the Keck School of Medicine of the University of Southern California and Rancho Los Amigos National Rehabilitation Center in Los Angeles, and a member of the American Academy of Neurology. “This is something family members can help watch for that could potentially save their loved one.” Towfighi also noted that similar associations have been found regarding depression and heart attack, but less is known about the association between stroke, depression and death.

What Research Says

The research included 10,550 people between the ages of 25 and 74 followed for 21 years. Of those, 73 had a stroke but did not develop depression, 48 had stroke and depression, 8,138 did not have a stroke or depression and 2,291 did not have a stroke but had depression. After considering factors such as age, gender, race, education, income level and marital status, the risk of dying from any cause was three times higher in individuals who had stroke and depression compared to those who had not had a stroke and were not depressed. The risk of dying from stroke was four times higher among those who had a stroke and were depressed compared to people who had not had a stroke and were not depressed. “Our research highlights the importance of screening for and treating depression in people who have experienced a stroke,” said Towfighi. “Given how common depression is after stroke, and the potential consequences of having depression, looking for signs and symptoms and addressing them may be key.”

The Risk

The risk of developing serious brain problems in a person who has a stroke is six to ten times greater than that in the general population. Even a stroke smaller than a pencil-head eraser increases the risk for dementia four to twelve-fold.

How to Reduce Your Stroke Risk

A stroke is a single, damaging attack, but the risk factors that lead to a stroke, such as high blood pressure, smoking, heart disease, and diabetes, develop over a long time. You can reduce your stroke risk by taking the following simple steps: • Keep blood pressure under control. Check your blood pressure often and if it’s high, follow your doctor’s advice on how to lower it. Treating high blood pressure reduces the risk of both stroke and heart disease. • Stop smoking. Cigarette smoking is linked to an increased risk of stroke and heart disease. The risk of stroke for people who have quit smoking for two to five years is lower than that for people who still smoke. • Exercise regularly. Exercise makes the heart stronger and improves circulation. It also helps control weight. Being overweight increases the chance of high blood pressure, atherosclerosis, heart disease, and adult-onset (type 2) diabetes. Physical activities like walking bicycling, swimming, and tennis lower the risk of both stroke and heart disease. Talk with your doctor before starting a vigorous exercise program. • Eat a healthy, balanced diet and control diabetes. If untreated, diabetes can damage the blood vessels throughout the body and lead to atherosclerosis.

We Can Help

There are many ways to optimize your brain and your mind. You CAN create a brain healthy life by learning how to love and care for your brain and body. If you, or someone you love, could benefit from an evaluation at Amen Clinics, call our brain health advisors today at 888-288-9834 or tell us more online to schedule an appointment. In May 2012, former all-star NFL linebacker Junior Seau tragically took his own life. This came as a shock to everybody as Seau was loved by family, friends and fans alike. The circumstances of his death at the young age of 43 also carry many questions surrounding his struggles with depression and its connection to playing football.

What Research Says

Researches from the National Institutes of Health sought to answer some of these questions in the report they release that confirmed that Junior Seau suffered from a degenerative brain disease often linked with repeated blows to the head. Chronic traumatic encephalopathy, or CTE, is a neurodegenerative condition that can lead to memory loss, dementia and depression. Seau’s family donated his brain to the National Institutes of Health in Washington, D.C., to find out if he was one of many players whose time in the NFL led to CTE. “It was important to us to get to the bottom of this, the truth,” Gina Seau added, “and now that it has been conclusively determined from every expert that he had obviously had CTE, we just hope it is taken more seriously. You can’t deny it exists, and it is hard to deny there is a link between head trauma and CTE. There’s such strong evidence correlating head trauma and collisions and CTE.” “It’s important that we take steps to help these players. We certainly don’t want to see anything like this happen again to any of our athletes.”

Junior Seau’s Diagnosis

Dr. Russell Lonser, the former Chief of Surgical Neurology at the NIH, said that because of the publicity surrounding Seau’s death, Seau’s brain was “blinded” during research so that nobody doing the diagnosis would know whose brain they were studying. “The neuropathologists each examined tissue samples from three different unidentified brains. The official, unanimous diagnosis of Mr. Seau’s brain was a ‘multi-focal tauopathy consistent with a diagnosis of chronic traumatic encephalopathy,’ the NIH said in its statement. “In addition, there was a very small region in the left frontal lobe of the brain with evidence of scarring that is consistent with a small, old, traumatic brain injury.” “Specifically, the neuropathologists found abnormal, small clusters called neurofibrillary tangles of a protein known as tau within multiple regions of Mr. Seau’s brain. Tau is a normal brain protein that folds into tangled masses in the brain cells of patients with Alzheimer’s disease and many other progressive neurological disorders. The regional brain distribution of the tau tangles observed in this case is unique to CTE and distinguishes it from other brain disorders.” “The type of findings seen in Mr. Seau’s brain have been recently reported in autopsies of individuals with exposure to repetitive head injury, including professional and amateur athletes who played contact sports, individuals with multiple concussions, and veterans exposed to blast injury and other trauma.

Behavior Swings

In the final years of his life, Seau had wild behavioral swings, according to ex-wife, Gina, and 23-year-old son, Tyler, along with signs of irrationality, forgetfulness, insomnia and depression. He hid it well in public, they said, but not when he was with family or close friends. Gina Seau said that the diagnosis was not a surprise. “We saw changes in his behavior and things that didn’t add up with him, but (CTE) was not something we considered or even were aware of. The difference with Junior … from an emotional standpoint [was] how detached he became emotionally,” she said. “It was so obvious to me because early, many, many years ago, he used to be such a phenomenal communicator. If there was a problem in any relationship, whether it was between us or a relationship with one of his coaches or teammates or somewhere in the business world, he would sit down and talk about it.”

