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Dr. Bretzin presenting an information session.

Detroit Public School Community District Athletic Symposium: Safeguarding Tomorrow’s Athletes

Dr. Abigail Bretzin and Ms. Michaela Broadnax represented the U-M Concussion Center at the Detroit Public School Community District’s (DPSCD) Athletic Symposium in [month]. This event saw the participation of approximately 180 coaches from the district, who gathered to deepen their understanding of best practices and techniques to ensure the safety and well-being of student-athletes. “The symposium was a great opportunity to meet with the leaders of DPSCD, and interact with the coaches and athletic coordinators of each school,” said Dr. Bretzin, “the structure of the overall symposium went very well and allowed each participant to contribute to the discussion regarding concussion recognition and management.”

The Concussion Center’s growing partnership with DPSCD started in the Spring of 2020 where a joint grant application on concussion was submitted. A comprehensive Concussion Toolkit was later launched in the spring of 2022, designed to assist the district’s coaches, students, parents and administrators with concussion management by providing educational materials and resources tailored to the district’s requirements.

The concussion-related information disseminated during this year’s Athletic Symposium relayed the most relevant information to coaches who often play a pivotal role in identifying early signs and symptoms of concussions.  The primary objective for the symposium was to foster a dialogue, emphasizing the intricacies of concussions – the physiological changes they trigger in the brain and the inherent risks of overlooking or trivializing the injury. “The coaches were great at keeping the conversation going,” Broadnax shared, “I was able to learn from their day-to-day experiences with their student-athletes and how they combat head injuries during practices and games. They are an amazing group of people, and our team looks forward to future opportunities to engage with DPSCD coaches, athletes, and administrators.”

“I  am so thankful to the University of Michigan Concussion Center for their continued partnership with DPSCD athletics. With their help, our coaches and staff are better equipped to help our student-athletes if they experience a concussion from start to finish.  In addition, they have given us a roadmap to better recognize, understand, care, provide, and how to get follow-up care regarding concussions”

Jay Alexander, Executive Director of DPSCD Office of Athletics

Over 120 coaches were in attendance at the Detroit Public Schools Community District-wide athletic coaches and administrator’s symposium.  “It was a great opportunity to have Michigan Concussion Center teaching classroom sessions.  Our coaches raved about what they learned and how to provide care for our student-athletes”, said Alexander.

Ongoing education and open dialogue are important in ensuring the safety of our young athletes. The partnership between the U-M Concussion Center and DPSCD not only signifies a step forward in concussion awareness but also underscores the collective commitment of educators, coaches, and healthcare professionals to the well-being of student-athletes. As we continue to arm those on the front line with the knowledge and resources needed, we remain hopeful for a future where student-athletes can pursue their passions with minimized risks and maximized support. 

Learn more:

A landmark development in concussion management, the most recent iteration of the Sport Concussion Assessment Tool, known as SCAT6, has been published in the British Journal of Sports Medicine. The SCAT6 is a thoroughly researched, standardized, and evidence-based tool used in the assessment and management of concussions in athletes. A team of international experts in the field of sports medicine, including the Concussion Center Director Dr. Steven Broglio, meticulously selected the components of the SCAT6 based on a review of the medical literature that included more than 420 published papers.

“It was an honor to contribute to the Concussion in Sport Group (CISG) that developed the SCAT6. The team’s focus was crystal clear –  ‘What are the best tools available to protect the health and well-being of active individuals?”

Steve Broglio, PhD, Director, U-M Concussion Center

Reflecting on his involvement, Dr. Broglio noted, “It was an honor to contribute to the Concussion in Sport Group (CISG) that developed the SCAT6. The team’s focus was crystal clear –  ‘What are the best tools available to protect the health and well-being of active individuals?’” The importance of timely identification and management of concussions for athletes’ safety and welfare cannot be overstated, and the SCAT is a widely acknowledged tool utilized by healthcare professionals to evaluate and monitor athletes who may have suffered a concussion. The SCAT6 is best used within the first 72 hours of a suspected injury and provides a structured approach to assessing concussions by evaluating a range of features commonly associated with concussion.

