Transcripts For KQED Charlie Rose 20151229 : vimarsana.com

KQED Charlie Rose December 29, 2015

Were to happen. When something happened to me, i dont think anyone noticed and, two, if they did notice, i dont think they knew what the do. Rose episode 4 of the charlie rose brain easy three, underwritten by the sloan foundation, coming up. Rose funding for charlie rose has been provided by and by bloomberg, a provider of multimedia news and Information Services worldwide. Captioning sponsored by Rose Communications from our studios in new york city, this is charlie rose. Rose tonight, we continue our exploration of the magnificent human brain with a look at sportsinduced trauma. We will focus specifically on its effects on young people kids and young adults make nearly 250,000 emergency room visits each year as a result of brain injuries from sports and recreation. Our increasing understanding of this traumas neurological effects have ignited a National Discussion about the risk of Contact Sports. Tori bellucci was an allmet Soccer Player at Huntingtown High School in maryland. She turned down a full soccer scholarship in college after suffering her firth concussion. She talks about her experience. Also here a Remarkable Group overscientists. Walter koroshetz of the National Institutes of health, Susan Margulies of the university of pennsylvania, Thomas Mcallister of the Indiana University school of medicine, dawn comstock of the university of colorado anschutz and dr. Eric kandel, of Columbia University and a Howard Hughes medical investigator. I am pleased to have them all here at this table. Tell me about concussions among young people. Sportsinduced brain trauma, sh has emerged, as you indicated, as one of the major Health Issues of our time. Why is that so . Let me put this in a bit of a perspective. There is a general consensus that team sports is extremely advantageous for young people. 50 million americans participated in group sports, in athletic competition, and this is beneficial in two ways. Athletic and social. From the athletic point of view, they learn early on that almost daily exercise is good for one, and many of them are likely to carry this forward for the rest of their life, ensuring them a healthier life span than they would otherwise. In addition to the physical values, there are also social values that come with it. One learns from team sports a sense of honesty, fair play, teamwork. These are very beneficial values that also help carry people through a lifetime. But a down side emerged recently, as you indicated. The media called attention to the fact that at the very highest level, professional football, soccer, basketball, there are traumatic brain injuries that are associated with sports activity, and some can lead to severe brain damage. And that has made us worry whether or not we are taking sufficient care of our young people to protect them from this, and this has become a national issue. President obama called a summit meeting on this in may in which he raised this issue. Could i have a brief tape, please . Concussions are not just a football issue. Young people made nearly 250,000 emergency room visits with brain injuries from sports and recreation. 250,000. The total number of young people who are impacted by this early on is probably bigger than we know. Rose so as president obama made absolutely clear, young people are particularly susceptible to traumatic brain injuries, and traumatic brain injuries is the leading cause of death and disability in young people. So we want to understand, you know, what this is about. What is a traumatic injury about . The brain is a ge gel gelatenoun protected by the skull. As a result of impact or inertia forces, there can be serious jarring of the brain as its moved rapidly back and forth within the closed space. Its only separated from this bony, inflexible skull by a fluid layer called the cerebral final fluid. Impact forces are from the physically bumping against the skull either by another skull hitting it, by hitting the ground, by hitting a soccer ball. But in addition to this, there are inertia forces which dont involve any contact at all. Its like a whiplash injury in which somebody bangs into your body and can shake up the brain or when you fall on the ground, it can shake up the brain. Often these forces interact with one another and have significant consequences on peoples neurological state. The traumatic brain injury varies from being modest to being moderate or severe. The modest injury falls into two categories. The vast majority, about 90 , recover within seve seven days. In some cases, even with modest injury, the recovery may take longer. With moderate or severe brain injury, the recovery takes longer. One of the factors that lead to this prolonged recovery, there are several. One is younger people are more susceptible than older people. Having had a prior concussion is particularly important for two reasons. One, prior concussion means it takes longer to recovery, but also one of the interesting, sad things of a prior concussion is if you had one concussion, youre much more likely to have a second concussion, and if youve had two, youre more likely to have a third or fourth one. So concussion is not only bad in itself, but what it does really for the future of the athlete playing. What are the predictors for the long recoveries besides prior concussions . There are severe initial symptoms. Loss of consciousness, if you have that, youre likely to have a prolonged recovery. In what career are you most susceptible for traumatic brain injury . Both in males and females, the peak injury occurs during adolescence, a period from about 12 to about 18, 19 years of age. And why is that so . And that is, everyone who has had an adolescent child realizes there are important brain changes that occur during adolescence. The two key ones well hear about later on are called tuning and myelination. The brain consists of nerve cells that make contact with another to a point of contact called the synapsis