\u201cIt\u2019s relatively easy to diagnose if someone\u2019s had a concussion\u201d, Fitzgerald says. \u201cWhat we don\u2019t know is whether that person is going to recover in the normal course of events, within a normal timeline, or whether they\u2019re going to go on to have poor outcomes.\u201d<\/p>\n
Fitzgerald\u2019s team is examining test results taken within two days from when people present to the emergency department with concussion. They\u2019re looking at a number of different parameters including neuropsychological test outcomes, MRI results and blood biomarkers. Four weeks after the injury, patients are re-tested to check if their symptoms have abated.<\/p>\n
\u201cThe aim is to see whether any of the markers we measured soon after injury predict a poor outcome,\u201d she says.<\/p>\n
Fitzgerald says the research is unlikely to reveal a single \u2018magic\u2019 biomarker or measurement that can foretell a protracted recovery.<\/p>\n
\u201cOur study is different in that we\u2019re assessing multiple outcomes, so we\u2019re assessing imaging and neuropsychological testing as well as blood biomarkers, with the aim of identifying a suite of outcome measures that may be predictive.\u201d<\/p>\n
The work has been part of a pilot study funded by the Neurotrauma Research Program of Western Australia and the Perron Institute for Neurological and Translational Science, with whom Fitzgerald is co-appointed.<\/p>\n
Five of the 36 participants who took part in the study showed signs they hadn\u2019t recovered normally. Despite this small sample size, Fitzgerald says the test results of these patients have yielded some promising insights.<\/p>\n
\u201cWe don\u2019t have the numbers to definitively answer the question, but we have a number of outcomes that may be predictive,\u201d she says.<\/p>\n
Fitzgerald plans to broaden the scope of her work to include patients from across Australia, which will ensure she gets the participation rate she needs.<\/p>\n
\u201cCurtin has been very supportive and funded us to develop a nationwide initiative to improve outcomes for people following traumatic brain injury of all severities, from concussion right through to the more severe.<\/p>\n
\u201cThe team is investigating the feasibility of generating a national registry of people with concussion. We want to recruit them into a clinical registry and conduct large-scale trials. It\u2019s a way to get big cohorts and that\u2019s what we need.\u201d<\/p>\n
If a suite of predictive measures can be established, it will allow swift diagnosis of those who are most at risk of a poor outcome, so they can receive the care they need from the very early stages. The nature of that care depends on the symptoms of the concussion, which vary, but Fitzgerald says most of the time, effective treatment can put the patient on the road to a full recovery.<\/p>\n
\u201cMany of the symptoms of concussion, such as psychological disturbances, depression, anxiety, dizziness and headache can be well managed. With those symptoms it is relatively straightforward to direct someone into the appropriate care,\u201d she explains.<\/p>\n
\u201cThe one that I think is the most difficult is the cognition \u2013 the feeling of fogginess \u2013 and that\u2019s the one that I\u2019m most interested in \u2013 developing neuroprotective treatments that might be able to actually reverse some of those effects, or better still, prevent them from occurring in the first place.\u201d<\/p>\n
Concussion in the age of litigation<\/h2>\n
In recent years, a severe degenerative brain condition associated with repeated head injuries \u2013 chronic traumatic encephalopathy (CTE) \u2013 has gained traction in the media and the courtroom. Characterised by mood swings and depression, CTE is thought to have led to the suicide of a number of high-profile retired athletes, including former BMX rider Dave Mirra and American football stars Junior Seau and Dave Duerson, whose untimely deaths informed the storyline of the 2015 Hollywood movie Concussion<\/em> starring Will Smith.<\/p>\n In 2013, the NFL reached a settlement with 4,500 former players or their estates for concussion-related conditions diagnosed after retirement, including CTE. The landmark agreement provided up to USD$5 million per retired player. In July 2018, it was reported the total amount paid had reached half-a-billion US dollars \u2013 enough to sink a humbler league.