When Chris Borland, a 24 year-old NFL Rookie, decided to retire from the NFL last week, it launched a public discussion about brain health and concussions. As we look at the long-term consequences of repeated brain trauma, there is a great deal to learn.
It is the invisible nature of brain disorders that makes them so hard to understand. Unlike a broken bone or an injured joint, there is no visible sign of injury or dysfunction. Indeed, even the people suffering from traumatic brain injury aren’t always aware of how much function they have lost or how their personalities have changed, except sometimes for a vague sense of frustration and difficulty that can come from the people around them. Many years of examining brain injury patients has taught us that the brain isn’t very good at assessing its own state of health.
There is no safe number of brain injury incidents. Each concussion is associated with the loss of brain cells (called neurons) and damage to the connections between them. However, the brain is also very adaptable and can adjust to small injuries. Thus, many people seem to make a full recovery after a concussion. However, the risk for long-term problems appears to increase with a greater numbers of concussions. Even more mild impacts, which may produce no symptoms at the time, can compound to cause long-term harm. With impact sports, we’re concerned about Chronic Traumatic Encephalitis. It’s a degenerative disorder, like Alzheimer’s or Parkinson’s Diseases, that is connected to repeated head trauma. Symptoms can take decades to emerge and slowly worsen, but the path was set at the time of trauma. It’s that uncertainty that makes brain injury so scary.
Importantly, even a single injury can have a devastating effect on the brain. A concussion is considered a mild traumatic brain injury. In contrast, a major traumatic brain injury can produce instant and long-lasting changes. I became aware of this through meeting the Goulet family from Saco. Michael Goulet suffered a traumatic brain injury during a snowmobile accident in 2003, at the age of 13. Michael was wearing a helmet, but it wasn’t sufficient to prevent substantial injury, including the development of epileptic seizures. After years of treatment, beginning with a medically-induced coma and continuing rehabilitation, Michael’s recovery was sufficient for him to attend college at Saint Joseph’s College. He would have graduated from there in 2012. Sadly, in 2010 he suffered from a Grand-Mal seizure and passed away. A beautiful life lost to brain injury and a grieving family left behind.
The Goulet family has put their grief into helping others. Michael’s family has set up the Michael T. Goulet Traumatic Brain Injury and Epilepsy Foundation. Brad Goulet and Lydia LeBlanc, Michael’s father and mother, as well as sisters Danielle Goulet and Candace Laliberte, have come together with scientists, medical practitioners and community leaders to help others. Their signature program is giving away properly fitting “Love Your Brain” helmets.
First reaching out to Dr. Edward Bilsky, founding director of the Center for Excellence for the Neurosciences at the University of New England, they created a partnership that gave away over a thousand helmets last year and educated several thousand people about the importance of wearing helmets.
As a board member of the foundation and a faculty member at the University of New England, I help coordinate and maintain that relationship. Our team at UNE has launched a nationally recognized K-12 outreach program that reaches between two and three thousand local students in Southern Maine each year. If you live within 30 minutes of our Biddeford Campus, the odds are good that your children have seen our dozens of faculty, staff and student volunteers. They are well trained and greatly enjoy the process. Our lessons teach about the brain, how it works and how to keep it safe. We cover neurological disorders, brain injury and addiction. Our carefully tailored lessons are age-appropriate and designed to encourage healthy behaviors and a healthy interest in science and the brain. When they’ve finished with us, we hope the children in our community understand the danger of brain injury, are motivated to keep themselves safe and perhaps will be better able and more motivated to help the brain injury sufferers around them.
There is nothing we can do to completely prevent brain injuries. However, there are things we can do to help mitigate their harm. Proper safety gear, including helmets, can prevent or reduce the severity of many injuries. When a hard impact does occur, symptoms of concussion may not appear for up to three days and may disappear before the brain is fully healed. Nevertheless, during this period, even if symptoms are not present, the brain is highly fragile and at risk for further damage ”“ called second-impact syndrome.
Athletes must take preventative action after an impact to make sure they fully heal before returning to play.
The University of New England, in partnership with the Michael Goulet Foundation, is dedicated to helping prevent traumatic brain injury. The Center for Excellence in the Neuroscience’s three-fold mission of education, outreach and research all serve this goal. As surprising as it seems when a 24 year-old is thinking about the long-term consequences of brain injury, all of us should be thinking more about brain health.
— Michael A Burman, Ph.D. is an assistant professor in the Psychology Department at the University of New England and K-12 outreach coordinator for the Center for Excellence in the Neurosciences as well as a board member for the Michael T. Goulet Foundation.
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