NFL, NHL: team players in brain-injury diagnosis

Neuropsychologists will be better able to diagnose mild traumatic brain injuries (MTBIs) thanks to data from the National Football League and the National Hockey League on athletes who suffer head injuries, says Mark Lovell, PhD, division head of neuropsychology at the Henry Ford Health System in Detroit.

Often neuropsychologists are hampered in their diagnoses because medical tests like CT scans and MRIs can?t detect MTBI. As a result, clinicians must base a diagnosis on neuropsychological tests of memory and other cognitive skills, says Lovell. But many physicians may not have known the patient before the injury, so they have difficulty assessing the damage, he says.

However, collision sports, such as football and hockey, are providing neuropsychologists an opportunity to track MTBI recovery. By testing a player?s cognitive skills before the season begins and again after each head injury, neuropsychologists will be able to determine a typical recovery pattern for MTBI, says Lovell.

'It is sometimes difficult to measure how much different people are after a head injury because we don?t have information on how they were before,' he says. 'With teams, we do know how they are, so we can measure whether there has been any change.'

The tests also help coaches and trainers to decide when a player with a head injury can return to the game, he says.

Lovell began working with the Pittsburgh Steelers about seven years ago to develop neurological tests that measure players? memory, attention, mental processing speed and motor speed. Today, a dozen NFL teams have their players tested. Last year, the NHL made the program mandatory for its 1,000 players. Several neuropsychologists work with Lovell on this project, including George Prigatano, PhD, at Barrow Neurological Institute in Phoenix.

Lovell?s work is giving neuropsychologists a better idea of how long it takes to heal an MTBI. Many say it is often difficult to assess whether patients are exaggerating their symptoms.

Based on the large number of athletes Lovell has seen with MTBI, he says there is no doubt that the symptoms can linger for some time after an accident. 'With players the incentive is to get back into the game,' he says, 'so when we see a player who two weeks after an injury still has symptoms, we can be sure he is really having problems.'

Lovell?s work with athletes also confirms that a person does not need to be knocked unconscious to suffer an MTBI. 'Instead, they have symptoms that we have learned to pay attention to?dizziness, concentration problems, sleep disruptions, behavioral changes such as irritability and depression,' he says.

?Lisa Rabasca