and the brain works by overproducing synapsis, produces many more than it actually needs to make sure that every kind of possible contact is covered. But with adolescence, the brain matures and inappropriate contact are gotten rid of, so those that are not functioning are gotten rid of, in order to streamline and make the brain function as a highly efficient computation device. As the brain enlarges, we need speed of communication between one region and another mediated by long structures called axons, and covered by myelin to increase production. Myelination is the process in which it is applied to ensure this. These are the two processes critical during adolescence and its due to these two processes going on that the brain is susceptible to injury. One to have the tragedies is because of the enormous susceptibility, we still have no pharmacological treatment for traumatic brain injury and it becomes more incumbent to use other measures, for people who are the coaches, trainers, the athletes and the person in the game to realize when a concussion has occurred, to immediately pull the athlete from the game and phot to let him return to the game on that particular day. In fact, they should not play again until they have been cleared by a health professional. So this is really absolutely essential. And in order to really, you know, discuss these issues in depth, we brought together a really extraordinary panel. We begin with tori, an outstanding Soccer Player and, because of several concussions, she has decided to give up competitive athletics and she now coaches Soccer Players to prevent them from having the kinds of difficulties shes had, and shes going to describe to us directly what its like to have a concussion. We have dawn comstock who is interested in the incidences of concussion. One of the kinds of circumstances what are the circumstances likely to bring this out. Thomas mcallister is interested in the cognitive behavioral consequences of concussion and doing a longterm study of College Students to see what the behavioral consequences is. Susan margulies is interested in actual through brain meek misms of concussion mechanisms of concussions and studies it in people and animal models, and Walter Koroshetz is wantin wantk about coming up with medical treatments. Rose tori, tell me what happened. I started playing soccer when i was four years old a little against my will. After my first practice, it was something i immediately loved and wanted to do all the time. So i played soccer. Since that day until i was a senior in high school. And around when i was 15 years old is when i got my first concussion. I really didnt know it was a concussion. I missed heading the ball and headed someone else. When i got home, i had a lot of headaches, was having trouble sleeping, but i didnt think it was a possibility of a concussion and i knew i had an important game the next day, so i decided to play anyways. Once i got to my game the next day, it was the semifinals in one of our state cup appearances. And i had gotten into a rough tackle and fell to the ground and hit my head on the ground pretty hard. And once i got up from the fall, i was kind of confused as to where i was, but i gained that back pretty quickly, but my vision was extremely blurry, head spinning, dizzy, but knowing it was an important game, i pushed on. After that, i went to the emergency room that night, after i finished the game, and it turned out i had whiplash in my neck and i did have a concussion. So i had to take probably a week off of school. I was very moody. I couldnt sleep. It was a very tough time for me. Rose were you going to medical care at this time at all in. No. When i went to the emergency room, they gave me a muscle relaxer for my neck. Other than that, i stayed home with my mom. She took off work. Rose thats the problem, not identifying the concussion. If, in fact, according to what youve already said, if there had been some identification, everybody would have insisted she not go back and play till it was cleared up. You went through how many concussions . I had five. Think its interesting to what degree did you know something was wrong but you didnt want to leave the field because you realized the team depended so importantly on you . I feel like, at that point, i would have tried to push through anything. No matter what my symptoms were, i was so competitive and my passion was incredible for the game to where i didnt want to stop, even if i knew something was terribly wrong with me. Instead of leaving the field, when they feel ill, they feel so rose and the n. F. L. Instituted a policy where a doctor examines anyone they feel might have a concussion when they come off the field. Today, how are you . A lot better but i still struggle with things. With my workload at school, i definitely have two to three headaches a week. Sometimes ill have headaches for five days without any break. My eyes have been struggling since my last concussion, which was almost two years ago. Both my pupils are not the same size all the time and, so, with that, its really difficult for me to be in lecture and be looking at the board and looking at the powerpoint and going back to my notes and that really, really city limits my headache. Are you under the care of scientists and physicians . Not anymore. After my last one, i havent really had to go back to the doctor other than telling them i have headaches and probably troubleshooting every idea we had. Rose your case is now well then because you were there at the obama summit with the president and you introduced the subject there. Yeah. Rose so youve become a part of the conversation, the impact of concussions. Which im happy about. Its unfortunate all this had to happen to me, but i think its something that needs to be talked about and known, so im glad i can be a healthier face for that. Rose how prevalent are concussions among young people . More prevalent than people realize. At the High School Age group alone, high schoolsanctioned sports, last year