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Neurofeedback should be provided as a matter of course to all athletes who 
suffer even a minor concussion as prophylactic treatment to prevent brain 
dysfunction. Athletes receiving neurofeedback treatments can expect a reduction
in symptoms commonly associated with post-concussion syndrome. Please encourage 
athletic directors to educate themselves about the value of neurofeedback to 
reduce the immediate and longer-term effects of concussion. 

Source: www.intelihealth.com, 6 May 2003; www.neurosurgery.org, May 2003

Research presented at the 71st meeting of the American Association of 
Neurological Surgeons in San Diego, USA, suggests that repeated bouts of
concussion may cause clinical depression in later life. 

People who play sport for a living, such as professional American football 
players, are more likely than the average person to suffer from repeated concussion, 
and the results from a study of retired National Football League
(NFL) players in the USA show that around 11% of retired footballers suffer from 
depression. Furthermore, retired players who experience more than 5 episodes of 
concussion during their career are three times more likely to suffer from 
depression than players without a history of concussion, while 3-4 episodes
double the risk of developing the illness.

In the study, 2,488 retired NFL players completed a general health 
questionnaire, and the results were analyzed by a team of researchers led by Dr
Julian Bailes, Dr Kevin Guskiewicz and Dr Stephen Marshall from the University of No
rth Carolina's Center for the Study of Retired Athletes in the USA. The results 
showed that 61% of respondents had experienced at least 1 episode of 
concussion during their career, 24% reported 3 or more episodes and 12% reported
5 or more episodes. Of the 11% who were diagnosed with clinical depression, 46% were 
taking antidepressant drugs and 64% felt that depression was limiting their 
daily life. 

Worryingly, 9% of respondents reported at least 1 concussion resulting in 
more than 4 weeks of symptoms, and 71% returned to play on the same day as their 
concussion. Dr Mark Lovell, a neuropsychologist from the University of 
Pittsburgh, USA, explained that many football coaches think that if obvious
symptoms of concussion disappear within 15 minutes, it is safe for the player to 
continue playing. However, Dr Lovell's own research has shown that teenage
athletes with mild concussion often show subtle symptoms days later. The best way to 
heal concussion is for the player to rest for about 1 week, he urged. "Athletes 
and their coaches and relatives need to take concussion more seriously," he 
continued. "If you get hit and have a headache...you need to tell somebody".

It obviously helps to be aware of the symptoms of concussion. Loss of 
consciousness for a few seconds to half an hour may or may not occur, while
other possible symptoms include amnesia, confusion, persistent headache, cognitive 
problems, fatigue, mood changes, and sight or hearing problems. Short-term
memory loss is particularly important, noted Dr Lovell. The longer the period of 
amnesia, the worse the episode of concussion. It is therefore important to watch 
for changes in the player's behavior, he suggested.

Another aim of the new study was to determine whether repeated concussion 
predisposes an individual to Alzheimer's disease. The results of the study
showed no association between these two factors.


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