New study on effects on brain of only one season of football...HS football at a crossroads

Submitted by wisecrakker on

https://www.sciencedaily.com/releases/2016/04/160425143653.htm

Head impacts from single season of high school football produce measurable change in brain cells

Football has the highest concussion rate of any competitive contact sport, and there is growing concern -- reflected in the recent decrease in participation in the Pop Warner youth football program -- among parents, coaches, and physicians of youth athletes about the effects of subconcussive head impacts, those not directly resulting in a concussion diagnosis, researchers noted. Previous research has focused primarily on college football players, but recent studies have shown impact distributions for youth and high school players to be similar to those seen at the college level, with differences primarily in the highest impact magnitudes and total number of impacts, the researchers noted.

 

http://mmqb.si.com/mmqb/2015/11/23/high-schools-dropping-and-adding-football-safety-concerns

One program shuts down, another starts up. A look at two schools—one in Ohio forced to end its season early and another in Arizona playing its first-ever season—reveals the complexity behind the raw numbers regarding high school football in the new safety-conscious era

BursleyBaitsBus

April 27th, 2016 at 2:30 PM ^

I wish they would get a larger sample size for these things. 

Two dozen players isn't a lot. 

 

That being said, there isn't much to be do about subconcussive hits. 

Blazefire

April 27th, 2016 at 3:20 PM ^

Yes. Were you never an HS boy? We injured ourselves daily as a matter of course. Hard fouls, stupid stunts, etc. I hit my head hard at least once a day and never played ANY organized sport.

And a study in which there was no control group, no sequestration, etc, is hilarious. "Did you drink or do drugs at all this year?" "What was your diet?" This isn't even science.




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GoBlueInNYC

April 27th, 2016 at 3:33 PM ^

Yes, in fact, I was a HS boy once. One who played sports, in fact. And yet somehow I didn't suffer an endless array of head traumas. Maybe your history of youthful head bashing isn't entirely generalizable to everyone.

And you know there are such things as within subject research designs, right? Did you read the science daily article or the published study? Have you seen the previous studies that informed this one? Or their long term research strategy?

I guess the editors of Journal of Neurotrauma and its reviewers disagree with your assessment that this is somehow hilariously not science.

MayOhioEatTurds

April 27th, 2016 at 4:59 PM ^

Well, this journal article says you did--you just didn't know it because you didn't receive a diagnosable concussion.

All activities carry real and quantifiable risk of injury.  Some of those injuries are externally measurable (e.g., concussions).  Some are not (e.g., every other hit). 

I just wish safety gurus would focus on dangerous involuntary activities (like unknowingly working in a building insulated with asbestos), rather than voluntary activities which are plainly perilous (like boxing, MMA, football, etc.). 

The Dreaded Re…

April 27th, 2016 at 3:36 PM ^

That's funny, the Journal of Neurotrauma seems to think that this is indeed science.  Or were you one of the peer reviewers? http://online.liebertpub.com/doi/10.1089/neu.2015.4267

There's an argument to be made that this is poor science reporting, in that the researchers themselves state the following: "It is important to note, the pathological implications of these metrics are not well understood.  In summary, we demonstrate a single season of high school football can produce DKI measurable changes in the absence of a clinically diagnosed concussion." 

And also: "Our sample size is relatively small; however, it is one of the largest studies of non-concussed high school football players to include biomechanics, imaging, and cognitive data to date."

What the researchers conclude is that a single season of high school football can indeed change brain structure.  Beyond that, more studies are needed, including a larger cohort, control groups, etc. 

 

wolverine1987

April 27th, 2016 at 3:47 PM ^

of millions of participants over the 90 years or so we've been playing football (at all levels), with the vast, vast majority showing no adverse signs at all in later life (vs. the small minority whom people used to call "punch drunk," mostly from boxing but also football) means less than the still emerging science of head trauma, and people draw conclusions on football safety not on based upon the millions of people without injury, but rather on the latest articles. 

To be clear, it makes perfect common sense that football can cause CTE or other head injuries that impact later life, for some. But what is far from clear is that the risks are such that people should avoid it, or that we should prevent anyone at all from playing it, even children (parents of course can decide that individually).

The Dreaded Re…

April 27th, 2016 at 3:51 PM ^

I guess it's not clear that there has been no adverse impact on folks, because the data simply hasn't been collected and analyzed.  I'd guess you're probably right; by and large people get by with no noticeable impacts to their quality of life.  Still, this research will help us better understand things when they do go bad for people like Tyler Sash and Junior Seau, and how to help them.

I think the research is important.  I also think science reporting is the worst type of reporting, because they go way beyond the conclusions of the article and try to draw eyeballs and ad revenue by drawing the wrost possible conclusions.

vbnautilus

April 27th, 2016 at 3:55 PM ^

It's not a pilot study. When we talk about a "small" sample size, we are saying "small" relative to what?