<\/p>\n Despite this, Fitzgerald believes gaining a greater awareness of concussion and its potential complications shouldn\u2019t be considered a threat to professional sporting codes which, for the most part, are putting stringent measures in place to reduce the incidence of concussion and provide the best care for their players.<\/p>\n She says until more rigorous concussion research is completed, and undeniable proof of a link between repeated concussions and CTE is established, litigators will have a hard time arguing that sporting bodies didn\u2019t provide the appropriate level of care to players.<\/p>\n \u201cTo face devastating litigation, the sporting bodies need to have known there was a problem and not done anything about it, and I don\u2019t yet think we\u2019re in a position where we absolutely know there\u2019s a problem. There\u2019s a strong likelihood that there is, and sporting bodies are acting accordingly,\u201d she says.<\/p>\n \u201cThere are legitimate concerns with some previous studies because they weren\u2019t controlled appropriately. We\u2019re at a stage where more longitudinal, properly controlled studies need to be done, and people are doing them, so we will know in around five years whether or not there really is undeniable proof. We\u2019re not quite there, but we\u2019re very close.<\/p>\n \u201cI think it will lead to better management of concussion by the governing bodies, and also, the footballer with a clear understanding can make an informed decision.\u201d<\/p>\n","protected":false},"excerpt":{"rendered":" A team of Â鶹ֱ²¥ researchers is conducting novel research that combines a variety of tests to try to predict whether a concussion patient will recover normally or face lasting symptoms.<\/p>\n","protected":false},"author":5,"featured_media":7189,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_oasis_is_in_workflow":0,"_oasis_original":0,"_oasis_task_priority":"","_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","wds_primary_category":0,"wds_primary_research-areas":0,"footnotes":""},"categories":[3,79,43],"tags":[],"research-areas":[],"class_list":["post-7186","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-campus-and-global-community","category-health","category-medical-science"],"acf":{"post_options":{"":null,"additional_content":{"title":"Health at Curtin: Biosciences and metabolic health","content":" This story contributes to our\u00a0Health at Curtin<\/em>\u00a0collection on new research in the Faculty of Health Sciences.<\/p>\n Curtin research in Biosciences and Metabolic Health ranges from life science discovery projects through to translational approaches and clinical investigations.<\/p>\n In this series we profile investigations into the genetic mechanisms of superbugs; describe how the liver\u2019s regeneration abilities offers a new approach to fighting liver disease; explore the link between\u00a0Alzheimer\u2019s disease\u00a0and diabetes; and dig deeper into the relationship between ageing and tumour development.<\/p>\n In clinical investigations: Could medical cannabis help treat pancreatic cancer? A neuroscience research team is developing diagnostics for concussion and related changes in the\u00a0central nervous system, an area of increasing public concern. And we applaud the Perth-based collaborations that are addressing malaria and rheumatic heart disease in Papua New Guinea and northern Australia.<\/p>\n","image":{"ID":8718,"id":8718,"title":"Scanning_electron_micrograph_of_Methicillin-resistant_Staphylococcus_aureus_MRSA_and_a_dead_Human_neutrophil_-_NIAID_1584x840-3.jpg","filename":"Scanning_electron_micrograph_of_Methicillin-resistant_Staphylococcus_aureus_MRSA_and_a_dead_Human_neutrophil_-_NIAID_1584x840-3.jpg","filesize":0,"url":"https:\/\/www.curtin.edu.au\/news\/wp-content\/uploads\/2022\/07\/Scanning_electron_micrograph_of_Methicillin-resistant_Staphylococcus_aureus_MRSA_and_a_dead_Human_neutrophil_-_NIAID_1584x840-3.jpg","link":"https:\/\/www.curtin.edu.au\/news\/misfortune-teller-predicting-concussion-complications\/scanning_electron_micrograph_of_methicillin-resistant_staphylococcus_aureus_mrsa_and_a_dead_human_neutrophil_-_niaid_1584x840-3-jpg-2\/","alt":"","author":"4275","description":"","caption":"","name":"scanning_electron_micrograph_of_methicillin-resistant_staphylococcus_aureus_mrsa_and_a_dead_human_neutrophil_-_niaid_1584x840-3-jpg-2","status":"inherit","uploaded_to":7186,"date":"2022-07-01 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