Was CTE To Blame?

In his 20-year NFL career, Seau was never listed as having a concussion on any medical or injury report, but he joins a list of several dozen football players who were found to have CTE. Boston University’s center for study of the disease reported last month that 34 former pro players and, nine who played only college football, suffered from CTE. Seau is not the first former NFL player who killed himself and later was found to have had CTE. Dave Duerson and Ray Easterling are others. Before shooting himself, Duerson, a former Chicago Bears defensive back, left a note asking that his brain be studied for signs of trauma. His family filed a wrongful-death suit against the NFL, claiming the league didn’t do enough to prevent or treat the concussions that severely damaged his brain. Easterling played safety for the Falcons in the 1970s. After his career, he suffered from dementia, depression and insomnia, according to his wife, Mary Ann. He committed suicide last April.

Your Brain on Football

Given how football is played, the problem the NFL is going to face is there is really no way to prevent these types of injuries. Helmets only prevent skull fractures. Your brain is very soft; composed of about 80 percent water and is the consistency of soft butter. Your brain is housed in a hard skull surrounded by fluid. When these hits happen on the football field, the head comes to an abrupt stop, but the brain which is suspended within the skull, continues in the path of motion where the head and helmet stopped. The brain then strikes that portion of the skull. Every time this happens neurons are being ripped and damaged. Over time these areas can lose function causing emotional, behavioral, and cognitive problems. It is imperative to bring this information to light so that more people understand the dangers of these contact sports and the detrimental effect it can have on their mental health.

We Can Help

If you are having suicidal thoughts, call the National Suicide Prevention Lifeline at 1-800-273-TALK (8255). Amen Clinics has helped thousands of people heal their brains and we can help you, too. With targeted treatment, you can change your brain and change your life. If you or a loved one is struggling with behavior issues or want to learn more about the effects of brain injury, please call us today at 888-288-9834 or visit our website to schedule an appointment. Hockey is an intense, fast-paced, and dangerous sport. It has the contact level of football but it’s magnified as players are skating on ice in excess of 20 mph. Hockey has a long history of players that embrace the “tough guy” mentality playing through any and every injury. And despite several years of intensive research, national media coverage, and discussion about the dangers of concussions, the idea of playing through head injuries is so deeply rooted in hockey culture that two university teams kept concussed players on the ice even though they were taking part in a major concussion study.

What Research Says

The study, which was published in a series of articles in the journal Neurosurgical Focus, was conducted during the 2011-12 hockey season by researchers from the University of Western Ontario, the University of Montreal, Harvard, and other institutions. The study is believed to be among the most comprehensive analyses of concussions in hockey, which has a rate of head trauma approaching that of football. Researchers followed two Canadian university teams — a men’s team and a women’s team — and scanned every player’s brain before and after the season. Players who sustained head injuries also received scans at three intervals after the injuries, with researchers using advanced magnetic resonance imaging techniques. The teams were not named in the study, in which an independent specialist physician was present at each game and was empowered to pull any player off the ice for examination if a potential concussion was observed. The men’s team, with 25 players and an average age of 22, played a 28-game regular season and a 3-game postseason. The women’s team, with 20 players and an average age of 20, played 24 regular-season games and no playoff games. Over the course of the season, there were five observed or self-reported concussions on the men’s team and six on the women’s team.

What They Found

Researchers noted several instances of coaches, trainers, and players avoiding examinations, ignoring medical advice, or otherwise obstructing the study, even though the players had signed consent forms to participate and university ethics officials had given institutional consent. “Unless something is broken, I want them out playing,” one coach said, according to the study. In one incident, a neurologist observing the men’s team pulled a defenseman during the first period of a game after the player took two hits and was skating slowly. During the intermission, the player reported dizziness and was advised to sit out, but the coach suggested he play the second period and “skate it off.” The defenseman stumbled through the rest of the game. In another episode, a physician observer assessed a minor concussion in a female player and recommended that she miss the next night’s game. Even though the coach’s own playing career had ended because of concussions, she overrode the medical advice and inserted the player the next evening. “Interesting gap between theory and practice,” one of the study’s physicians said in the report. “The athlete’s and coach’s decision to return to play the next day despite incurring a minor concussion reflects what occurs thousands of times every day.” After this second instance of a coach overriding medical advice following a concussion diagnosis, the researchers talked to the coaches about the serious long-term threat their actions posed to their players’ health. By the end of the study, the teams’ cooperation improved markedly.

Concussion Rates 7x Higher Than Reported

They found concussion rates seven times higher than previously reported. In this most recent study, male players sustained concussions at three times the rate reported in most previous studies, and female players at five times the rate reported in most studies. The women also sustained concussions almost twice as frequently as the men, despite rules in women’s hockey designed to curb body checking. The brain scans taken after the season also showed substantive metabolic changes among the majority of players, including those who were not diagnosed with concussions. Researchers said the changes in the brains might be evidence of trauma caused by sub-concussive blows.

We Can Help

If you are concerned about persistent symptoms of head trauma, a call to our Care Center can answer your questions and provide you with valuable information that can lead you to a better brain and a better life. Find out how. Call 888-288-9834 or schedule a visit today.