NIH grant supports Wake Forest Baptist researchers to study effects of head impacts in young players

Supported by a National Institutes of Health (NIH) grant worth a projected $3.3 million over five years, Wake Forest Baptist Medical Center investigators have expanded their research into the cumulative effects of head impacts in young football players to the high school level.

The project, which began prior to the start of the current season, involves players at a public high school in the Winston-Salem area.

"Most people associate concussions and other head injuries in football with forceful hits during games," said the study's principal investigator, Christopher T. Whitlow, M.D., Ph.D., associate professor and chief of neuroradiology at Wake Forest School of Medicine, a part of Wake Forest Baptist. "But there's growing evidence that the repeated, sub-concussive head impacts experienced by players over the course of a season may result in brain changes similar to those seen with traumatic injuries. Such changes are especially alarming in children and adolescents, whose brains are in a stage of rapid development."

The Wake Forest Baptist researchers are currently in the third year of a five-year study, also funded by the NIH, of the same issue in children ages 8 to 12 who play organized football in the Winston-Salem area.

Both the youth-league and high school studies - called iTAKL, for Image Telemetry and Kinetic Modeling - employ imaging, cognitive testing and biomechanical data to evaluate the cumulative effects of head impacts. The data collection and analysis techniques were developed by Whitlow and co-principal investigators Joel Stitzel, Ph.D., professor and chair of biomedical engineering at Wake Forest School of Medicine, and Joseph A. Maldjian, M.D., a former Wake Forest School of Medicine faculty member now at the University of Texas Southwestern Medical Center in Dallas.

The study participants undergo pre- and post-season cognitive testing and two imaging procedures, MRI and magnetoencephalography (which maps brain activity by measuring the magnetic fields generated by the brain's neurons). During practices and games, sensors placed in each player's helmet record the number and force of impacts and the head motions caused by them. If any player experiences a clinical concussion during the season, the same testing and imaging are conducted as soon as possible after the injury is diagnosed.
"Our main purpose is to determine the consequences of repeated sub-concussive impacts on the brains of young players through the collection of data on a scale never before attempted in this age group and a contact sport," Whitlow said. "The ultimate goal is to provide evidence-based information that will lead to better prevention, identification and treatment of pediatric head injuries and help make football a safer activity for the millions of young people who play it."