Research

PNG's current research examines the connection between mild traumatic brain injury (mTBI) biomechanics and the underlying pathophysiology as well as methods for the prevention of mTBI. Our research methods include the use of functional magnetic resonance imaging (fMRI), neurocognitive testing, sports telemetry, finite element analysis, . By combining these diverse methods, PNG seeks to better understand the nature of mTBI and to develop improved methods of detection and prevention.

PNG's research is supported through grants from the Indiana Spinal Cord and Brain Injury Research Foundation, a part of the Indiana State Department of Health, and through GE Medical.

• Journals
• Presentations
• Posters
• Talks

In 2010, Talavage et al. provided the first direct evidence of subconcussive injury. They began a prospective, multimodal study of concussion in a high school football population using head impact telemetry, neurocognitive testing (ImPACT), and functional neuroimaging (fMRI). Changes in neural health were determined by establishing a subject-speci_c pre-season baseline for ImPACT and fMRI against which subsequent in-season and post-season follow-up sessions could be compared.

As expected, concussed players exhibited clinically-identifiable symptoms and measurable deficits both in ImPACT and fMRI. These subjects were said to exhibit both “clinically-observed impairment" and “functionally-observed impairment" and were labeled COI+/FOI+. Conversely, some subjects who were not diagnosed with a concussion neither presented clinical symptoms of concussion nor exhibited appreciable changes in their ImPACT or fMRI results. Therefore, they were labeled COI-/FOI-. Surprisingly, 50% of the asymptomatic players studied by Talavage et al. exhibited substantial changes in their ImPACT and fMRI results that were on the level of the COI+/FOI+ players. These players were designated COI-/FOI+.

Further analysis of the COI-/FOI+ group indicated that they had sustained significantly more hits throughout the season than their COI-/FOI- and COI+/FOI+ peers, particularly to the Top-Front region of the head. Moreover, changes in the frontal lobe were found to correlate with the number of hits to the head sustained at the time of the in-season scan. A follow-up analysis by Breedlove et al. indicated that fMRI changes in the asymptomatic (i.e., COI-) players existed on a continuum. The number and location of hits throughout the season and in the week preceding the scan were found to correlate with fMRI changes in both COI-/FOI- and COI-/FOI+ players, which indicated that, as Talavage et al. had stated, the defining difference between the COI-/FOI+ and COI-/FOI- group was the number of hits they had sustained. Given this observation, Breedlove et al. suggested that players more simply be classified as symptomatic (COI+/FOI+) and asymptomatic (COI-/FOIx).

Breedlove et al. also reinforced the notion that subconcussive hits “set up” the concussion by observing that the changes in fMRI for COI+/FOI+ players also strongly correlated with the number and location of hits to the head. Therefore, the hits leading up to the concussion contribute toward increasing levels of damage until the final, concussion-inducing blow is the “straw that broke the camel's back". This helps to explain why hit magnitude is a poor predictor of concussion.

Refereed Journal Articles

Functionally-Detected Cognitive Impairment in High School Football Players Without Clinically-Diagnosed Concussion. Thomas M. Talavage, Eric Nauman, Evan L. Breedlove, Umit Yoruk, Anne E Dye, Katie Morigaki, Henry Feuer, Larry J. Leverenz, Journal of Neurotrauma. Oct 2010, online ahead of print.

Biomechanical Correlates of Symptomatic and Asymptomatic Neurophysiological Impairment in High School Football. Evan L. Breedlove, Meghan Robinson, Thomas M. Talavage, Katherine E. Morigaki, Umit Yoruk, Kyle O'Keefe, Jeff King, Larry J. Leverenz, Jeffrey W. Gilger, Eric A. Nauman, Journal of Biomechanics, vol. 45, no. 7, pp. 1265-1272, Apr 2012.

Conference Presentations

Sport Related Concussion Management: From Field to the Laboratory. Leverenz, L.J., International Convention of Science, Education and Medicine in Sport (ICSEMIS), Glasgow, Scotland, July 2012.

Subconcussive Impacts in High School Athletes. Leverenz, L.J., Great Lakes Athletic Trainers' Association Annual Meeting and Clinical Symposium, Wheaton, IL, Mar. 2012.

Sub-concussions: What Are We Learning. Leverenz, L.J., 4th Annual Sports Medicine Symposium, Barrington, IL, Mar. 2012.

Neuroimaging of Concussive and Subconcussive Injury: Potential Clinical Application. T. Talavage, 2012 Keystone Symposium on Clinical and Molecular Biology of Acute and Chronic Traumatic Encephalopathies, Keystone, CO, Feb. 2012.

Biomechanical Linkage of History of Head Collisions to Neurophysiological Impairments in High School Athletes. E. Breedlove, M. Robinson, K. Morigaki, M. Rasmussen, A. Zakrajsek, L. Leverenz, T. Talavage, E. Nauman, 2012 Big Sky Athletic Training and Sports Medicine Conference, Big Sky, MT, Feb. 2012.

Sub-concussive Impacts in High School Athletes. Leverenz, L.J., Concussion Summit, University of Texas at Arlington, Arlington, TX, Jan. 2012.

