Week Two

After a brief break for Memorial Day, the team was back in action in the Imaging Research Facility on Tuesday…everyone it seemed was still shaking off the last bit of their holiday hangovers. The night before I had received a text from my internship supervisor Taylor that I would be training a new undergrad on our L1 MRI operator protocol. Given that I had myself just really learned the protocol the week before, I was a little anxious and as I would expect of an anxious version of myself, I screwed up a couple times but all the mistakes were easily recoverable and I like to think they might’ve even made for a better training session for our new post grad operator.

So my reward for training the new operator was that she would take all my morning scans the next day, so I was able to revel in the shining glory of sleeping in on a Wednesday and came into the lab late to discuss the independent research project that I’d been brainstorming for some time. My initial “Plan A” was one of a “practical implication” from the data which Taylor had just published the day before in the JAMA network regarding year one data. A main finding of her paper is that our football players showed a significant decrease in oculomotor nerve functioning as the season went on (as demonstrated by the “Near Point Convergence Test” or essentially how close an object can be brought before your nose before it gets blurry). This really stuck out to me as the concussion I’ve sustained have nearly all had an oculomotor component to their symptomatologies, and I’ve even been prescribed oculomotor and vestibular therapy as a way of counteracting these symptoms (which unfortunately do tend to occur every now and then when a little jolt in the car for instance catches my brain just right). Moreover, one study I came across found that oculomotor dysfunction was a marker of lifetime concussions sustained in college hockey players, thus suggesting that this dysfunction may never go away if left unmanaged. Not to mention my uncle who sustained countless concussions playing high school and college football claims that these kinds of oculomotor exercises (eye tracking, gaze stabilization) remain really difficult for him even 30 years removed from football.

Given that these football players who did NOT even sustain a concussion over the season were showing dysfunction in oculomotor processing and given how much oculomotor therapy had helped me, I saw it as an opportunity to fulfill one of the main missions of our study to inform policy related to keeping our adolescent football players safe and healthy. As such, I wanted to compose something along the lines of recommending that football players in-season undergo oculomotor therapy so as to counteract whatever may be occurring in their brainstem as a result of their repeated head impacts. In the same way that stretching one’s muscles is recommended every night to athletes in season, it could be recommended that football players (and other contact sport athletes) perform a few oculomotor exercises every night so as to maintain the functioning of this cranial nerve.

However, and as I suspected, this kind of paper would require input and co-authorship from someone who actually has the authority to make these kinds of claims and recommendations. As such, it’s a bit beyond the scope of this summer project, but given the wealth of research relating oculomotor dysfunction to concussions and the remediatory role which the therapy can play, I still would like to see someone take such an approach to managing in-season in athletes in the future. So the meeting was indeed a process of reigning in my imagination and we ended up deciding that I would analyze our King-Devick data from last year. The King-Devick test is a kind of oculomotor test which carries with it a more cognitive aspect than the Near Point Convergence test. Because of this, we do not plan on seeing any significant decreases as the season went along because the football players showed a “learning effect” where the cognitive aspect of the test allowed them to get better at the tasks as the season went on. However, because our study is hoping to tests whether football is detrimental or not, these findings should still be publishable as long as I can analyze the data correctly and tell a good story to accompany it.