Concentric Medical And The SITS Network Announce Partnership To Initiate Clinical Study On Merci(R) Retrieval System

Concentric Medical, Inc. and the SITS Network today jointly announced their partnership on the THRUST (Thrombectomy in Unsuccessful Stroke
Thrombolysis) study. The study will be sponsored by Concentric Medical and managed by the SITS Network. The study is anticipated to begin enrolling patients later this year, and Concentric Medical and SITS are actively recruiting sites to participate. Experience with the Merci(R) Retrieval System, documented in the SITS thrombectomy registry, is required for participation.

The THRUST study will investigate the Merci Retrieval procedure in
ischemic stroke patients who fail standard thrombolytic therapy. It is
estimated that about one third of patients with intravenous thrombolysis
have not improved two hours after the start of treatment. Further, the
prognosis of this group of patients is poor in comparison to those who
demonstrate some degree of improvement. The Merci Retriever is indicated for use in patients who fail standard lytic therapy, and mechanical thrombectomy with the Merci Retrieval procedure may offer substantial benefit for these individuals. THRUST will compare, in patients who fail to improve on intravenous thrombolysis, the clinical outcome of patients treated with mechanical thrombectomy using the Merci Retrieval System versus patients with no further intervention.

The Merci Retrieval System has been marketed in the U.S. since 2004,
based upon data gathered during the Mechanical Embolus Removal in Cerebral Ischemia (MERCI) trial. The Merci Retrieval System also has earned the European Union’s CE mark. The results of the MERCI trial were published in Stroke in July 2005. More recently, interim results from the ongoing Multi MERCI trial (presented at the International Stroke Conference, February 2006) provide further evidence of the benefits of the Merci procedure in failed thrombolysis patients.

“We believe that restoring blood flow quickly is key in a devastating
stroke, and that restoration of flow correlates with good outcomes,” said
Gary Curtis, President and CEO of Concentric Medical. “We look forward to working with the international stroke community, through the SITS Network, to provide further clinical evidence to support the use of the Merci Retrieval System.”

“The THRUST study is an important step in providing practitioners with
additional treatments in stroke,” said Professor Nils Wahlgren, Chairman of SITS International. “There has been a high interest from members within the SITS Network to participate which shows the importance of this study.”

About Concentric Medical

Located in Mountain View, California, and founded in 1999, Concentric
Medical is committed to opening the pathway to new stroke treatments. The flagship product line, Merci(R) Retriever, is indicated for use in removing blood clots from the brain in patients suffering an ischemic stroke. The Merci procedure is currently being performed in over 180 centers around the world, and Concentric Medical estimates that over 3,000 patients have been treated with the device. More information about Concentric Medical and its products can be found at concentric-medical.

Concentric, Merci and MERCI are trademarks/registered trademarks of
Concentric Medical.

About the SITS Network

The SITS Network is the world’s largest stroke network covering more
than 500 stroke clinics in more than 30 countries on four continents. The
SITS Network is an optimal vehicle for clinical/post-launch studies and
registries in stroke. The objective of the SITS Network is the broad
implementation and amplification of evidence based stroke treatments. More information about the SITS Network can be found at acutestroke.

Concentric Medical, Inc.
concentric-medical

Board Member Makes $1 Million Challenge Gift To The Jackson Laboratory

Geneticist and author Weslie Janeway of New York has made a $1 million “challenge gift” to The Jackson Laboratory for the recruitment and support of new scientists working to understand the genetic basis of human disease. The challenge gift, intended to encourage $1 million in matching gifts from other donors, will be used to pay for faculty starting salaries, lab equipment and experiments.

“Mrs. Janeway’s generous gift will help us attract bright young faculty with new ideas and approaches to enhance our genetics research at the Laboratory,” said Rick Woychik, Ph.D., president and CEO of the Laboratory.

“A secure funding base is necessary to attract outstanding researchers,” Mrs. Janeway said. “This represents the best possible investment in the future of The Jackson Laboratory and its work in the basic science that makes it possible to advance human health.”

The gift is timely because the Laboratory has developed a five-year strategic plan to expand its faculty to 45 principal investigators from the current 38 by 2014.

