A New Frontier: The Future of Concussion Research

Illustrated by Victoria Liu

Jon Vertonghen is a star defender on one of the world’s premier soccer teams – the Tottenham Hotspurs. Playing in one of soccer’s biggest, annual competitions – the Champions League – Vertonghen was trying to head a ball coming from a cross on a standard set-piece. But he collided with the goalkeeper and hit his head against the ground.  Theoretically, the medical staff of this world-class team would rush onto the field and perform a comprehensive concussion test. In the case of a concussion, Vertonghen would have been pulled from the game and sent to the locker room for further treatment. 

Unfortunately, this was not the case.  After suffering an injury and receiving treatment from the medical staff, Vertonghen was cleared to play on. But only minutes later he collapsed on the sideline.

  Jon Vertonghen’s injury illustrates the complexity of concussions and traumatic brain injuries. It shows the impact of the mechanical force on the brain in the collision of his head with the ground and how external forces can hurt the brain. Two major facets of concussions and traumatic brain injury – the mechanical response of the brain and the immune-neurological response of the brain – have acute effects on traumatic brain injuries (TBI) and concussions. 

Understanding the mechanical response of the brain requires of how waves propagate through anisotropic material and how different angles of impact cause different deformations in the brain both at the site of impact and through the brain. According to a paper from Meaney in 2014, “[p]rimary injuries caused by direct contact loading can occur both in the region of impact and in regions distant from the impact site.” Focusing on how this mechanical motion translates to brain injury remains a main area of focus. Meaney contents, “[t]his energy transfer process—both how the acceleration moves and deforms the brain tissues and the effect of this physical stimulus on the living tissue and neural/glial networks—is the key step in understanding the basis for concussion

When a person gets a cut on your arm, typically the immune system plays a vital role in healing the small cut and preventing infection at the site of the wound. Furthermore, the immune system’s visible impact can be seen whenever someone gets a cold or a fever. But the immune system also plays a critical role in the brain’s post-injury response (2). Immediately following a brain impact, the immune system is activated.  The immune system plays a critical role in minimizing damage and the removal of damaged cells. But understanding the role of the immune system specifically “neuroinflammation can be detrimental or beneficial…it is necessary to better understand the timing and complexity of the immune responses that follow TBI” (3).

  The importance of understanding traumatic brain injuries (TBI) and concussions. Today, we cannot definitively explain the precise physiological causes of the symptoms expressed by those who have suffered a concussion or traumatic brain injury. There is also not a therapeutic drug on the market that can reverse the damages caused by a TBI. But the research efforts on understanding the mechanical response of the brain and the immune response of the brain demonstrates the complexity of this problem. The mechanical and immune response are just two facets of concussion injury. Building a complete model of the different facts of concussions can help with better prevention and treatment for concussions.

Edited by: Jessica Wu

Illustrated by: Victoria Liu

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