The U-M Concussion Center recently hosted Dr. Ruben Echemendia, lead author of the SCAT6, Director of the National Hockey League’s Neuropsychological Testing Program, and Co-Chair of the NHL/NHLPA Concussion Subcommittee, to discuss the process and method supporting the design of the new SCAT6 tool. In Dr. Echemendia’s presentation, he noted: “We (CISG) wanted a very structured format that had transparency, with a clinically applicable outcome. It’s a true approach towards translational knowledge and getting the information out there.”

The SCAT6 consists of several components, including a screening for injuries more severe than a concussion, a symptom evaluation, a cognitive assessment, and a coordination and balance examination. One of the significant benefits of SCAT6 is its standardized approach to concussion assessment. It enhances the accuracy and reliability of concussion evaluations, leading to more informed decision-making regarding an athlete’s health status. Moreover, the SCAT6 facilitates communication among healthcare professionals, coaches, and athletes.

“We wanted a very structured format that had transparency, with a clinically applicable outcome. It’s a true approach towards translational knowledge and getting the information out there.”

Ruben Echemendia, PhD, Lead Author of SCAT6

By adopting a common language and assessment tools, different stakeholders involved in an athlete’s care can effectively exchange information and collaborate on appropriate management strategies. This interdisciplinary approach helps ensure the athlete’s well-being and minimizes the risk of further injury.

While the SCAT6 is one part of the comprehensive evaluation process for concussions, it should be used in conjunction with a thorough medical evaluation performed by a healthcare professional. The launch of SCAT6 is a testament to the collaborative efforts of the international community ensuring athlete safety, providing that strides are being made towards better understanding and management of concussion in sports. 

Interested in hearing more from the co-authors of the SCAT6 Tool:

We are thrilled to share an important milestone in sports medicine – the latest release of the international Concussion in Sport Group (CISG) consensus statement on the management of sports concussions, hot off the press from the British Journal of Sports Medicine as of June 15, 2023.

The statements are published once every four years and lay the foundation for concussion management worldwide. This 2023 release marks the sixth statement the group has published since 2001. Each release represents our advanced understanding and management of sport-related concussions, safeguarding the health and safety of athletes worldwide. 

The CISG document distills the current scientific knowledge, research findings, clinical experience, and consensus among professionals working across a variety of settings. It provides a platform for ongoing dialogue and research. Concussion Center Director, Dr. Steven Broglio, had the privilege of co-authoring this statement. He observed, “It has been great to see the continual evolution of guidelines as our understanding of concussion grows. This consensus statement is the culmination of ten systematic reviews that screened over 78,000 citations and completed nearly 1500 full-text reviews. To be one of the 28 researchers and medical providers convening, deliberating, and ultimately deciding on the best recommendations to put forward was an honor.” Concussion Center members contributed to three of the ten systematic reviews.

Dr. Steve Broglio at the 6th International Consensus Conference on Concussion in Sport, October 2022

This statement serves as a pivotal document, providing guidelines and recommendations for the recognition, assessment, and management of concussions in sports. With a focus on evidence-based practices and a multidisciplinary approach to medical care, the CISG has successfully sketched a blueprint for a more harmonized understanding and consistent protocols across the sporting community. At the heart of this consensus statement lies a commitment to the safety and well-being of athletes. It provides clear guidelines on the removal and evaluation of athletes suspected of having a concussion, as well as structured and gradual return-to-learn and return-to-play protocols.

“To be one of the 28 researchers and medical providers convening, deliberating, and ultimately deciding on the best recommendations to put forward was an honor.”

Steve Broglio, PhD, U-M Concussion Center Director

The document serves as a valuable resource for healthcare professionals to access the best available evidence-based practices in the field of concussion management. It provides guidelines ensuring athletes are allowed the necessary time to recover fully, minimizing the risk of repeated injury. By bringing together different perspectives and expertise, the consensus statement contributes to the advancement of knowledge, identification of gaps, and the development of future research initiatives aimed at protecting the health and well-being of athletes across various disciplines.

Interested in hearing more from the co-authors of the CISG Consensus Statement:

The Concussion Center is proud to support Dr. Andy Hashikawa’s Pop-up Safety Town initiative, providing age-focused injury prevention resources to Michigan’s underserved communities.

