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Spring 2014
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Heavy Hitter
New center treats sports-related concussions.
Have you ever heard the crack of helmets while watching a football game? Mounting evidence shows that football players—from the peewee leagues to the NFL—suffer frequent concussions that sometimes result in life-long brain damage. Brown Medicine recently spoke with Assistant Professor of Neurology (Clinical) Mason Gasper, DO, MPH, F’05 about the Sports-Concussion Management Program he started at Memorial Hospital of Rhode Island.

How did your interest in concussion research begin?
Besides an interest in neurorehabilitation and keeping up-to-date on an expanding scientific understanding of mild traumatic brain injury, a personal experience of a concussion during a high school football game drove my interest. During the concussion, I clearly recall not being able to communicate at all with coaches or other players, even though I recall them speaking to me and saying “welcome to the NFL” in jest. The curious thing about the experience was that I must have outwardly appeared OK, as I was sent back out on the field, but inwardly I really had no clue where to stand or what play was being called. This is a story shared by many
after a mild head injury, and many concussed athletes remain in the game, seemingly normal yet with no ability to understand and react quickly to events around them—a set-up for another injury.

What is the Sports-Concussion Management Program?
Janet Grace, PhD, a neuropsychologist at Memorial, and I began talking about a sports concussion program two years ago. At the time, sports-concussion management was a growing concern in the media. While much of the focus of public discussion in sports-concussion care is on professional athletes, we felt we could make an impact on the local high school and college levels, especially since there are few options for concussion care in Rhode Island. Additionally, we are fortunate at Memorial to have a group experienced in concussion care and sports medicine. Our goals are to evaluate student athletes at any age as quickly as possible (we are prepared to see athletes the next day in most cases) and set a return to play and school plan (with graded exercise protocols when symptomatically and cognitively appropriate, and cognitive rest as
appropriate), and follow up for postconcussive syndrome (persistent memory problems, vertigo, headache, fatigue).

What is your reaction to recent legislative involvement in NFL policies regarding concussions?
The NFL has come a long way (with prodding from the media, players, and Congress, of course) in recognizing the importance of addressing concussion. The decision to have independent neurological
evaluations will be important to remove any conflict of interest in highly competitive situations. However, it is important to realize that players ultimately are responsible for reporting concussions. An interesting idea is to allow the on-field referees to disqualify players for suspected concussion, as in rugby, thereby removing some of the dependence on player reports.

Brown football alum Sean Morey ’99 of the Arizona Cardinals has agreed to donate his brain to the Boston University CSTE study. What do you think the significance of this study will be?
Neuropathology studies were a key part of making sports concussion an important health concern. Dr. Bennet Omalu performed autopsies on multiple NFL football players who had died at relatively young ages. At the time, it was surprising that these young players’ brains showed changes seen usually with Alzheimer’s
disease. The question now is, Do some cases of mild head injury where there are less frequent head impacts result in neuropathological abnormalities?
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