The Push To Test Athletes' Brains Before They're Injured

October 7, 2013

Molly Caron is a freshman at Emerson College, where she studies marketing and plays soccer for the Emerson women’s team. Two years ago, in a high school soccer game, Caron took a nasty shot to the head. 

It was clear right away Caron had a concussion, and it turned out to be a severe one. She had a headache that lasted three months and that Tylenol couldn't touch. She was  also nauseous, dizzy, and sensitive to light and sound, symptoms she still has today.

During her recovery, Caron couldn't do many of the things she took for granted, like playing soccer and doing schoolwork. Even reading and watching TV were off limits. She responded by throwing herself into concussion advocacy.

Specifically, Caron began working to raise awareness of something called "baseline testing." The premise is simple: test the cognitive functions of young athletes before they're injured, to make diagnosis and treatment of any trauma that occurs more precise.

Caron hadn't received a baseline test, and still believes it made her physician's task more difficult. 

"It was really hard for my doctor to give a comparative standard where my brain function was at," Caron says. "So it was hard for him to put me back on the field, let me drive again, things that were crucial." 

State considers baseline testing for all student athletes

Currently, Massachusetts Legislature is considering requiring baseline testing for every high-school athlete in the state. Meanwhile, a growing number of schools and towns are embracing it on their own.

Neuropsychologist Neal McGrath works with 45 different schools at his clinic in Brookline. As he explains it, baseline testing takes the guesswork out of concussion treatment--and lessens reliance on the subjective descriptions of injured athletes themselves, who may not be inclined to be totally candid. 

"One of the things we see at all levels of sport is that athletes tend to suppress or deny symptoms," McGrath says. "They want to play; they don’t want to be not well. So they tend to say, 'My headaches aren’t too bad, I can play with this dizziness.' They’re willing to do it, but the risks are substantial if they go back to play with symptoms."

The test McGrath uses takes about 20 minutes and measures a range of cognitive functions, like the ability to recall random sequences of words and patterns.  After it's completed, McGrath and his patients have a data-based profile of the healthy brain that can be used to assess the severity of whatever injury has occured.

Two head traumas in a matter of seconds

Last winter, during an Austin Prep hockey game, one of McGrath's patients, a high-schooler named Becky Raphael, suffered two head traumas in a matter of seconds, smashing headfirst into the boards and then landing on her jaw after she was tripped by an opponent.

But Raphael kept playing. On the bus ride home, her symptoms hit with a vengeance: nausea, ringing in her ears and light sensitivity. Today, she recounts feeling panicky and desperately wanting to exit the bus.

Today, Raphael’s recovery is nearly complete. She’s skating without contact, and is itching to get back to regular play. When WGBH spoke with her last week, she was sure Dr. McGrath would give her the OK.

As it turned out, however, McGrath asked her to scrimmage with moderate contact for two more weeks, then return for another round of testing before resuming full-contact game play. Her mom said Becky is deeply frustrated.

Molly Caron could relate--but said it’s important to keep the urge to compete in perspective. 

"If it gets really intense, I try to not go at it so hard, just because I know there’s a chance it could happen again," Caron said of the way her own injury has impacted her style of play on the soccer field. "In my eyes, soccer is probably one of the greatest things in the world to me. But my life and my future is a lot more important."

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