Mrs. Janeway has extensive philanthropic involvement and executive experience. She is president of the Pyewacket Foundation, manager of the Cambridge Endowment for Research and a member of the Stem Cell Council of Cambridge University. Moreover, she is currently on sabbatical in Dr. Roger Pedersen’s Laboratory at the University of Cambridge in the United Kingdom where she is gaining experience as a biomedical scientist conducting stem cell research.

She is coauthor of the newly published Mrs. Charles Darwin’s Recipe Book, a collection of historic scholarship, botanical drawings and insights about the lives and tastes of Charles and Emma Wedgwood Darwin. This year is Charles Darwin’s 200th birthday and the 150th anniversary of his book On the Origin of Species, describing his theory of evolution, the foundation of the genetics revolution.

Mrs. Janeway is married to William H. Janeway, senior advisor at the global private equity firm Warburg Pincus. They have a summer home in Hancock Point, Maine.

Notes:

The Jackson Laboratory is an independent, nonprofit biomedical research institution and National Cancer Institute-designated Cancer Center based in Bar Harbor, Maine, with a facility in Sacramento, Calif. Its mission is to discover the genetic basis for preventing, treating and curing human diseases, and to enable research and education for the biomedical community. The Laboratory’s work is contributing to a future of personalized medicine tailored to each individual’s unique genetic makeup.

Source:
Joyce Peterson

Jackson Laboratory

“Bicycling For Ovarian Cancer” Around Perimeter Of United States Begins Today

A 9,000-mile trek in 100 hundred days around the perimeter of United States to raise money to cure ovarian cancer begins today. The cyclist, Craig Broeder, Ph.D., is an exercise physiologist and Fellow of the American College of Sports Medicine (ACSM) who is dedicating his ride to help fund research and build awareness about ovarian cancer.

Broeder, 54, began his cycling journey today, starting at Lance Armstrong’s bike shop, “Mellow Johnny’s,” in Austin, Texas. His three-month trip, projected to end back in Austin on Aug. 25, will take him through some of the nation’s largest metropolitan areas, including New York City and Los Angeles.

He has been training for the bike ride for the last two years, and will be honoring his wife’s 20-year ovarian cancer survival anniversary with the fund-raising trip. Kay Broeder will follow her husband during the entire ride in a vehicle donated by Toyota of North America (Naperville, Chicago).

“Although my wife inspired me to train for and complete this ride, it’s really a way to honor all women who have suffered from ovarian cancer,” Broeder said. “I hope I can not only be an inspiration to others, but also bring a high level of awareness to the disease.”

Broeder hopes to raise $1 million for funding and research for ovarian cancer. All proceeds from his ride will be donated to the ACSM Foundation, in order to support scientific research in the field. Broeder is a 22-year member of ACSM.

Also sponsoring Broeder’s journey is Exercise is Medicine™, an ACSM program dedicated to make physical activity a standard part of health care. Exercise has powerful preventive and curative effects on chronic disease and conditions, and has been shown to lower risk of ovarian cancer by contributing to regulation of estrogen and hormones.

To view Broeder’s ride schedule and read more about his training, visit bicyclingforovariancancer. Broeder is director of the clinical exercise physiology program at Benedictine University in Naperville, Ill.

The American College of Sports Medicine is the largest sports medicine and exercise science organization in the world. More than 35,000 international, national, and regional members and certified professionals are dedicated to advancing and integrating scientific research to provide educational and practical applications of exercise science and sports medicine.

Source
American College of Sports Medicine

USA – TB Vaccine Trials – First in 60 Years

Contact: Anne A. Oplinger
aoplingerniaid.nih
301-402-1663
NIH/National Institute of Allergy and Infectious Diseases

A new vaccine, made with several proteins from the bacterium that causes tuberculosis (TB), will soon enter the first phase of human safety testing. The National Institute of Allergy and Infectious Diseases (NIAID), part of the National Institutes of Health, has supported research on the candidate vaccine from its earliest stages.

