UPMC, others tackling the diagnosis of concussions with help from the NFL and General Electric
January 23, 2014 11:47 PM
Jacquelyn Martin/Associated Press
NFL commissioner Roger Goodell
By J. Brady McCollough / Pittsburgh Post-Gazette
NEW YORK -- Roger Goodell kept talking about Pittsburgh. The National Football League commissioner visited there last summer, meeting with doctors at the UPMC Sports Medicine concussion program, and he was taken aback by the treatments that are already available at the country's largest center of its kind.
"Extraordinary," Mr. Goodell said.
Thursday morning, on the sixth floor of the midtown Manhattan skyscraper that houses NFL headquarters, Mr. Goodell stood behind Michael Collins, director of UPMC's concussion program, and two other scientists at the front of a large conference room. They were gathered to announce the 16 winners in the first stage of the $20 million "Head Health Challenge," through which each of the chosen institutions, UPMC among them, will receive a $300,000 award to advance their research in speeding up diagnosis and improving treatment for mild traumatic brain injury with financial backing from the NFL and General Electric Co.
From more than 400 entries spanning 27 countries, UPMC was one of three picked to explain their research to the public and generate excitement about the initiative. For Mr. Collins, who arrived at UPMC in 2000 with little fanfare, it was a moment that showed how far he and his team have come and, at the same time, the daunting journey ahead in understanding the body's most complex and understudied organ.
"We had a press conference at the Steelers building the day we arrived," he said, "and everyone there was like, 'What the hell are these guys doing here?' What I said that day was that we're going to make Pittsburgh ground zero for this injury, and we have. I'm very proud of our program and what we've accomplished, and, yeah, I'm proud of the fact that we're from Pittsburgh, a very special place when it comes to medical research."
Like the other 15 winners, UPMC will have a specific goal in mind as it uses the grant during the next year. Researchers will assess whether a powerful imaging technology called high-definition fiber tracking (HDFT) -- developed by Walter Schneider, a Pitt professor of psychology and neurological surgery -- can identify concussions and subsequent recovery in a newly injured athlete in order to safely return him or her to the field of play.
The project will study 50 or more athletes ages 13 to 28 who seek care at UPMC within seven days of sustaining a head injury. In addition to undergoing the usual assessments, patients will have an HDFT scan when first joining the study and another when they are cleared to play.
HDFT scans go deeper than conventional imaging, revealing what Mr. Collins referred to as the "white matter" of the brain. There are billions of neural connections in 40 major fiber tracts in the human brain, comprising the information cables of the mind. Conventional imaging does not show subtle damage that can be caused by a mild traumatic brain injury. HDFT uses advanced computational means to process data from MRI machines, revealing these brain pathways and spots where the tracts might be disrupted.
To this point, Mr. Schneider's work with HDFT has focused only on tumors and severe brain injuries. What UPMC hopes to discover is that it also can be used to find biomarkers to help them identify and treat concussions. If UPMC is successful, it would be the first program to successfully use imaging technology in the field of concussions.
"We don't want to put the scientific cart before the horse here," Mr. Collins said. "We want to make sure we are measured. It doesn't mean it's going to work, but it's a great place to start. That's why we do the research."
The NFL and GE will follow the winners this year, and six of the 16 will be chosen for a $500,000 grant to continue their research. GE's CEO, Jeff Immelt, gave the NFL credit for being a catalyst.
"There's a convening process that goes on," he said. "What I've always seen in the NFL is the ability to be a convening factor. This is a way to bring a real focus on a big challenge for society, to bring more dollars and more scientists to it."
The NFL is at the heart of a major public relations battle over its perceived lack of care for former players who have suffered the effects of degenerative brain diseases, like chronic traumatic encephalopathy (CTE), that are caused by repeated hits to the head.
More than 4,800 former players have sued the NFL, which came to an agreement in August to settle the suit for $765 million. But last week, U.S. District Judge Anita Brody rejected the settlement, "fearing the sum may not be enough to cover injured players."
The NFL and GE combined on the research initiative last year, and employed five judges to narrow the field from an already narrowed 59 entries to 16. One of the judges was retired Gen. Peter Chiarelli, a former vice chief of staff of the Army who now runs One Mind for Research and devotes his time to galvanizing further study of the brain.
"I spent 24 months in Iraq, and I had no idea what traumatic brain injury was," Mr. Chiarelli said. "Traumatic brain injury to me was what my football coach told me I should just shake off and get back in the game. When I came back, someone threw a chart in front of me. It listed the most prolific wounds we had coming out of the war, and I thought for sure the bar on the far left was going to be those soldiers who had lost arms and legs and been shot. Instead it was soldiers with traumatic brain injury and post-traumatic stress."
The NFL, along with most of the scientific world, is playing catch-up on head injuries.
"We're going to make you proud of Pittsburgh with this program," Mr. Collins said.
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