Introduction to Pop-up Safety Town

Pop-Up Safety Town, a unique program dedicated to pediatric injury prevention education supported by AAA and the Auto Club Group Foundation, caters to young children and their families. In the 2022-2023 school year, Dr. Hashikawa led a multitude of successful events across the state. Locations included the Marygrove Conservancy in the Detroit Public School Community District, Cummings Head Start Center in Flint, Genesee Intermediate School District (GISD), Jackson, Ypsilanti, Addison, and Whitmore Lake. Our shared mission saw us fit over 600 helmets, a step towards our goal of extending our reach to more underserved communities. 

Dr. Hashikawa’s dedication to this cause is evident. He is already actively liaising with other districts, with a special focus on rural and tribal communities in dire need of these resources. In addition, we are working with student organizations, such as Medical Arabic at the University of Michigan, in organizing more events in Hamtramck, a region rich with a multicultural population with immigrant backgrounds. 

As we look to the future, Dr. Hashikawa aspires to broaden our approach to include children aged five and older, an idea informed by valuable feedback from administrators and families alike. To connect with Head Start centers and schools beyond our driving radius, including reaching the Native American Tribal Head Start programs in Michigan,  a “Safety Curriculum in a Box” program will be launched next year. This innovative concept involves creating four comprehensive lesson plans for teachers, complete with a dedicated website for orientation, handouts for parents, and a box filled with props to enrich each lesson. A series of educational videos have been developed covering crucial topics like helmet safety, pedestrian safety, medication safety, and dog bite prevention. Additional demonstration videos are planned for the coming year to enhance the core curriculum.

“This comprehensive approach sets us apart from other organizations in the field, making the U-M Concussion Center a leader in not only understanding concussions but also actively working towards preventing them.”

Andrew Hashikawa, MD, Clinical Professor, Emergency Medicine

As we reflect on the accomplishments in the past year, we remain cognizant that our mission to maximize societal impact is far from over. With every helmet fitted, every lesson given, and every community reached, we’ve seen the transformative power of early education in the sphere of injury prevention. “To ensure children have access, we offer free helmets and educate families on proper helmet-fitting techniques,” said Dr. Hashikawa, “By reaching out to preschool children and elementary students, our aim is to instill good safety habits from an early age, empowering families with knowledge that can help prevent head injuries. This comprehensive approach sets us apart from other organizations in the field, making the U-M Concussion Center a leader in not only understanding concussions but also actively working towards preventing them.”

The next Pop-up Safety Town event will be held on Friday, August 25th, 10:00AM – 1:00PM at the Beatty Early Learning Center (1661 Leforge Rd., Ypsilanti, MI 48198). Interested in learning more and lending a hand? Sign up HERE or Email: pop.up.safetytown@umich.edu.

Due to the nature of their sports, parasport athletes may be exposed to an increased risk of concussions. To support a better understanding of concussion risk and short and long-term outcomes in Paralympic athletes, the Concussion Center, along with the Exercise and Sport Science Initiative from the University of Michigan, is proud to announce a partnership with the United States Olympic and Paralympic Committee (USPOC).

Some parasports, such as wheelchair rugby, wheelchair basketball, and adaptive skiing, involve physical contact and the potential for collisions.  Factors such as the speed of play, physical contact, and equipment used can contribute to the likelihood of concussions. It is of utmost importance to promptly identify and appropriately manage concussions in parasport athletes, considering the injury’s potential short-term and long-term health impacts.  

Concussion evaluation and management for parasport athletes carry unique challenges. Not all athletes can undergo balance testing, and symptom reporting may vary from ablebodied athletes depending on the physical disability. Dr. Geoff Burns, the lead physiologist for the USOPC and Team USA, shared his enthusiasm about this new collaboration, stating, “We are excited to partner with the U-M Concussion Center. They bring tremendous knowledge and a clear mission that aligns with the needs of our international athletes”.

Initial research efforts will be centered around understanding the risk for concussion across several sports and levels of impairment and the biomechanical risk factors for concussion in combat and sliding sports. Plans for more long-term projects are still in the pipeline. Concussion Center director, Dr. Steven Broglio, expressed his eagerness, “The Olympics represent the pinnacle of athletic competition, and we are excited to offer our help and support to the para-athlete community. We have so much to learn about this group, I am confident we can have a positive impact quickly.”

“We are excited to partner with the U-M Concussion Center. They bring tremendous knowledge and a clear mission that aligns with the needs of our international athletes.”