The trial will be conducted in the United States by Seattle biotechnology company Corixa and GlaxoSmithKline Biologicals, a vaccine manufacturer headquartered in Belgium.

‘This is the first recombinant tuberculosis vaccine to reach human trials in the United States,’ says NIAID Director Anthony S. Fauci, M.D.

‘Indeed, this is the first new TB vaccine to be tested in our country in more than 60 years. This candidate vaccine, as well as other novel products emerging from the TB research and development pipeline, offers hope for reducing the burden of a disease that claims approximately two million lives each year.’

The vaccine combines two TB proteins known to stimulate strong immune responses in humans. The proteins were initially identified by screening blood taken from volunteers who never became ill with tuberculosis despite long-term infection with Mycobacterium tuberculosis bacteria.

Using recombinant DNA technology, the TB proteins were fused and then combined with adjuvants, substances that further boost the immune system’s response to the vaccine. NIAID grants awarded in the late 1990s supported research that uncovered the most effective adjuvant-protein combination.

NIAID’s TB program officer, Christine Sizemore, Ph.D., notes, ‘This clinical trial is a wonderful example of advances made possible through sustained support and creative use of resources in NIAID’s TB program.’ NIAID initially funded Corixa scientists, under the direction of Steven Reed, Ph.D., in their identification of the most promising TB proteins for use in a vaccine.

Versions of the candidate vaccine were tested in animals through an NIAID contract facility at Colorado State University. In 2000, Corixa, with Dr. Reed as investigator, received an NIAID ‘challenge’ grant designed to enhance government-industry partnerships and to speed new product development.

This support allowed the researchers to further advance the most promising vaccine-adjuvant combinations into animal models, including non-human primates, and to prepare and produce a vaccine candidate suitable for human trials.

Finally, Dr. Reed and his team successfully competed for support through NIAID’s Millennium Vaccine Initiative. This ongoing work is enabling the scientists to refine adjuvant technologies and to develop better methods of vaccine delivery.

The Phase I trial will enroll 20 volunteers at a single site in the United States and will assess the vaccine’s safety. Researchers will examine blood from the volunteers to determine which dosage of vaccine promotes the greatest anti-TB immune response.

If the vaccine proves safe in this initial stage of testing, it will be further tested for evidence of efficacy in larger clinical trials.

The currently available TB vaccine, called BCG, offers some protection against the form of TB most often contracted by very young children. But the vaccine’s effectiveness wears off over time. Also, BCG is not very effective against pulmonary TB, the most contagious form of the disease.

NIAID is a component of the National Institutes of Health (NIH), which is an agency of the Department of Health and Human Services. NIAID supports basic and applied research to prevent, diagnose and treat infectious and immune-mediated illnesses, including HIV/AIDS and other sexually transmitted diseases, illness from potential agents of bioterrorism, tuberculosis, malaria, autoimmune disorders, asthma and allergies.

Press releases, fact sheets and other NIAID-related materials are available on the NIAID Web site at niaid.nih.

Conference On Fecal And Urinary Incontinence, Dec. 10-12

To many, incontinence is seen as a shameful secret rather than a treatable medical condition. Though treatments are available, developing prevention strategies and identifying risk factors has been challenging. The conference will explore what we know and what we need to learn about both fecal and urinary incontinence.

What

Experts will summarize the available evidence on prevention of fecal and urinary incontinence in adults December 10 – 12. Following a series of scientific presentations and open public discussions, an impartial, independent panel will issue a statement of its findings on the final day of the conference, and will hold a press conference at 2:00 p.m. on Wednesday, December 12. Convened by the Office of Medical Applications of Research (OMAR) and the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK) of the NIH, this conference is free and open to the public and the media.

The conference presentations, open discussions, and the panel’s statement will focus on these questions:

* What are the prevalence, incidence, and natural history of fecal and urinary incontinence in the community and long-term care settings”

* What is the burden of illness and impact of fecal and urinary incontinence on the individual and society”

* What are the risk factors for fecal and urinary incontinence”

* What can be done to prevent fecal and urinary incontinence”

* What are the strategies to improve the identification of persons at risk and patients who have fecal and urinary incontinence”

* What are the research priorities in reducing the burden of illness in these conditions”

When

Monday, December 10, 2007 – 8:30 am – 5:15 pm
Tuesday, December 11, 2007 – 8:30 am – 12:40 pm
Wednesday, December 12, 2007 – 9:00 am – 11:00 am
Press Conference: Wednesday, December 12, 2:00 p.m.

