Research

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.

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.

MRI

Refereed Journal Articles

Sub-concussive Hit Characteristics Predict Deviant Brain Metabolism in Football Athletes V.N. Poole, E.L. Breedlove, T.E. Shenk, K. Abbas, M.E. Robinson, L.J. Leverenz, E.A. Nauman, U. Dydak and T.M. Talavage, Developmental Neuropsychology (Accepted 30 Oct 2014).

Cerebrovascular Reactivity Alterations in Asymptomatic High-School Football Players D.O. Svaldi, C. Joshi, M.E. Robinson, E.A. Nauman, L.J. Leverenz and T.M. Talavage, Developmental Neuropsychology (Accepted 3 Oct 2014).

Detecting Neurocognitive & Neurophysiological Changes as a Result of Subconcussive Blows in High School Football Athletes. K.M. Breedlove, E.L. Breedlove, M. Robinson, V.N. Poole, J.R. King III, P. Rosenberger, M. Rasmussen, T.M. Talavage, L.J. Leverenz and E.A. Nauman, Athletic Training & Sports Health Care, volume 6, no. 3, pages 119-127, May/June 2014.

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, vol. 31, no. 4, pp. 327-338, Feb 2014.

MR Spectroscopic Evidence of Brain Injury in the Non-diagnosed Collision Sport Athlete. V.N. Poole, K. Abbas, T.E. Shenk, E.L. Breedlove, K. Breedlove, M.E. Robinson, L.J. Leverenz, E.A. Nauman, T.M. Talavage and U. Dydak, Developmental Neuropsychology, vol. 39, no. 6, pp. 459-473, 2014.

Role of subconcussion in repetitive mild traumatic brain injury. Julian E. Bailes, Anthony L. Petraglia, Bennet I. Omalu, Eric Nauman, and Thomas Talavage, Journal of Neurosurgery, vol. 119, no. 5, pp. 1235-1245, Nov 2013.

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

Concussions and Other Effects of Repetitive Head Blows in High School Athletes T. Talavage, Annual Retreat of the North Central Indiana School Study Council, Nashville, IN, June 27, 2014.

Sub-concussive Impacts in High School Athletes L. Leverenz, E. Nauman and T. Talavage, Science with a Twist, Indianapolis, IN, February 20, 2014.

Pre-Clinical Neuroimaging of Effects of Repetitive Blows to the Head in High School Athletes T. Talavage, 3rd Indiana Neuroimaging Symposium, Bloomington, IN, October 25, 2013.

Preventing Traumatic Brain Injury in High Impact Sports T. Talavage, President's Colloquia at Westwood, West Lafayette, IN, October 2, 2013.

Pre-Clinical Neuroimaging of Repetitive Head Collisions in High School and Collegiate Athletes T. Talavage and L. Leverenz, General Electric Healthcare, Waukesha, WI, September 16, 2013.

Purdue Neurotrauma Group: Study of Collegiate Athletes 2013-2014 T. Talavage, Big Ten/CIC/Ivy League Summit on Traumatic Brain Injury, Chicago, IL, July 18, 2013.

MRI of mTBI in High School Collision Sports T. Talavage, TBI Summer School, Wayne State University, Detroit, MI, June 14, 2013.

Sub-concussive Impacts on High School Athletes L. Leverenz and T. Talavage, Purdue Alumni Association, Columbus, OH, May 29, 2013.

Sub-concussive and Concussive mTBI in Contact Sport Athletes T. Talavage, Purdue West Coast Partnership "Discovery with Delivery" Symposium, San Jose, CA, November 7, 2012.

How Many Hits is Too Many? Neurophysiological Consequences of Head Collisions in Football T. Talavage, Delaware Center for Neuroscience Research Brain Buzz, a Public Talk, Dover, DE, October 10, 2012.

Sub-Concussive and Concussive mTBI in High School Contact Sport Athletes T. Talavage, 2012 Orthopedic Symposium for Physicians and Medical Professionals, Methodist Sports Medicine, Indianapolis, IN, October 5, 2012.

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, 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 AthletesE. 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

Functional Connectivity in Asymptomatic High School Football Players and Non-Contact Athletes K. Abbas, T. Shenk, E. Breedlove, K. Breedlove, V. Poole, L. Leverenz, E. Nauman, T. Talavage and M. Robinson, 2014 Big Sky Athletic Training and Sports Medicine Conference, Big Sky, MT, February 2-6, 2014.