Geoff Burns, PhD, Lead Physiologist for USOPC and Team USA

Dr. Kanagaraj Palsamy, fondly known as Kanagu, is no ordinary researcher. Currently a Research Investigator in the Department of Neurology at Michigan Medicine, he has been an integral part of the University of Michigan community since 2015. His journey began in Dr. Jack Parent’s laboratory as a post-doctoral research fellow, where he delved into the intricacies of brain injury, neuroinflammation, brain regeneration, and epilepsy disease modeling using a seemingly humble organism: the zebrafish. Kanagu has been working with zebrafish for 12 years and utilizing this remarkable animal for biomedical research to improve human life. Dr. Parent’s earlier work on epilepsy-induced aberrant neurogenesis in rats paved the way for adult neurogenesis in the mammalian brain.

Dr. Palsamy’s fascination with zebrafish as a preclinical research model started during his doctoral studies at Goettingen University in Germany. Leveraging his developmental biology training and skills acquired during his Master’s degree, he chose zebrafish for their unique breeding attributes that made them an excellent model for studying the central nervous system. Zebrafish shares 70% genetic homology with human and has almost all mammalian anatomical counterparts. Most importantly, they are amenable to pharmaceutical and genetic manipulations and suitable for live imaging with transgenic fish lines to monitor the development and physiological changes and suitable for robust drug screening for cures.

His first research focus was early development, particularly influenced by “maternal genetic mutations.” By inducing mutations in zebrafish mothers and mating them with normal/wild-type males, he could study the impacts on embryonic development. During his PhD, his mentor discovered several genetic mutants linked to early development and neurodegenerative disease in zebrafish. Interestingly, these observable characteristics are named with culinary terms, specifically, around eggs due to their severe defect in egg development during oogenesis. They are sunny side up, over-easy, ruehrei (German: scrambled eggs), and souffle/SPG15. Kanagu studied the souffle phenotype in zebrafish to understand the human disease, which shed light on how SPG15 mutation manifests early developmental defects and how, in humans, it induces progressive motor neuron degenerative disease called Hereditary Spastic Paraplegia (HSP). 

The zebrafish’s transparency, especially during the embryonic phase, made it possible to observe live developments without causing harm to the creatures (See more: NIHCD Zebrafish Development). Moreover, the prolific breeding of zebrafish – one female can produce around 300 embryos weekly – provided ample subjects for in vivo research,  the embryo develops outside and completes the whole animal development in 48 hours. In addition, zebrafish have a phenomenal capability to regenerate almost every part of their brain after injury (Kanagaraj et al., 2022 Biorxiv https://doi.org/10.1101/2020.10.08.330662).

Youtube: WIRED Science, “Zebrafish Brain”

Ultimately, Dr. Palsamy aims to translate his preclinical findings from zebrafish research into practical solutions to promote human brain repair. Kanagu focuses on immune cells’ reaction and role in promoting brain repair after injury. Intrigued by the field of concussion research, Kanagu contemplated the similarities and differences between zebrafish and humans when it comes to concussion symptoms and responses. By carefully administering controlled needle-induced brain injuries or non-penetrating forces to induce concussions in zebrafish brains, these experiments will contribute to a deeper understanding of concussions and their impact on zebrafish, potentially paving the way for future collaboration with Concussion Center members. He wants to study how zebrafish repair their brain when subjected to TBI using the weight drop method and how repeated TBI/concussion in their early life period will affect their regenerative ability and cognitive behaviors. 

When he is not conducting research or writing grant applications, Dr. Palsamy leads an active life. A sports enthusiast, he has participated in the cricket national league in Germany, enjoys badminton, and has a passion for dance. He is also a food connoisseur and can recommend some excellent places for authentic Indian food in Ann Arbor, such as Everest Sherpa and Shalimar on Main Street.

Marco Savone, former collegiate football player and now Clinical Research Coordinator at Michigan Medicine’s Oncology Clinical Trial Support Unit (O-CTSU), is paving his path to make a difference in the world of medicine and athlete safety. Marco has a personal interest in understanding research efforts devoted to athlete safety and long-term neurological outcomes. 

“Having started football in the 7th grade, the sport became a passion for me,” Marco recalls. “It instilled in me values of teamwork and leadership, but it also introduced me to the fear -the fear of the long-term impacts of concussions, due to the limited information available at the time.”