Where

Natcher Conference Center
NIH Main Campus – Building 45
9000 Rockville Pike
Bethesda, Maryland 20892

Campus visitor information: nih/about/visitor/index.htm

The conference will also be webcast live at videocast.nih/.

Why

Fecal and urinary incontinence – the inability to control bowel movements or urination, respectively – are conditions with ramifications that extend well beyond their physical manifestations. Many people find themselves withdrawing from their social lives and attempting to hide the problem from their families, friends, and even their doctors. The embarrassing nature of these conditions poses a significant barrier to seeking professional treatment, resulting in a large number of unreported, untreated individuals. Incontinence is more likely to affect the aging population, although it is not considered a normal consequence of aging. As baby boomers approach their 60s, the incidence and public health burden of incontinence are likely to increase.

Fecal incontinence affects up to 5 percent of the general population and up to 39 percent of nursing home residents. It affects people of all ages, but is more common in women and the elderly. Although urinary incontinence can affect people at all stages of life, it has been estimated that urinary incontinence affects 38 percent of women and 17 percent of men 60 years of age and older.

Because incontinence is likely widely underdiagnosed and underreported, it has been difficult to identify both at-risk and affected populations. Also, because the biological mechanisms that cause both fecal and urinary incontinence are not well understood, it has been difficult to develop robust prevention and management strategies. This conference was designed to facilitate an objective review of the available evidence to clarify what is known and what research gaps remain concerning the conference questions.

###

Background: The conference is presented through the NIH Consensus Development Program. A fact sheet describing the conference process is available at consensus.nih/forthemedia.htm.

For More Information: Conference agenda, speakers, logistics, and online registration are available at consensus.nih/.

The National Institutes of Health (NIH) – The Nation’s Medical Research Agency – includes 27 Institutes and Centers and is a component of the U.S. Department of Health and Human Services. It is the primary federal agency for conducting and supporting basic, clinical and translational medical research, and it investigates the causes, treatments, and cures for both common and rare diseases. For more information about NIH and its programs, visit nih/.

Source: Lisa Ahramjian

NIH/National Institutes of Health, Office of Disease Prevention

Scientists Create Stem Cells From Eggs Of Aging Mice

Researchers at NYU Langone Medical Center have created stem cells from the eggs of aging mice that could be used for reproductive purposes and regenerative medicine. The study, published in April issue of Aging Cell, found that even though the eggs from older females were slightly less efficient at making stem cells than those from younger females, the capacity to create stem cells was sustained.

“Using stem cells derived from older female mice eggs, we have produced new heart cells, brain cells and nerve cells,” says David Keefe, MD, chairman of the Department of Obstetrics and Gynecology at NYU Langone Medical Center. “If these findings are applied to humans, a woman could use her eggs to produce a child and then store other eggs to later create stem cells to be turned into cartilage, for example, for the treatment of arthritis, neural cells if she develops Parkinson’s disease and even heart cells to repair a damaged heart.”

Study authors say the technique described in the study could avoid most ethical and religious concerns about embryonic stem cells because only eggs, not embryos, would be used to create the stem cell lines. Stem cell lines created from eggs also carry the same immune markers as the eggs, which would eliminate the risk of rejection.

The study was funded by Carl B. and Florence E. King Foundation in Dallas, Texas.

About NYU Langone Medical Center

NYU Langone Medical Center is one of the nation’s premier centers of excellence in healthcare, biomedical research, and medical education. For over 168 years, NYU physicians and researchers have made countless contributions to the practice and science of health care. Today the Medical Center consists of NYU School of Medicine, including the Smilow Research Center, the Skirball Institute of Biomolecular Medicine, and the Sackler Institute of Graduate Biomedical Sciences; and the NYU Hospitals Center, including Tisch Hospital, a 705-bed acute-care general hospital, Rusk Institute of Rehabilitation Medicine, the first and largest facility of its kind, and NYU Hospital for Joint Diseases, a leader in musculoskeletal care, a Clinical Cancer Center and numerous ambulatory sites.

