Jan 29, 2015
Bulletin Board

Migraines & Recovery

Athletes typically experience headaches after sustaining a concussion, with some suffering migraines. Two separate studies published in the July issue of the American Journal of Sports Medicine suggest that migraines experienced within a week of a concussion could indicate a longer recovery time. In one study, researchers at the University of Pittsburgh evaluated 138 concussed high school football players. Fifty-six experienced migraines, 63 had non-migraine headaches, and 19 had neither. The athletes were put through neurocognitive tests and symptoms were recorded in two time periods: days one through seven and days eight through 14. The athletes with migraines had the most symptoms at the end of the 14-day period, as well as the worst visual memory and reaction time scores. They also had the lowest verbal memory scores in the eight to 14-day span. Those who experienced migraines were 2.6 times more likely to have a protracted recovery (greater than 21 days) than those who were experiencing non-migraine headaches only. “Clinicians should identify the specific type of headache a patient has following a concussion to inform better management and treatment of the injury,” Anthony Kontos, PhD, Assistant Director of Research for the Concussion Program at the University of Pittsburgh Medical Center and one of the study’s authors, told Reuters Health. “Clinicians should also consider the patient’s migraine history as well, as this may be another risk factor that could affect recovery time.” In a similar study, researchers at the University of North Carolina evaluated 296 student-athletes with sports-related concussions of which 52 had migraines, 176 experienced non-migraine headaches, and 68 had neither within one day of their injury. Balance, cognition, and concussion-related symptoms were measured when the injury occurred and at days one, two, three, five, seven, and 90. The athletes experiencing migraines reported higher symptom severity and decreased functioning than the other two groups at the time of injury and through day seven. These findings suggest that patients who suffer migraines within a day of receiving a concussion are more likely to have greater short-term limitations and extended recovery times. To view the abstracts of both studies, go to ajs.sagepub.com and search “Posttraumatic Migraine as a Predictor of Recovery and Cognitive Impairment After Sport-Related Concussion” and “Recovery of Posttraumatic Migraine Characteristics in Patients After Mild Traumatic Brain Injury.”

Mussels to Help Muscles

Could an effective treatment for exercise-induce asthma really come from something called a green-lipped mussel? According to researchers at Indiana University, that is precisely the case. In a study appearing in the August issue of the journal Respiratory Medicine, scientists found that a unique omega-3 supplement derived from the New Zealand green-lipped mussel “significantly improved lung function and reduced airway inflammation in asthmatics who experience exercise-induced bronchoconstriction.” Lyprinol/Omega XL is a dietary supplement whose key ingredient is PCSO-524, an extract of stabilized lipids in New Zealand green-lipped mussels, as well as olive oil and vitamin E. In a randomized, double-blind, placebo-controlled crossover trial, Lyprinol/Omega XL provided 59 percent improvement in lung function after an airway challenge and facilitated a reduction in airway inflammation, asthma symptoms, and the need for emergency medication. “Not only does it reduce [exercise-induced asthma] symptoms, which will make you feel better, but it potentially could improve athletic performance,” the study’s lead author, Timothy Mickleborough, PhD, Professor in the Indiana School of Public Health-Bloomington, said in a news release. “Any time you can reduce medication is good.”

Prior to the exercise-induced asthma study, PCSO-524 had proven effective in treating osteoarthritis, rheumatoid arthritis, and inflammatory bowel disease. Ahead, Mickleborough said he plans to expand his research to examine the impact of PCSO-524 on delayed onset muscle soreness and delayed onset muscle damage. He added that he is also evaluating whether PCSO-524 can improve lung function and relieve airway inflammation in elite athletes who do not have asthma or exercise-induced asthma.

To view an abstract of the study, “Marine lipid fraction PCSO-524 (lyprinol/omega XL) of the New Zealand green lipped mussel attenuates hyperpnea-induced bronchoconstriction in asthma,” go to: www.resmedjournal.com and type “PCSO-524” into the search window.

Football Players See Increase in BP

The blood pressure of football players typically increases during their first year of participation at the collegiate level, according to a study published in the July 30 issue of the journal Circulation. Linemen were the most likely to experience the rise, and they also ran the highest risk of concentric left ventricular hypertrophy, which the research correlated with changes in systolic blood pressure. Researchers examined six years of incoming freshman players at Harvard University and found their average blood pressure went from 116 over 64 before the season to 125 over 66 after it ended. While 63 percent of the players studied had normal blood pressures going into their rookie campaign, a statistically significant number met the Joint National Commission criteria for prehypertension (47 percent) or stage I hypertension (14 percent) in postseason tests.

“What our data shows is that–as with concussion–hypertension and high BP should be another part of routine screening for young, healthy people,” Aaron L. Baggish, MD, Associate Director of the Cardiovascular Performance Program at Massachusetts General Hospital and the study’s corresponding author, told Cardiology Today. “We have spent a lot of effort talking about screening athletes before they play, but we pay comparatively less attention to screening once that decision is made.”

Postseason testing of linemen revealed that 58 percent were prehypertensive and 25 percent met the criteria for stage I hypertension. By comparison, no other players reached the stage I numbers. Baggish told HealthDay News that the linemen were more likely than other players to gain weight during their first season, which may account for some of the BP changes. He also said that the heavy weightlifting commonly done by linemen has been known to trigger short-term spikes in blood pressure, but stresses that no link between such activity and chronically high blood pressure has been established. However, linemen did experience a marked increase in LV hypertrophy. “Our analyses suggest that the concentric LV hypertrophy in this population is caused in part by increases in resting BP, not simply by the transient isometric stress that occurs during training and competition,” Baggish and colleagues wrote in the study report.

The researchers used male rowers as a control group and saw no increase in their blood pressure at the end of their seasons. This “indicates that the BP increase and the development of hypertension are not a uniform response to all forms of vigorous exercise training,” they wrote.

“The findings are not cause for alarm as much as they are for piqued interest,” Baggish told Cardiology Today. “Football players are a new population that we know is at risk for high BP. If [a player] is a lineman, has gained weight, or has a family history of hypertension, check his BP before, during, and after the season.”

The full text of the study can be found at: circ.ahajournals.org by typing “Blood Pressure and Left Ventricular Hypertrophy During American-Style Football Participation” in the search window.

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