Approximately 3.8 million cases of traumatic brain injury are reported in the United States each year, most of which are concussions.
According to new research led by Portland University, an entirely new approach to understanding the complexities of concussion, and how to treat it, will become the criterion. The researchers favor systems science, a discipline that analyzes complex problems, as whole systems, and integrates research findings from different disciplines.
“Complex systems are those in which the behavior of the whole is not entirely explained by the behavior of its parts,” said Erin Kenzie, systems science researcher at Portland State. “Traumatic brain injury, or TBI, is very complex. It’s been called the most complicated disease of the most complex organ of the body.”
Kenzie went on to explain that concussion is a mild form of traumatic brain injury. Traditional methods of studying the disease are key to understanding small pieces of the puzzle. But to understand why some individuals recover quickly from concussion and other do not, requires a look into the big picture.
Over the past ten years system science has been used to understand cardiovascular disease, drug abuse, depression and obesity.
According to Kenzie, a main challenge in studying concussion is that there is no single definition that is cooperatively accepted in the scientific community. Disagreement and uncertainty exist about the diagnosis, evaluation, measurement and classification of TBI.
“Every clinical trial for TBI treatment to date has failed to demonstrate reliable and safe improvement in outcomes,” Kenzie said. “Systems science models can be used to develop new ways of classifying TBI, which is critical for designing better studies.”
A National Public Radio poll showed that one in four Americans report having received a concussion sometime in their lives. It is estimated that as many as 43% of concussion patients experienced prolonged physical, cognitive or emotional issues lasting longer than 3 months – a condition referred to as post concussive syndrome (PCS). A recent study showed that only 27% of PCS sufferers made a complete recovery at 3 months post-injury.
The reasons some individuals recover quickly while others do not are still not clear. Factors to be considered include genetics, health status, biomechanics and environmental factors. Additionally, the mode of injury, clinical features, and patient experience are often divergent. The motivation for the project stems from these varied trajectories.
Kenzie’s team was comprised of researchers from Oregon Health and Science University, Veterans Affairs Portland Health Care System and Brigham Young University. Their study was published in Frontiers on Neurology on Sept. 28, 2017.
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