In the world of brain injury, a trifecta of technologies is driving the translation of research into real hope for patients, soldiers and athletes of all ages: advanced imaging that can detect even minor damage deep inside the brain, tests that detect biomarkers associated with brain tissue damage, and new genomics tools that tell us if individuals are vulnerable to developing long-term brain damage. The best illustrations of these advances can be found in the fields of contact sports and combat.
In Canada and throughout the world, veterans return home from war seemingly physically intact, but with brains that actually carry small invisible scars, that we are only beginning to understand neurologically. Some of these scars can produce serious personality changes – uncontrollable anger, anxiety, and suicidal tendencies.
NHL and NFL athletes who have suffered repeat concussions are also at risk, as are young amateur athletes with seemingly minor injuries. A series of sub-threshold hits can lead to the emergence of concussive symptoms, and eventually can present as a progressive neurodegenerative disease – chronic traumatic encephalopathy (CTE).
Given the enormous health and psychological benefits of participating in competitive sports at all ages, how do we promote brain health while at the same time making sports – and combat – safer for those involved?
Advances in imaging research show that previously invisible wounds that appear after minor injuries place roadblocks and potholes in the flow of traffic in the brain’s white matter superhighways – the neural paths that carry masses of information at lightning speed. By seeing where early damage appears, we can better predict symptoms, model the nature of the impact that created them, and understand which kind of blast or athletic hit produces the injuries more likely to cause long-term damage.
However, brain disease progresses in different ways for different people, even if the initiating stimulus is the same. The new field of epigenetics – how our life experience has influenced how effectively we use the genes we have inherited – is providing clues to how these differences arise. The same way that genetics once identified “disease genes,” affordable genomic analysis of differently vulnerable individuals is now pinpointing hotspots on our genome that will help to identify those most likely to be affected long-term.
Our ability to use this data is really the game changer. Neuroscientists are stepping centre-stage to drive both the development of new diagnostics and therapies, and to guide the people charged with keeping our brains safe – the coaches and rule-makers, the engineers who design our protective equipment, and the professionals who oversee our classrooms, our emergency rooms, our courtrooms and our battlefields. The stage is now set for true interdisciplinary collaboration to drive the real world change we will all welcome every time we suit up our children to go out and give their all – at the hockey arena, soccer field, or to fulfill the call of duty.