{"id":666092,"date":"2025-09-06T14:19:41","date_gmt":"2025-09-06T18:19:41","guid":{"rendered":"https:\/\/www.rochester.edu\/newscenter\/?p=666092"},"modified":"2025-11-19T15:23:21","modified_gmt":"2025-11-19T20:23:21","slug":"tackling-traumatic-brain-injuries-head-concussions-666092","status":"publish","type":"post","link":"https:\/\/www.rochester.edu\/newscenter\/tackling-traumatic-brain-injuries-head-concussions-666092\/","title":{"rendered":"Tackling head injuries with science"},"content":{"rendered":"

From the sidelines to the front lines, Rochester research is redefining how concussions are detected, treated, and prevented.<\/h2>\n

Once, twice, three times a head hit.<\/p>\n

How many are too many? How could a traumatic brain injury be diagnosed with minimal or no outward symptoms? What\u2019s the lasting impact of a mild traumatic brain injury or concussion?<\/p>\n

According to the Centers for Disease Control, millions of people<\/a> suffer traumatic brain injuries (TBIs) each year. While most are caused by accidents or falls, many are the direct result of sports injuries. In the last several years, how the brain responds to a concussive head hit and to repeated sub-concussive hits, particularly during a sporting event, has shifted. Researchers at the Ä¢¹½´«Ã½<\/a> Medical Center<\/a> have been at the forefront of concussion and traumatic brain injury discoveries, resulting in updated rules and protocols in sports like soccer and football.<\/p>\n

Jeffrey Bazarian<\/a>, a professor of\u202femergency medicine\u202fand of\u202fneurology\u202fat Rochester, has dedicated his career to improving the detection and treatment of traumatic brain injuries\u2014particularly those on the lower end of the severity spectrum, which are more likely to be overlooked. That work has not only benefited the scientific community, but also the people most likely to experience the effects of concussions and other head injuries.<\/p>\n

\"Jeffrey
GAME-CHANGERS:<\/strong> In recent years, science\u2019s understanding of how the human brain responds to head hits has shifted due to research conducted by Bazarian (left) and his colleagues with student-athletes. (Ä¢¹½´«Ã½ photo \/ J. Adam Fenster)<\/figcaption><\/figure>\n

Case in point: Nearly 10 years ago, Bazarian and Edwin vanWijngaarden<\/a>, a professor of public health sciences at the University, recommended that return-to-learn should be considered just like return-to-play<\/a> for high school and college-aged students after a concussion. Their research findings showed that academic problems were more frequent at one week after concussions compared to the students with other types of sports injuries. Today, the CDC\u2019s HEADS UP program<\/a> provides schools with guidelines on how to work with students after a concussion.<\/p>\n

\u201c<\/span>Concussion recovery can be difficult to track, and symptoms often dissipate before the brain is fully healed.\u201d<\/div>\n

Bazarian continues to work with student-athletes, this time as the leader of a multisite study funded by the Department of Defense<\/a> (DOD) to detect subtle neurologic dysfunction after repetitive head hits\u2014many of which don\u2019t result in obviously outward injury\u2014and to develop treatments to mitigate this dysfunction. He is also a site investigator for another multisite study<\/a>, this one supported by the National Institute of Neurological Disorders and Stroke (NINDS), to study the effects of concussions on children, including how this injury impacts the developing brain of youths and adolescents.<\/p>\n

And so, study by study, researchers like Bazarian and his colleagues at the University are bringing clarity to the big questions of how trauma and injuries\u2014one-off and repeated\u2014can affect the human brain and overall health and well-being across the lifespan.<\/p>\n

The hidden dangers of repetitive head hits<\/strong><\/h3>\n

Each hit to the head can compound the one before\u2014sometimes without symptoms to warn of a growing injury. When a person\u2019s occupation or activity exposes them to repeated head hits\u2014like members of the military or athletes\u2014they can experience subtle declines in neurologic function, such as balance, eye movements, and rapid decision making.<\/p>\n

These declines in neurological function are not currently detectable by a doctor but can nonetheless impair athletic or military performance and increase the risk of sustaining other injuries. In the long run, such repeated head hits may contribute to the development of serious neurodegenerative diseases or disorders. However, unlike concussion, there is no current standard of care to track, prevent, or treat these hits.<\/p>\n

Bazarian is at the front lines of efforts to address that gap.<\/p>\n

\"Close-up
ARM IN ARM FOR BETTER RESEARCH:<\/strong> Bazarian and his fellow researchers are recruiting football players to gather baseline data for a four-year, multisite study to better understand the subtle physiological impacts of repetitive hits to the head. (Ä¢¹½´«Ã½ photo \/ J. Adam Fenster)<\/figcaption><\/figure>\n