there were 160,000 concussions among Football Players, 60,000 among girl Soccer Players, 45,000 among boy Soccer Players and 20,000 each among girl basketball players and boys wrestlers, National Estimates based on National Insurance data. Over the last decade, concussions increased dramatically over time this is a time where scarylooking statistics might actually be something good. This rapid increase over time likely does not indicate a true increase in the incidence of concussion. High School Athletes havent grown dramatically bigger and stronger and faster over the last decade and most of the rule changes in the last decade actually improved player safety. I think what this image actually demonstrates with the dramatic increases weve had in education, in knowledge. The Young Athletes, their parents, their coaches, the policymakers have become more aware of this issue of sportsrelated concussion. Its recognized more readily. Exactly. Rose is it across the spectrum of sports or more Contact Sports . I think awareness was originally generated because of highprofile incidence at the professional level, but now it would be very difficult to find a parent to let a High School Athlete that couldnt at least explain some of the signs and symptoms of concussion and recognize that its important injury that needs to be addressed. Another thing this image demonstrates is concussion rates are significantly higher in competition than they are in practice. Rose yes. And part of this may be because athletes like tori simply dont want to come out of the game, but its also because there is more events of athlete contact that occur in competition compared to practice. These differences between competition and practice rates vary dramatically by sport, however. For example, in Boys High School ice hockey, competition concussion rates are 13 times high than practice cogs rates, while in girls softball, competition rates are only twice as high as practice rates. Rose how do you explain this . A lot of it tends to be just the activities associated with individual sports. Across the entire spectrum of all 24 sports that i study, the most common mechanism of concussion is athletetoathlete contact. So the combat or collision sports boys football, boys ice hockey, boys of lacrosse have more incidences of athlete to athlete contact. Youre more likely to hit your opponent than your teammates in practice. Rose let me turn to tom bennett and talk about what happens in concussion. From a clinical standpoint, tori described it but the force and the mechanics eric alluded to and well touch on, there is a disruption in brain function that is usually described as an alteration in the level of consciousness which simply means people may have incomplete memory for the event. May appear as described, may have headaches, blurred vision, sensitivity to light and noise or dizziness are particularly common along with headache. The other sort of major domain people will describe related to that are problems with thinking and usually the big ones are problems with memory and attention and concentration. The good news is that most times these symptoms gradually resolve over, lets say, seven to ten days or perhaps several weeks, but weve known for a long time that there is a Certain Group of folks for whom thats not the case, and the symptoms can persist for a fair amount of time. Whats interesting is that the way that the concussion happens and the way the brain is designed and the skull is designed and so forth actually predict nicely the kinds of symptoms that tori described, or you can see again these two forces, either one can be from the brain hitting the inside of the skull and the areas in red on that slide suggest the areas that are particularly vulnerable, and then whats important to know is that the skull is great at protecting the brain from a lot of things, but when you put the brain in motion and its moving out of phase with the skull itself, its rubbing up against a somewhat hostile Work Environment there, you can see on this cutaway of the image there are certain roughages and areas on the inside othe skull that make it more likely the brain gets damaged in those particular areas. But you dont even have to have that in order to have the damage that or the injury and symptoms that tori described. I think just the very movement of the brain itself, eric described it as a ge gelatinous material and the brain the moving and there are shearing forces and that can damage the delicate white matter fibers or axons. These are delicate and this twisting and action can damage that and damage the connectivity of the different brain functions. So putting it all together, the next image will show the particular brain regions which are most likely to be damaged, and what i think makes concussion and brain injury in general a sort of perfect storm, if you will, for the kinds of neuropsychiatric complaints tori described are these areas illustrated on the image map very nicely on to brain regions which are responsible for the symptoms tori described herself as having. So memory, for an example, is a particularly common complaint. This next image shows which brain regions are important, and memory function, i think if you compare that, the other image, you can see it maps on to that very, very nicely. Tori, i think, described difficulties with school work and lots of our athletes described that. They described it as not thinking as quickly, decreased information, processing. And then i thought it was interesting tori mentioned being moody, depressed. This is an enormously common complaint from people who have concussion and other types of brain injuries, so the whole Psychological Health aspect is impacted, and this next image shows, again, brain regions that are thought to be particularly important in depression and, once more, really, if you were to design an injury that was calculated to sort of damage cognition and neural behavioral symptoms, you couldnt have designed a better one, unfortunately.

© 2025 Vimarsana