Marco Savone, Linebacker of Kalamazoo College Hornets (2018-2021)

During his time with Kalamazoo College Hornets, Marco sought clinical opportunities fueled by his inherent interest in medicine. His first encounter with neurodegenerative diseases was as a home health aide, caring for patients suffering from conditions like dementia, Alzheimer’s, and Parkinson’s disease. The stories of these patients intrigued him. His curiosity took him to Costa Rica, where he volunteered his medical skills and passion for helping a similar patient population on a global scale. 

Marco Savone in Costa Rica as a medical volunteer

Currently working with the Rogel Cancer Center, Marco finds satisfaction in interacting with his research patients participating in Phase 1 oncology clinical trials. A few months ago, a news story featuring Jarrett Irons, a member of the Concussion Center’s Advisory Board and former Michigan Football captain, caught his attention.  Jarrett’s candid account of his experiences and support for the Concussion Center inspired Marco to become a member. “Much like Jarrett, I aim to equip the younger generation with the knowledge to play football safely, without the fear I had due to the limited understanding of evidence-based research addressing the long-term effects of concussion,” Marco shared. 

In Southeast Michigan, his hometown, Marco extends his medical knowledge to the ringside of professional MMA and Boxing matches, attending to fighters who sustain injuries, including concussions. Looking ahead, his ambition is to apply to medical school, aspiring to become a physician who can make a significant difference in the field of athlete safety and beyond. 

“I aim to equip the younger generation with the knowledge to play football safely, without the fear I had due to the limited understanding of evidence-based research addressing the long-term effects of concussion.”

Marco Savone, BS, Clincial Research Coordinator, Rogel Cancer Center

Jasmine Morigney is a Clinical Psychology PhD student at Eastern Michigan University, just a few miles from the University of Michigan’s Ann Arbor campus, where she obtained her undergraduate degree in biopsychology, cognition, and neuroscience. As an undergraduate research assistant with U-M’s School of Public Health, Jasmine had the opportunity to work with students and student-athletes. She became deeply intrigued by the varying ways mental health impacts collegiate athletes, particularly after sustaining injuries such as concussions. 

In the past year, through her clinical practicum, Jasmine worked with faculty and clinicians at the University of Michigan’s Brain Injury Rehabilitation Program, directed by Dr. Katharine Seagly, a rehabilitation neuropsychologist and Clinical Associate Professor with the Department of Physical Medicine and Rehabilitation at Michigan Medicine. The program aims to support recovery for all persons with traumatic brain injury (TBI) through evidence-based, time-limited holistic programming and services. One key focus area of this program is concussion recovery, which has proven to be invaluable for patients experiencing prolonged symptoms after concussion. “Our concussion program really focuses on providing patients with the evidence-based education and tools needed to get back to living life in a meaningful way, even if there is still some symptom experience,” said Dr. Seagly, “paradoxically, when we are busy living life and feel confident in our ability to manage symptoms, we don’t focus as much on symptoms which in turn helps decrease symptom severity and frequency.”

“Our concussion program really focuses on providing patients with the evidence-based education and tools needed to get back to living life in a meaningful way, even if there is still some symptom experience.”

Katharine Seagly, PhD, Clinical Associate Professor, Department of Physical Medicine & Rehabilitation

Jasmine’s practicum work involved exploring how a rehabilitation neuropsychology approach through the Concussion Recovery Group could help alleviate symptoms following concussion that may impact daily functioning or induce distress. The range of symptoms measured included anxiety, headache, sensitivity to loud noise, blurry/double vision, depression, trouble thinking, irritability, tiredness, sensitivity to bright light, difficulty remembering, difficulty concentrating, and dizziness. 

The Concussion Recovery Group is a six-session workshop built on evidence-based methodologies with an emphasis on patient values, patient-specific goals, and optimizing functional outcomes.  The group is led by a clinical social worker, Rebecca Squires, or a clinical neuropsychology postdoctoral fellow, supervised by Dr. Seagly. Since 2020, a virtual format has been offered to patients, which has increased accessibility. “The feedback I receive from patients is that the group model is helpful to them in two ways – consulting with others who are also recovering from concussion, and gaining interventions and tools for skill-building and re-engagement in life,” said Becca, “patient participants appreciate hearing from other individuals who have experienced similar circumstances around their symptom experience, and that provides motivation to practice and engage with the tools and interventions taught during group – including sleep optimization, pacing, mindfulness, emotional awareness, managing unhelpful thoughts and behaviors, and value-based goal setting.” 