This fall, he\u2019s recruiting football players at the URochester, University at Buffalo, Indiana University, and the Citadel military college. The aim? To track the subtle changes that occur because of sports-related head hits in student-athletes in order to better understand the early indicators of repetitive injuries and what the response protocol should be. The researchers hope to add female soccer players to the research project next year. This would provide critical insight into the impact these head hits have on the female brain, since previous work has only included male subjects.<\/p>\n

\u201cWe\u2019re trying to determine if we can detect and mitigate the acute effects of exposure to repetitive head hits on the brain,\u201d says Bazarian. \u201cDo these hits alter neurologic functions in a way we can pick up using objective measures suitable for use in low-resource environments like battlefields and athletic fields? If so, what can be done to return neurologic function back to baseline as quickly as possible?”<\/p>\n

Bazarian received the aforementioned grant from the DOD\u2019s Army Medical Research Acquisition Activity (ARMY MRAA), a congressionally directed medical research program, to better understand these repetitive hits to the head, with goals to find ways to detect, prevent injury, and treat them.<\/p>\n

\"US
AT RISK:<\/strong> Certain jobs and careers, including some with the military and in sports, can expose people to repeated head hits. Department of Defense research funding allows Bazarian to study the implications of such occupational hazards. (Getty Images photo)<\/figcaption><\/figure>\n

\u201cIn a sense, we are borrowing from the field of occupational medicine by applying a brain health monitoring approach to individuals exposed to an environmental factor, in this case repetitive head hits, that increases their risk for neurologic injury,\u201d he says. \u201cOur hope is that one day this approach will lower the long-term risk of neurodegeneration in those exposed.\u201d<\/p>\n

Blood tests for brain health<\/strong><\/h3>\n

Recently, Bazarian joined nearly 100 clinicians and researchers from around the world to propose the first revision to how TBIs are classified since 1974, when the current diagnostic method known as the Glasgow Coma Scale<\/a> was established.<\/p>\n

The new method of characterizing TBI replaces the standard categories of \u201cmild,\u201d \u201cmoderate,\u201d and \u201csevere,\u201d with descriptors in four domains: Clinical, Biomarkers, Imaging, and patient Modifiers (CBI-M). This new characterization approach was recently described in The Lancet Neurology<\/em><\/a> and Journal of Neurotrauma<\/em><\/a>.<\/p>\n

Decades of research in Bazarian\u2019s lab has produced groundbreaking discoveries<\/a> in how the blood can inform brain health. Specifically, the researchers have identified a technique that measures three brain proteins that can appear in the blood within hours of a brain-injuring head hit\u2014glial fibrillary acidic protein (GFAP), ubiquitin carboxy-terminal hydrolase L1 (UCH-L1), and S100 calcium-binding protein B (S100B).<\/p>\n

The levels of these proteins can provide unique insight into the magnitude of brain injury that was not previously available to clinicians. High levels can predict six-month mortality and incomplete recovery, while low levels indicate an extremely low risk of a brain bleed on CT scan, which would inform whether a CT scan is necessary.<\/p>\n

\"Ä¢¹½´«Ã½
HEAD TO HEAD:<\/strong> Adding female soccer players to concussion research would provide critical insight since previous work has only included male subjects. (Ä¢¹½´«Ã½ Athletics)<\/figcaption><\/figure>\n

In 2018, the Food and Drug Administration approved a blood test called the Banyan Brain Trauma Indicator.\u202fThe University\u2019s Medical Center was a site for one of the test\u2019s clinical trials<\/a>, with Bazarian as the lead author of a related study that appeared in the journal The Lancet Neurology<\/em>. That work proved influential as part of the FDA\u2019s decision to approve the first blood-based biomarkers of traumatic brain injury in the United States.<\/p>\n

Recruiting subjects for this research, Bazarian and his fellow researchers work with Ä¢¹½´«Ã½ student-athletes and patients in the Strong Memorial Hospital Emergency Department. They also collaborate with Kian Merchant-Borna<\/a>, an associate professor of emergency medicine at Rochester, to follow these subjects through their recovery. Beyond the initial diagnosis, a person is generally monitored based on what symptoms they have\u2013subjective markers like patient-reported symptoms such as headaches, nausea, or light sensitivity.<\/p>\n

\u201cNot knowing what is happening in the brain can affect an individual\u2019s quality of life in the long term,\u201d Merchant-Borna says. \u201cConcussion recovery can be difficult to track, and symptoms often dissipate before the brain is fully healed.\u201d<\/p>\n

The Ä¢¹½´«Ã½\u2019s concussion research is more than a series of studies\u2014it\u2019s a sustained effort to safeguard brain health across the lifespan. In pushing the boundaries of what medicine can know and do, Rochester is leading the way toward a future where the complex dangers of head injuries are better understood, better treated, and ultimately, better prevented.<\/p>\n","protected":false},"excerpt":{"rendered":"

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