Identifying the Problem: Sub-concussive Blows in High School Football. Leverenz, L.J., National Athletic Trainers' Association Annual Meeting & Clinical Symposium, New Orleans, LA, June 2011.

Use of Computer-Based Neurocognitive Testing to Identify Impairments in Patients Without Symptoms. L. Leverenz, T. Talavage, E. Nauman, K. Morigaki, E. Breedlove, 2011 Big Sky Athletic Training and Sports Medicine Conference, Big Sky, MT, Feb. 2011.

Predictive Modeling of Cognitive Impairment from Head Trauma. K. Morigaki, E. Breedlove, E. Nauman, The 63rd Annual Eastern Athletic Trainers' Association Convention, Philadelphia, PA. Jan. 2011.

Detecting Traumatic Brain Injury in Athletes and Soldiers. Eric A. Nauman, Tom Talavage, Evan Breedlove, Anne Dye, Meghan Robinson, Umit Yoruk, Katie Morigaki, Larry Leverenz, Systems Integrity for Defense Technology Summit, West Lafayette, IN. April 2010.

Neuroimaging Correlates of Neurocognitive Evaluation of High School Football Players. T. Talavage, Purdue University-University of Pittsburgh Medical Center Summit on Concussion in Sports, West Lafayette, IN. Feb. 2010.

Conference Posters

How many hits is too many? Toward a dose-response of head collisions as revealed in football by fMRI. M Robinson, T Talavage, E Breedlove, K Morigaki, R Benson, E Nauman, L Leverenz, 17th Annual Meeting of the Organization for Human Brain Mapping, Quebec, Quebec, Canada, June 2011.

fMRI Assessment of Effects of Technique on Neurological Impairment in High School Football Players. TM Talavage, EL Breedlove, KE Morigaki, ME Robinson, RD Ranaweera, EA Nauman, LJ Leverenz, 19th Annual Meeting and Exhibition of the International Society for Magnetic Resonance in Medicine, Montreal, Quebec, Canada, May 2011.

Cognitive Deficits in Football Players When No Classic Signs of Impairment are Exhibited. E. Breedlove, E. Nauman, T. Talavage, U. Yoruk, A. Dye, K. Morigaki, and L. Leverenz, 2nd Annual Research Symposium for Weldon School of Biomedical Engineering Graduate Student Association, West Lafayette, IN. July 2010.

Functionally-Observed Concussion in High School Athletes: Hidden Brain Injury with Lasting Effect? T. Talavage, L. Leverenz, E. Nauman, E. Breedlove, U. Yoruk, K. Morigaki, M. Robinson, D. Miller, C. Bouman, 16th Annual Meeting of the Organization for Human Brain Mapping, Barcelona, Spain. June 2010.

Helmet Monitoring Can Screen for Cognitive Deficits in the Absence of Clinical Signs of Concussion. E. Breedlove, E. Nauman, T. Talavage, U. Yoruk, A. Dye, K. Morigaki, L. Leverenz, Systems Integrity for Defence Technology Summit, West Lafayette, IN. April 2010.

Invited Talks

Seeing Through The Fog: The Truth About Concussions. Katie Breedlove, TEDxPurdueU, West Lafayette, IN, April 2013.

Neuroimaging of Concussive and Subconcussive Injury: Probing Neurological Health in High School Athletes. T. Talavage, Speech and Hearing Biosciences Technology Program Seminar, MIT-Harvard Division of Health Sciences and Technology, Cambridge, MA, May 2011.

Neurology and Neurotrauma Research at Purdue. E. Nauman, L. Leverenz, T. Talavage, Big Ten/CIC Head Injury Summit, Chicago, IL, April 2011.

Can We Play Football Safely? Lessons learned from studying high school football players. L. Leverenz, E. Nauman, T. Talavage, Science on Tap, Lafayette, IN, April 2011.

Can We Play Football Safely? Lessons learned from studying high school football players. T. Talavage, E. Breedlove, Carmel Chamber of Commerce, Carmel, IN, March 2011.

Use of Computer-Based Neurocognitive Testing to Identify Impairments in Patients Without Symptoms. L. Leverenz, E. Nauman, T. Talavage, West Lafayette Kiwanis Club, Feb. 2011.

Traumatic Brain Injury: Comparing Military to Civilian Trauma. E. Nauman, Institute of Medicine, Committee on Cognitive Rehabilitation Therapy for Traumatic Brain Injury Public Workshop, Feb. 2011.

Neurological Impairment in Football Players. Detecting Injury and Miminimizing Future Risk. E. Nauman, T. Talavage, Purdue University Science Journalism Laureates. Nov. 2010.

Functional Impairments in High School Football Players: How do we detect occult injury and minimize future risk?. T. Talavage, Section on Functional Imaging Methods, NIMH, NIH. Nov. 2010.

Functional Impairments in High School Football Players: How do we detect occult injury and minimize future risk?. T. Talavage, Center for the Study of Learning, Georgetown University. Nov. 2010.

Concussion in Football: More Than a Ding on the Head. Evan L. Breedlove, Invited talk to the Purdue chapter of BMES. March 2010.