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Why we still know so little about concussion

It's been over a decade since the publication of Bennet Omalu's groundbreaking research on Chronic Traumatic Encephalopathy (CTE) , and yet we still know relatively little about concussion and its long-term effects. In this blog post, we'll briefly explore some of the reasons why concussion research is still in its infancy, and what that means for the future of our understanding of this complex injury.

 

One of the main reasons why we still know so little about concussion is that it is a relatively new field of study. Unlike other injuries, such as broken bones or torn ligaments, concussion cannot be seen on an X-ray or MRI. This makes it difficult to diagnose, and even more difficult to study. Scientists are only just beginning to develop technologies that will allow them to see the subtle changes in the brain that occur after a concussion.


Another reason why concussion research is lagging behind other areas of medicine is that it is extremely difficult to conduct studies on concussions in humans... It’s unethical to give someone a concussion in the name of science! CTE cannot be diagnosed with certainty until after death and a concussion may not show any signs even under a physical examination of a brain as it may only be a chemical change, or a physical change that is so small it’s not detectable. Researchers rely on animal models, studies of brain tissue from deceased athletes or most recently lab cultivated tissue exposed to linear and rotational trauma. However, these methods have their limitations, and it is hard to extrapolate from them to what happens in a living human brain.


Systematic reviews found that in studies between 2015 and 2020, the majority of concussion studies were focused on elite sports and male participants. Future studies should aim to focus on amateur sports, and include assessment tools, such as the sports concussion assessment tool (SCAT), to allow for consistency across studies.


Finally, real-life head injuries are studied after the injury occurs with limited knowledge of the events and forces felt by the individual which led to the injury. Imagine a car manufacturer studying the safety of their vehicle through pictures after crash tests, with no sensor data to inform them about the speeds and forces that caused the car to crumple the way it did. This is where instrumented mouthguards, such as ORB Smartguard, are starting to shed light on where, when and why traumatic head injuries occur. They capture the exact forces and movements with high-precision accelerometers and gyroscopes in real-time, before, during and after an injury occurs.

 

Concussion is a complex injury that we are only just beginning to understand. In order to learn more about it, we need better diagnostic tools and more large-scale studies. New devices such as ORB Smartguard are fast becoming the future of concussion research, allowing researchers to capture high-precision data of injuries as they occur, something that seemed impossible a decade ago. However, these things require significant amounts of money, which are currently in short supply. Until we can generate more interest and funding for concussion research, our understanding of this injury will continue to lag behind other areas of medicine.



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