Jasmine Morigney presenting at the 2023 Sports Neuropsychology Society, Annual Concussion Symposium, Denver, CO.
Jasmine Morigney presenting at the 2023 Sports Neuropsychology Society, Annual Concussion Symposium, Denver, CO.

Ms. Morigney’s practicum experience has turned into a scientific presentation at the 2023 Sports Neuropsychology Society Annual Concussion Symposium in Denver, Colorado. “Concussion patients often come in scared with a lot of unknowns,” said Jasmine, “and we can focus on ‘what now’ and what’s meaningful for the patients, give them an option for recovery.” 

Interested in learning more about the Concussion Recovery Group or the Brain Injury Rehabilitation Program? Reach out to Dr. Katharine Seagly at kseagly@med.umich.edu or Becca Squires at rcommiss@med.umich.edu.

“Concussion patients often come in scared with a lot of unknowns, and we can focus on ‘what now’ and what’s meaningful for the patients, give them an option for recovery.”

Jasmine Morigney, PhD Student

On May 18, 2023, the University of Michigan Regents approved the recommendations for faculty promotions, and we would like to congratulate our center faculty members on their achievements.

Katharine Seagly, clinical associate professor, Department of Physical Medicine and Rehabilitation

Zhenke Wu, associate professor of biostatistics, with tenure

Kelley M. Kidwell, professor of biostatistics, with tenure

Alexander J. Rogers, clinical professor, Department of Emergency Medicine, and clinical professor, Department of Pediatrics

Darin Zahuranec, professor of neurology, with tenure

Ioulia Kovelman, professor of psychology, with tenure, and professor of linguistics, without tenure

Frederick K. Korley, professor of emergency medicine, with tenure

Jingwen Hu, research professor, U-M Transportation Research Institute, and research professor, Department of Mechanical Engineering, College of Engineering

The U-M Concussion Center is proud to host a Special Speaker Series event on Friday, April 28, 10:30 am-11:30 am ET, featuring Dr. Ross Zafonte, the President of Spaulding Rehabilitation Network and the Earle P. and Ida S. Charlton Professor and Chairman of the Harvard Medical School Department of Physical Medicine and Rehabilitation (PM&R). During this special event, Zafonte will give a talk entitled: “Does Repeated Brain Injury Lead to a Maladaptive Phenotype? Can we Untangle the Gordian Knot?”

Dr. Zafonte serves as Chief of the Department of PM&R at Massachusetts General Hospital, Chair of the Department of PM&R at Brigham and Women’s Hospital, and Senior Vice President of Medical Affairs, Research, and Education at Spaulding Rehabilitation Network. Dr. Zafonte’s textbook, Brain Injury Medicine, is considered one of the standards in the field of brain injury care.

His work is presently funded by the NIH, DOD, and NIDRR, and he directs several large clinical treatment trials. His research primarily focuses on understanding mechanisms of recovery after Brain and Spinal Cord Injury. At the RedSox MGH HomeBase program, he directs the Brain Injury and the Warrior Health and Fitness programs, and at the Football Players Health Study at Harvard University, he is the Principal Investigator.  Dr. Zafonte also sees patients in numerous clinics and hospitals in the Boston community, including former NFL athletes, as part of a special MGH initiative known as the Brain and Body Program.

Dr. Zafonte has published extensively on traumatic brain injuries, spasticity, and other neurological disorders and presented on these topics at conferences nationally and internationally. He is the author of more than 300 peer review journal articles, abstracts, and book chapters. He is on the Journal of Neurotrauma editorial board and, in 2020, was named the Editor in Chief for the Journal of the American Osteopathic Association.  His most recent awards include the Innovative Clinical Treatment Award presented by the North American Brain Injury Society, the 2020 Distinguished Member Award from the American Academy of Physical Medicine and Rehabilitation, and a Public Service Medal from the United States Department of the Army for his work with military veterans. 

Through all of Dr. Zafonte’s endeavors – research, academic, clinical, and administrative – he has sought to improve the lives of persons with traumatic brain injury, spinal cord injury, and other catastrophic illnesses.

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