Source: New York University Langone Medical Center

American Academy Of Sleep Medicine Applauds NTSB’s Effort To Communicate The Importance Of Sleep To Air Traffic Controllers

The American Academy of Sleep Medicine (AASM) commends the National Transportation Safety Board’s (NTSB) recommendation for the Federal Aviation Administration (FAA) to strengthen air traffic controllers’ compliance with existing work hour regulations in an effort to prevent accidents and errors linked to fatigue and sleep deprivation.

According to the letter sent by NTSB, air traffic controllers report sleeping for an average of 6.5 hours prior to a day shift and 2.3 hours before a midnight shift. While sleep need is individual, these statistics are far below the average sleep time of 7 to 8 hours required by most adults to feel alert and well rested.

Also, the letter stated a majority of shifts for air traffic controllers change too fast and frequently to allow for adequate rest and that shifts start progressively earlier. The result of these factors is that controllers may experience sleep deprivation, which potentially contributes to an increase in errors and accidents.

Sleep deprivation is a common result of rotating shift work schedules especially when limited time off between shifts occurs during the evening hours when it is most difficult to sleep Excessive sleepiness can be caused by sleepiness or sleep disorders. While daytime sleepiness is the most common effect of sleep deprivation, data report that sleep loss can have severe effects on performance, including reduced alertness, poor memory and concentration, and slower reaction times.

Anyone who is struggling with severe daytime sleepiness or on-the-job alertness can find help by visiting a board-certified sleep specialist at an AASM-accredited sleep center. A searchable list of accredited sleep centers is available online at sleepcenters.

Statistics

– One in five adults report getting insufficient sleep.

– More than 20 million Americans perform shift work.

– Problems falling asleep or daytime sleepiness affect 35 percent to 40 percent of the population.

– Driver sleepiness is related to one in five serious car crash injuries.

– More than 50 million Americans suffer from a chronic sleep disorder.

aasmnet

American Academy Of Sleep Medicine Applauds NTSB’s Effort To Communicate The Importance Of Sleep To Air Traffic Controllers

The American Academy of Sleep Medicine (AASM) commends the National Transportation Safety Board’s (NTSB) recommendation for the Federal Aviation Administration (FAA) to strengthen air traffic controllers’ compliance with existing work hour regulations in an effort to prevent accidents and errors linked to fatigue and sleep deprivation.

According to the letter sent by NTSB, air traffic controllers report sleeping for an average of 6.5 hours prior to a day shift and 2.3 hours before a midnight shift. While sleep need is individual, these statistics are far below the average sleep time of 7 to 8 hours required by most adults to feel alert and well rested.

Also, the letter stated a majority of shifts for air traffic controllers change too fast and frequently to allow for adequate rest and that shifts start progressively earlier. The result of these factors is that controllers may experience sleep deprivation, which potentially contributes to an increase in errors and accidents.

Sleep deprivation is a common result of rotating shift work schedules especially when limited time off between shifts occurs during the evening hours when it is most difficult to sleep Excessive sleepiness can be caused by sleepiness or sleep disorders. While daytime sleepiness is the most common effect of sleep deprivation, data report that sleep loss can have severe effects on performance, including reduced alertness, poor memory and concentration, and slower reaction times.

Anyone who is struggling with severe daytime sleepiness or on-the-job alertness can find help by visiting a board-certified sleep specialist at an AASM-accredited sleep center. A searchable list of accredited sleep centers is available online at sleepcenters.

Statistics

– One in five adults report getting insufficient sleep.

– More than 20 million Americans perform shift work.

– Problems falling asleep or daytime sleepiness affect 35 percent to 40 percent of the population.

– Driver sleepiness is related to one in five serious car crash injuries.

