PSYCHIATRIC ASPECTS OF TBI IN SPORTSneurosciencecme.com/library/MM027-day2-1515-baron.pdf · David...
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PSYCHIATRIC ASPECTS OF TBI IN SPORTS David Baron, MSEd, DO University of Southern California Acknowledgement Steven Baron, PhD Associate Professor of Psychology, Montgomery College
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DAVID BARON, MSEd, DO
!!Research/Grants: None
!!Speakers Bureau: None
!!Consultant: None
!!Stockholder: None
!!Other Financial Interest: None
!!Advisory Board: None
Disclosures
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LEARNING OBJECTIVE Identify current and emerging developments that will shape the management of sports-related traumatic brain injury (TBI) in athletes
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WHERE WE’VE BEEN
!!Lack of appreciation of impact on long-term effects (especially psychiatric)1
!!Treated like an ankle sprain !!Called it a brain bruise !!Administered smelling salts !!“Get back in the game”
!!Virtually no research on effects of chronic, multiple head trauma2
1. Mayers L. Arch Neurol 2008;65:1158-1161. 2. McCrory P, et al. Phys Sportsmed 2009;37:141-159.
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WHERE WE’VE BEEN (CONT.)
!!Culture of collision/contact sports !!Macho image
!!Very limited hard data !!Similar to steroid issue
30 years ago
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WHERE WE ARE
!!Increasing awareness of neuropsychiatric consequences !!Increased suicide in pro football !!Andre Waters story
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WHERE WE ARE (CONT.)
!!Working on consensus guidelines !!NFL locker room poster
changed July 20101
!!“Return-to-play” guidelines2
1. New York Times. NFL Asserts Greater Risks of Head Injury. July 26, 2010. http://www.nytimes.com/2010/07/27/sports/football/27concussion.html. 2. Herring SA, et al. Med Sci Sports Exercise 2005;37:2012-2016.
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WHERE WE ARE (CONT.)
!!Emerging technology !!Susceptibility-weighted imaging (SWI)1
!!Wilton logic screen2
!!Hot topic in lay/sports press !!Time Magazine article in January 20103
!!Global interest
1. Giza CC. Curr Sports Med Rep 2010;91:35-39. 2. http://www.wiltonlogic.com/news-info/index.html. 3. http://www.time.com/time/nation/article/0,8599,1957046,00.html.
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WHERE WE ARE GOING (HOPEFULLY)
!!Evidence-based consensus guidelines !!Evaluation !!RTC !!Strictly enforced rules
!!Baseline screening with regular follow-up to detect early subtle changes !!Change in our culture and attitude about
head/neck trauma
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WHERE WE ARE GOING (HOPEFULLY)
!!Better baseline measurement and documentation !!Early intervention post-trauma !!Better education !!Atlas and Athena program
!!Improved equipment for better protection !!Retrospective evaluation of athletes
with former subclinical concussions
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WHAT’S NEEDED
!!Coordinated collaboration and cooperation !!Sports federations !!Youth sports !!NCAA !!Professional sports !!Trainers/coaches/med staff !!Sports psychiatrists/psychologists !!Neuroimagers
!!Funding !!Media portrayal of head trauma changed !! Improved equipment/testing of effectiveness
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