The Latest in Concussion Research with Dr. Munro Cullum

Brain Beat

Dr. Peter Arnett, Immediate Past President of NAN, hosts the podcast this week and welcomes Dr. Munro Cullum, PhD, ABPP, Professor of Psychiatry, Neurology, and Neurological Surgery at UT Southwestern Medical Center, where he holds the Pamela Blumenthal Distinguished Professorship in clinical psychology, to the show. A board-certified clinical neuropsychologist, Dr. Cullum has been involved in research, teaching, and clinical practice in neuropsychology, serving his field in multiple roles at the national level and contributing to major organizations over the past 30 years of his career. Currently the President of the Sports Neuropsychology Society, Dr. Cullum’s research focuses in part on the short and long term effects of concussions, and today he brings his vast amount of knowledge and experience in this area to this informative and fascinating conversation.

He begins by describing how he got started in studying sports concussions, and then goes on to examine baseline testing, the validity concerns associated with it, and alternative assessment models to be considered. He also reviews such aspects of concussions as common symptoms, recovery times and protocols, lingering symptoms, post-concussion syndrome, as well as how anxiety and depression can become factors in concussions. Neuroimaging, managing athletes with concussions, blood testing, and the risk of later life problems are also explored. The episode concludes as Dr. Cullum shares his advice regarding when athletes should consider retirement, Chronic Traumatic Encephalopathy and Traumatic Encephalopathy Syndrome, as well as his final thoughts for listeners. Bringing information from the forefront of research into the science of concussions, Dr. Cullum offers a masterclass here today in understanding and treating this increasingly common condition as he continues to fulfill his stated mission of educating the general public about this timely and essential topic.

Episode Highlights:

• Dr. Cullum’s start in studying sports concussion
• Baseline testing for athletes and validity concerns surrounding it
• Alternative assessment models
• Some of the most common concussion symptoms
• Recovery times and protocols for concussions
• Lingering symptoms and their risk factors
• Dr. Cullum’s perspective on post-concussion syndrome
• Anxiety and depression
• Circumstances warranting neuro imaging
• Managing athletes following concussions
• Blood testing for concussions
• The risk of later in life problems related to concussions
• His advice for when athletes should consider retirement
• Chronic Traumatic Encephalopathy (CTE) concerns
• Traumatic Encephalopathy Syndrome (TES)
• Dr. Cullum’s final thoughts

Quotes:

“If you think about it, most of us either have experienced or know someone who's experienced a concussion or someone will have traumatic brain injury.”

“It always falls back to clinical decision making, I think, regardless of what the scores necessarily suggest.”

“To experience a concussion, you just have to shake up the brain enough to cause that brief disruption in normal cognitive efficiency or cognitive functioning to produce symptoms.”

“Kids tend to take longer to recover than adolescents who take longer to recover than adults.”

“We really need to get these folks back to their pretty normal routines as quickly as possible.”

“We have to be mindful of the potential symptoms that can occur unrelated to the concussion itself, but related to the nature of the injury.”

“We have to pay attention to any lingering symptoms that are presented, but it's a complex challenge clinically.”

“The biggest predictor of lingering symptoms is severity and initial symptoms.”

“Treatments are all dependent on the symptoms.”

“Everybody's looking for a blood based biomarker, and we don't have any right now that will diagnose concussion.”

“The actual risk of developing a neuro degenerative condition after concussion is pretty low.”

“CTE is a rare condition, so what I tell parents is, ‘It is a rare disorder. The likelihood of your child developing this years and years down the road is quite unlikely.’”

“But I think our job as a psychologist, is to educate your patients, the families, but also the public, and, when we can, the media.”

“It's also a wonderful area that brings together important cutting edge research with real world clinical problems and challenges.”

Links:

National Academy of Neuropsychology Foundation website

Sports Neuropsychology Society Homepage