– More than 50 million Americans suffer from a chronic sleep disorder.

aasmnet

Research Highlights Need For Smoke-Free Car Laws, Public Health Campaigns To Protect Youngsters From Toxins

It is absolutely unacceptable to subject children to any tobacco smoke exposure in cars, according to the authors of an abstract to be presented Sunday, May 1, at the Pediatric Academic Societies (PAS) annual meeting in Denver.

“An infant strapped into a car seat is involuntarily and intensely exposed to more than 400 toxic chemicals in tobacco smoke,” said abstract co-author Jonathan P. Winickoff, MD, MPH, FAAP. “They have no voice and no choice in whether their parents smoke in the car.”

Dr. Winickoff and his colleagues conducted the analyses to determine the prevalence of tobacco smoke exposure in cars among children and to examine factors associated with parents strictly enforcing a ban on smoking in their cars.

Parents were invited to participate in a survey after their children had been seen for a well or sick visit at one of seven pediatric practices in six states. Parents who smoked were asked if they had a car, whether they had smoking rules in their car, their child’s age and if their pediatrician advised them to have a smoke-free car. Parents were considered to have a strictly enforced car smoking ban if they reported having a smoke-free car rule and that no one had smoked in their car for the past three months.

The results are based on a Pediatric Research in Office Settings (PROS) trial called the Clinical Effort Against Secondhand Smoke Exposure (CEASE), which addressed parental smoking. PROS is a network of pediatric primary care practices established by the American Academy of Pediatrics (AAP) to conduct research on child health problems.

Results showed that 146 of 528 parents who smoked (28 percent) reported having a smoke-free car rule, and 114 (22 percent) reported having a strictly enforced car smoking ban. Factors associated with having a smoking ban included having a younger child and smoking fewer cigarettes per day.

Of the parents who reported smoking in their car, 52 percent said smoking occurred with children present. Only 14 percent of parents said they were advised by a pediatric health care provider to have a smoke-free car.

“Because they have smaller air passages than adults, infants and children are more sensitive to chemicals in tobacco smoke and suffer increased asthma attacks and severe respiratory infections,” said Dr. Winickoff, CEASE principal investigator and associate professor of pediatrics at MassGeneral Hospital for Children.

“Coupled with the finding that few pediatric health care providers advise against smoking in cars, these results highlight the need for improved pediatric interventions, public health campaigns and health policy regarding smoke-free car laws to protect children from tobacco smoke toxins,” he said. “Setting strict rules about never smoking in cars will benefit the whole family and help reduce tobacco use nationally.”

Other abstracts based on the CEASE data presented on Saturday, April 30, during the PAS meeting include:

“Are Strictly Enforced Smoke-free Home and Car Rules Associated with Parent Quit Attempts?” A strictly enforced no-smoking policy in the home and car was associated with recent quit attempts by parents who smoked. “This research suggests that completely protecting children from tobacco smoke in the home and car may also help parents quit smoking,” said lead author Stacia Finch.

“What Factors Are Associated with Smoke-free Homes Among Smoking Parents?” Parents were more likely to report having a smoke-free home if they had a child younger than 10 years old; fewer than three smokers lived in the home; and if parents banned smoking in the car.

“Parent/Smoker Identity Conflict and Readiness to Quit.” Parents who agreed with the statement, “My being a smoker gets in the way of my being a parent,” were considered to have identity conflict and were more likely to be seriously planning to quit smoking than those who disagreed with the statement. “Interventions that increase identity conflict among parents who smoke might increase their readiness to quit smoking,” Dr. Winickoff said.

Source:
Susan Martin
American Academy of Pediatrics

Specialized Exercise Regimen At UB Shown To Relieve Prolonged Concussion Symptoms

University at Buffalo researchers are the first to show that a controlled individualized exercise training program can bring athletes and others suffering with post-concussion syndrome (PCS) back to the playing field or to their daily activities.

In a paper published in the January issue of the Clinical Journal of Sport Medicine, the researchers report that a program of progressive exercise developed individually for each participant and performed at levels just below the onset of symptoms is safe and can relieve nearly all PCS symptoms.

