IU investigates “subconcussions” to ensure safety and fun in youth sports: IU News
Indiana University is a leader in neuroscience research and could identify new ways to protect young athletes from the risks of repeated small blows to the head.
Kei Kawata, an IU research scientist and former professional sports coach, is leading the nation’s largest study of subconcussive impacts in high school football players.
“We didn’t previously know anything about head impacts in American football because there was no research,” says Kawata, a clinical neuroscientist and associate professor at the IU School of Public Health-Bloomington. “We now know a lot – there are accepted protocols for assessment and recovery – but we still don’t know much about smaller, repeated impacts in younger players.”
As a former athletic trainer for the Detroit Lions and Sporting Kansas City, Kawata is an expert in sports performance and safety. As a former high school football player whose son now plays football, he also knows the passion and skills that team sports inspire in young people.
“If you go to a high school as a diehard neuroscientist and ask the coaches to sign up their students for a research study, they’re going to say no,” Kawata said. “But my experience as a sports medicine coach gives me street cred.”
“I’m not here to demonize football.”
Since 2019, Kawata has been studying high school football players across Indiana with a $3 million grant from the National Institutes of Health. Indiana schools involved in the study include Bloomington North and Bloomington South high schools, Edgewood High School, Bedford North Lawrence High School and Mooresville High School.
Kawata wants to do more than just measure the risks. He also wants to understand how to protect players. The goal is to collect enough data to influence safety and recovery protocols for subconcussions in young players, similar to those that exist for concussions. (A significant portion of that concussion data also comes from IU through its role as co-leader of the CARE Consortium, the world’s largest longitudinal concussion study funded by the Department of Defense and the NCAA.)
“This holistic perspective is very rare,” Kawata said of his research. “You almost never see all three of these issues – risk, protection, and mitigation and recovery – being studied in the same laboratory.”
The study of high school football players focuses on quantifying risk, measuring the cumulative effect of subconcussive head impacts to understand when a player’s exposure has become too great. The work uses advanced mouthguard technology with built-in sensors to collect data on each impact the players face. Graduate students from Kawata’s lab are leading data collection and coordination efforts at each of the schools studied, including communication with players, coaches and parents.
As part of his risk reduction work, Kawata is leading another study on head impacts in football, also funded by the NIH for $3 million, and is co-leading a separate $6 million inter-institutional grant funded by the Department of Defense.
The first study focuses on the protective effect of omega-3 fatty acids. The role of IU in the other study focuses on the protective effect of increasing the time intervals between exercises.
For the study on omega-3 fatty acids, Kawata and his colleagues divided participants into two groups: an experimental group that receives the supplements and a control group that does not. Both groups are then asked to head the ball repeatedly, similar to a standard drill. Afterward, they take part in cognitive tests such as memory tests and physical measurements such as blood tests or brain scans. Although the effects are imperceptible to the players, they are enough to be visible in blood biomarkers and MRIs.
For the time interval study, Kawata conducts similar tests and measurements, but varies the time between participants’ impacts.
Participants in both studies include volunteers from football teams and clubs in Indiana and neighboring states. The brain scans will be performed by Kawata’s team members, including graduate students who are all certified MRI technicians.
“We are the only laboratory in the country set up to do this type of study,” Kawata said. “There are others who have studied fish oils in athletes during a sports season, but we are the only ones who can do all this in a very tightly controlled environment.”
Kawata is also leading a series of studies on other factors that might reduce the risk of subconcussive head impacts, including ADHD status, cannabis use and hormone levels during menstruation. Early results suggest that players with ADHD may be at increased risk, require fewer hits to experience more severe side effects and that cannabis may reduce the risks. The study on hormone levels, conducted with participants on the IU women’s water polo team, suggests that risk levels vary depending on fluctuations in hormone levels.
To envision the future of high-impact sports, Kawata considers the idea of a “pitch count” in baseball—the total number of pitches a player is allowed to make in a game.
“In baseball, a player can throw 100 pitches and then he’s out, no matter how he feels,” he said. “But in football, there’s literally no limit to how many hits a player can take. When we start to know the ceiling effect — when we know from blood biomarkers, for example, that a player experiences adverse effects after a certain number of hits — then that’s good because you can start to adjust training drills to reduce the burden of new hits.”
In football, for example, a coach could replace live tackling with less strenuous exercises.
“There are many, many factors that affect brain resilience,” Kawata said. “But first we need the data to distinguish risk factors from protective factors. Only then can sports federations take the best measures to protect each player.”
