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Brain tethers may target early damage from concussions

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SALT LAKE CITY — While the science of projecting what will happen in a concussion is still in its infancy, a University of Utah researcher believes an often overlooked structure in the brain may hold the key to a better and earlier diagnosis.

Biomechanics professor Brittany Coats is looking at a one to six millimeter space just below the surface of the skull. Inside are microscopic web-like tissues made of collagen. Nobody has really studied them before, but Coats believes changes or even damage to these minute tethers could be an early clue for what has or could happen to the brain after a hit.

"These structures are on the surface of the brain, so imaging techniques just need to be able to get down a few layers to actually image them," Coats said.

In theory, injecting dye that would bind to these damaged tethers might pinpoint vulnerable areas of the brain — dramatically improving the accuracy of a diagnosis.

"In our computer modeling we've been able to improve prediction of bleeding on the brain surface by about 96 percent," Coats said.

Adam Bullough is watching with more than just a passing interest at what unfolds in Coats' research. He joined the Brain Injury Alliance of Utah more than a year ago, hoping to get people to recognize the seriousness of concussions and the side effects that often linger long after an injury. While riding his bicycle in California almost eight years ago, Bullough hit a street reflector and lost control. He was not wearing a helmet. After coming out of a two-month coma, he had to learn how to walk and talk again.

"I have trouble following things. For example, when I'm playing soccer or driving if something passes me quickly I have trouble focusing on that," Bullough said. "One of the biggest problems is my ability to speak and articulate ideas. I have problems with memory. My vision is still a little off."

Bullough's injury was obvious from the beginning. But for others when the hit is not as hard and the damage more subtle, injuries can be deceptive. Coats believes her studies of the microscopic tethering might reveal significant changes not detected with current diagnostic tools.

"We're actually looking at developing certain techniques to tag or mark these damaged structures in the brain right now," Coats said.

Coats said researchers need to know a lot more about these structures and how they transmit forces from the skull to the brain. What role do they play after a hit, while the brain is in motion?

"It's probably the tethering of these structures that helps keep the brain connected to the skull. We really don't know what happens when this tethering is disrupted," Coats said.

After almost eight years of recovery from his injury, Bullough rock climbs indoors and plays a number of sports now, but he's sensitive to the risks. He was hit recently while playing soccer and told his team he wouldn't play the remaining games — just as a precaution.

Coats believes the brain's tethering may offer clues for this as well. "What does that mean for brain deformation if you get a second impact and what's the healing process like," she says.

"The more we know what to expect from any concussion or brain injury, the better. So I think this research is fantastic," Bullough said.

Ed Yeates

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