Neurometabolic Influences on ImPACT Cognitive Testing in Collision Athletes V. Poole, K. Breedlove, T. Shenk, K. Abbas, M. Robinson, E. Breedlove, L. Leverenz, E. Nauman, U. Dydak and T. Talavage, 2014 Big Sky Athletic Training and Sports Medicine Conference, Big Sky, MT, February 2-6, 2014.

Spectroscopic Analysis of Neuro-metabolic Changes in Female Soccer Players. V. Poole, U. Dydak, L. Leverenz, E. Nauman and T. Talavage, 19th Annual Meeting of the Organization for Human Brain Mapping, Seattle, WA, June 2013, #3296.

Functional Connectivity in Asymptomatic High School Football Players and Non-Contact Athletes. K. Abbas, T. Shenk, E. Breedlove, K. Breedlove, V. Poole, L. Leverenz, E. Nauman, T. Talavage and M. Robinson, 19th Annual Meeting of the Organization for Human Brain Mapping, Seattle, WA, June 2013, #3280.

DTI Detection of Symptomatic and Asymptomatic Injury Due to Repetitive Head Blows. I.Y. Chun, A. Diaz, X. Li, Y.J. Jin, L. Leverenz, E. Nauman and T. Talavage, 19th Annual Meeting of the Organization for Human Brain Mapping, Seattle, WA, June 2013, #3277.

Proximal and Distal Effects of Subconcussive Head Impacts on fMRI Activity in Asymptomatic High School Football Players. M. Robinson, E. Breedlove, V. Poole, L. Leverenz, E. Nauman and T. Talavage, 21st Annual Meeting of the International Society for Magnetic Resonance in Imaging, Salt Lake City, UT, April 2013.

Robust Detection of Progressive White Matter Abnormalities in mTBI using DW-MRI I.Y. Chun, A. Diaz, Y.-J. Jin, X. Li, L. Leverenz, E. Nauman and T. Talavage, 21st Annual Meeting of the International Society for Magnetic Resonance in Medicine, Salt Lake City, UT, April 2013.

Functional Connectivity Alterations in Asymptomatic High School Football Players. T. Shenk, K. Abbas, E. Breedlove, V. Poole, K. Breedlove, L. Leverenz, E. Nauman, T. Talavage and M. Robinson, 21st Annual Meeting of the International Society for Magnetic Resonance in Medicine, Salt Lake City, UT, April 2013.

1H MRS Suggests Chronic and Acute Injury in High School Football Players V.N. Poole, L. Leverenz, E. Nauman, T. Talavage and U. Dydak, 21st Annual Meeting of the International Society for Magnetic Resonance in Medicine, Salt Lake City, UT, April 2013.

Neurophysiological Deficits in Football Assessed Using ImPACT, fMRI and Head Impact Telemetry. K.M. Breedlove, E.L. Breedlove, M. Robinson, V. Poole, T.M. Talavage, L.J. Leverenz, E.A. Nauman, 2013 Big Sky Athletic Training and Sports Medicine Conference, Big Sky, MT, February 4, 2013.

The Effect of Number, Location, and Magnitude of Hits to the Head on Changes in Neurophysiology for a Population of High School Football Players. E.L. Breedlove, J. Gilger, M. Robinson, K. Morigaki Breedlove, V. Poole. L.J. Leverenz, T.M. Talavage and E.A. Nauman, 2013 Big Sky Athletic Training and Sports Medicine Conference, Big Sky, MT, February 4, 2013.

Influence of In-Season Hit History and Post-Season Recovery Time on Brain Health in High School Football Players. N. Zhang, M. Robinson, V. Poole, E. Breedlove, K. Morigaki Breedlove, L. Leverenz, E. Nauman and T. Talavage, The 65th Annual Eastern Athletic Trainers' Association Convention, Buffalo, NY, January 2013.

Asymptomatic high school contact sport athletes exhibit metabolic changes that correlate with head collision history V.N. Poole, E. Breedlove, M. Robinson, K. Morigaki, L. Leverenz, E. Nauman, U. Dydak and T. Talavage, Neuroscience 2012, New Orleans, LA, October 13-17, 2012, #552.07/L13.

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, West Lafayette, IN, 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, West Lafayette, IN, 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.


PNG

Contact Information

Larry J. Leverenz, PhD, ATC
Clinical Professor
Department of Health & Kinesiology

Eric A. Nauman, PhD
Professor
School of Mechanical Engineering
Weldon School of Biomedical Engineering
Department of Basic Medical Sciences

Thomas M. Talavage, PhD
Professor
School of Electrical & Computer Engineering
Weldon School of Biomedical Engineering

Our Partners

Purdue MRI Facility HK Purdue Engineering HIRRT