Even mild head impacts, when experienced repeatedly, may influence brain growth and aging. This is known as chronic traumatic encephalopathy, or CTE, a brain condition often associated with years of head impact exposure in athletes. Indiana University researchers have long been at the forefront of the fight to better understand the effects of these head impacts, and now they're researching ways to prevent this brain trauma.
Keisuke Kawata.
Kei Kawata, associate professor at the IU School of Public Health-Bloomington and one of the nation's leading researchers on this topic, is preparing his team for two clinical trials to find prevention methods for this brain trauma. A $3 million grant from the National Institutes of Health will help Kawata's team and other IU researchers determine whether pretreatment with omega-3 fatty acids- particularly docosahexaenoic acid, known as DHA, and eicosapentaenoic acid, or EPA - can increase brain resiliency to repetitive subconcussive head impacts.
The upcoming clinical trial will use a controlled soccer heading model, where participants perform standardized soccer headers in a gym. This approach aims to isolate the effects of head impacts and to characterize how taking omega-3 fatty acids enhances neural cellular, physiological and functional resiliencies.
"Subconcussive head impacts are often inherent to athletic drills, like soccer headings and tackles in contact sports," said Kawata, who has played a pivotal role in understanding the acute and cumulative effects of subconcussive head impacts in adolescent and young adult athletes. "There are limits to how much policy and rule changes can regulate these impacts. Establishing prophylactic measures against subconcussive injury is urgently needed. Omega-3 fatty acids may have the potential to be a breakthrough in clinical care for contact sports athletes."
The clinical trial will incorporate state-of-the-art neurological assessments, including blood biomarkers, autonomic reactivity, advanced neuroimaging and neuro-ophthalmologic function.
"Omega-3 fatty acid dietary supplements are widely available, inexpensive and well tolerated at any age," said study co-lead Timothy Mickleborough, a professor of exercise physiology at the School of Public Health-Bloomington with a long record in testing the efficacy of dietary supplements in human diseases. "Since both DHA and EPA are important for brain function, they may provide neuroprotection against subconcussive head impacts."
Subconcussive injury is common not only among athletes but among military service members, who are exposed to blasts, artillery fire, explosive devices and vehicle collisions. Kawata is a co-leader in a $6 million, multi-institutional program award from the U.S. Department of Defense, led by Dr. Jeffrey Bazarian at the University of Rochester.
Kawata will lead a clinical trial at IU addressing a critical question: What is the role of intervals of head impact exposure in brain resiliency?
Some animal studies suggest that the duration between head impacts may significantly influence brain recovery and cellular responses. However, Kawata said this concept is poorly understood in humans due to a lack of well-controlled clinical studies. Also using the soccer heading model, this study will recruit a different pool of participants to test interval durations between each head impact cluster. The study will also periodically assess biochemical contents in the blood, eye and retinal health and brain waves.
"This widely scalable concept of manipulating head impact intervals will provide tremendous insights into the prevention, monitoring and treatment of subconcussive brain injury in service members, contact-sport athletes and beyond," said Kawata.
"The research Dr. Kawata and other School of Public Health-Bloomington faculty are conducting is novel and remarkably important," said David Allison, dean and Distinguished Professor in the School of Public Health-Bloomington. "This work is not only scientifically creative, but it is addressing an imperative problem and protecting the health and wellbeing of our future: children and those who serve our country in our military. The tangible impact of this work will be felt widely across the country and the world."
Others contributing to the two projects include Blair Johnson, Hu Cheng, Patrick Quinn and Patricia Silveyra from Indiana University, Sharlene Newman from the University of Alabama, Zhongxue Chen from Arizona State University and Philip Calder from the University of Southampton.