Their results counter the accepted wisdom that PCS should be treated with rest, reassurance and antidepressants, and that physical activity should be avoided.

“Perhaps the most exciting aspect of this study is that all of the subjects that participated, both athletes and non-athletes, got better eventually, although the athletes certainly improved the fastest,” says Barry Willer, PhD, UB professor of psychiatry and rehabilitation sciences and senior author on the study.

“It also was reassuring to discover that the use of exercise was safe and did not prolong symptoms, a worry expressed by other practitioners.”

John J. Leddy, MD, associate professor of orthopaedics and co-director of UB’s Sports Medicine Institute, where the study was conducted, is first author on the study. Willer, Leddy and Karl Kozlowski, PhD, UB clinical instructor of exercise and nutrition sciences, developed the exercise protocol. (To view a slide show about a patient who participated in the UB program, go to youtube/watch?v=pUEmfnIIhwM.)

For unknown reasons, 5-10 percent of people who experience a concussion have symptoms that persist beyond six weeks. These persons are diagnosed with PCS. Previously there was no treatment for the condition with proven success.

The UB regimen is based on the hypothesis that the regulatory system responsible for maintaining cerebral blood flow, which may be dysfunctional in people with a concussion, can be restored to normal by controlled, graded, symptom-free exercise.

The researchers developed their program in 2004. “We were testing athletes for return to sport using an exercise test,” says Willer, “and we decided that if an athlete becomes symptomatic at a heart rate of, say, 140, maybe they could exercise at a heart rate of 125, without complications. We soon discovered that the athletes got better much quicker if they exercised.”

Physicians in UB’s Sports Medicine Concussion Clinic initially used their approach only with athletes from UB teams, but word spread, and they now have assessed and treated many professional athletes, especially those from the National Hockey League.

“One of the advantages we offer to professional teams is a more precise test of post-concussion syndrome,” says Leddy. “If the patient does not develop symptoms during the exercise test, then the cause of their difficulties is likely to be another source. Most commonly it is neck strain, which tends to cause headaches that mimic post-concussion headache.”

For the preliminary study just published, the researchers enrolled six non-athletes who suffered concussions in auto accidents or falls, along with six athletes, five who were injured in their sport and one in a car accident.

Participants were tested initially on a treadmill to determine the exercise intensity that triggered symptoms. With individual baselines established, each participant exercised at 80 percent of that intensity every day for three weeks and then returned for a repeat test. In most instances, retesting demonstrated that participants could work at a higher intensity and the exercise protocol then was increased. This pattern continued until participants could exercise completely without experiencing PCS symptoms.

As might be expected, the athletes recovered more quickly than the non-athletes, results showed. They returned to normal within 11 to 36 days, while the non-athletes required 41 to 112 days of intervention. All participants had returned to work, school or athletic activities at a three month post-program follow-up.

Ten of the 12 participants were completely free of symptoms at follow-up. One participant still experienced cognitive and visual symptoms, and another, who had a history of migraines, continued to experience headaches.

“The data suggest that some PCS symptoms are related to disturbed cerebral autoregulation, and that after this treatment, the brain was able to regulate blood flow when the blood pressure rose during exercise,” says Leddy. “We think progressive stepwise aerobic training may improve cerebral autoregulation by conditioning the brain to gradually adapt to repetitive mild elevations of systolic blood pressure.”

Kozlowski adds that although each concussion should be considered a “unique injury,” a randomized trial that included a PCS control group should be conducted to address the possibility that PCS symptoms would have resolved spontaneously without intervention.

“All of our subjects had been symptomatic for months before treatment and were not getting better on their own,” says Kozlowski, “so we are pretty convinced that the regulated exercise program did the trick.” A grant application to NIH to conduct such a randomized trial currently is under review.

James P. Donnelly, PhD, from the UB Department of Counseling, School and Educational Psychology; David R. Pendergast, EdD, UB professor of physiology and biophysics; and Leonard H. Epstein, PhD, UB professor of pediatrics, also contributed to the study.

The study received financial support from the Buffalo Sabres Foundation and the Robert Rich Family Foundation.

Source: Lois Baker

University at Buffalo