I do brain imaging research, and there are many constraints that are not well understood by the public that limit sample sizes. But sample sizes are designed to be a balance between these practical constraints and the needs of the study. 

Sample size in a research study has basically two important consequences. The first is statistical power. The smaller the sample, the less likely we are to find an effect of a given size. However, a smaller sample size may be sufficiently powered to find an effect if the effect you are looking for is large. Statistical power in the case of this study was sufficient to find a significant relationship between head acceleration and diffusion imaging, so that isn't a reasonable complaint, unless you are saying there are even more, sublter effects, that could have been identified with a larger sample (which is true). 

The other concern is generalizability. If the sample is small, the conclusions may be less generalizable becase they are limited to the particulars of the people studied. So, in this case, if this high school was special or different in some way, the conclusions might not apply to people from other high schools. 

gopoohgo

April 27th, 2016 at 5:16 PM ^

That's the kicker; the reasearchers have no idea what DKI (diffusional kurtosis imaging) changes have on cognitive functioning.  The pre-post season comparisons in post-concussive testing did not correlate with DKI changes.

For the person trashing the study design above; der, this was a prospective cohort study looking at the impact of one variable (playing football) on imaging changes.  There is no experimental modifier to test against a control.

ijohnb

April 27th, 2016 at 2:36 PM ^

no idea they were even investigating a possible connection between concussions and football because it is completely surprising and not at all obvious that such a connection could exist. 

GoBlueInNYC

April 27th, 2016 at 2:46 PM ^

Are you suggesting they not investigate it, because the connection seems obvious? Cuz even with all the attention this has gotten, you have people even in this thread calling it a "witch hunt," plus it's fair to say that even with connections being pretty obvious these days, there are still open questions and a lot of people motivated to undermine the implications of the research.

Also, they are explicitly looking at what happens even when players aren't diagnosed with concussions.

ijohnb

April 27th, 2016 at 2:58 PM ^

is the end game?  I completely support any and all research that is designed to improve equipment that could prevent such injuries, but if the research is designed to do little more than produce terrifying numbers that shock, awe and offend everybody who then crowds around the stadium or TV to watch on Friday through Sunday I see little use for it.  There does not seem to be a genuine movement to "end" the sport and they have basically made all changes that they can to reduce the inherent violence in the game.  What else can they do?

Concussions and football - the longest running "if it bleeds it leads" scenario of all time.

In reply to by ijohnb

GoBlueInNYC

April 27th, 2016 at 3:04 PM ^

As I understand it - this study looks at a level of play that most research hasn't ventured in to: high school. You see a lot of people defending HS football on the grounds that the real problem don't arise until you've been playing into college or the pros. This is (from what I know of the field) relatively novel evidence that a single season of HS football causes alternations in the brain. Plus, it seems like they are piloting new research techniques.

The end game is to understand the effects of football on the brain. Maybe the result is that we collectively, as a society, decide that a game is not worth the brain damage that research is discovering happens early and (according to this study) easily. Is that a bad thing? If the sport is legitimately hurting people, we should probably know that.

Maybe the result is understanding HOW exactly football impacts the brain, so safety can be improved. I think you're wrong in declaring that football is as safe as it will ever possibly be.

You say completely support research, but only if it is designed to improve safety without somehow actually questioning if football is harmful. I think it's pretty obvious that you have a heavy bias in not seeing people even ask questions that might shed negative light on a game you like.

ijohnb

April 27th, 2016 at 3:13 PM ^

can be harmful to the brain.  I have no bias and I think it is pretty clear.  I don't think that "we collectively as a society" are going to decide anything, I think that people and their legal guardians will continue to make decisions regading their respective well-being as they always have.  All that is left is number crunching and the endless stream of news segments, articles, and movies where people gasp and then forget everything they just heard and go watch the game. 

In reply to by ijohnb

cletus318

April 27th, 2016 at 3:17 PM ^

You seem to be conflating a media issue with a scientific one. The issue from a big-picture perspective has never been about ending football. The research is needed to clarify the actual risks and damage (beyond the generic and obvious "getting hit in the head repeatedly is bad") caused by head trauma of any severity, and then from there you can potentially take steps to mitigate the long-term effects. Clearly, there are only so many things that can be done to limit or prevent head trauma, and this isn't only a football issue, as there's a good bit of evidence that things such as headers in soccer have neurological effects. A study such as this (and this isn't the first one to show the effects of a single season of football) is needed as the basis of longer-term research.

vbnautilus

April 27th, 2016 at 3:09 PM ^

They actually aren't studying the relationship between concussions and football. Nor are they studying the relationship between concussions and brain injury. Players who had concussions were excluded from the study. 

They are studying the relationship beween head acceleration during football and white matter health.