Michael Sowers, a star of the Premier Lacrosse League, endured his fifth recognized concussion in 2021. His private physician informed him he may need to contemplate retiring, however one other doctor had an thought that will hold him on the sector.
Dr. Wayne Olan, a neurosurgeon at George Washington University Hospital in Washington, D.C., steered Sowers put on a silicone collar round his neck made by an organization he serves as a medical adviser. Called Q-Collar and costing $199, the gadget restricts the move of blood from the pinnacle, and, if science touted by the corporate is accepted, provides the mind an additional layer of cushioning.
“I can’t think of anything we can do that is so simple but also so important,” Dr. Olan, who additionally coaches highschool lacrosse, mentioned in an interview.
But does the Q-Collar, whose origin story entails a novel evaluation of the anatomy of a woodpecker, really defend the mind? Football gamers on greater than two dozen school and N.F.L. groups are carrying it as they seek for one thing, something, that may hold them protected. Still, critical doubts have emerged in regards to the science behind the gadget, in accordance to an intensive overview of presidency paperwork and scientific research by The New York Times, in addition to interviews with scientists who’ve examined analysis into the Q-Collar.
Far from making athletes safer, some consultants in mind accidents and neuroscience say, the Q-Collar could embolden them to take dangers they in any other case wouldn’t.
“The danger with a device like this is that people will feel more protected and play differently and behave differently,” mentioned James Smoliga, a professor of physiology at High Point University in North Carolina who has led a campaign in tutorial journals towards the gadget.
Sowers, 25, the lacrosse star, appeared to validate this concern. “I can go out there and play my game,” he mentioned. “I don’t have to fear the contact.”
Q30 Innovations, the corporate that developed the Q-Collar, and consultants like Dr. Olan have stood by their claims that the gadget could make gamers who put on it safer, with rule modifications and security protocols mitigating any tendencies towards recklessness.
“We’re not talking about concussions,” Tom Hoey, the corporate’s chief govt, mentioned in an interview. “We are talking about the repetitive hits,” he mentioned, including, “the Q-Collar reduces the injury and changes to the brain caused by subconcussive impacts.”
Q30 Innovations, primarily based in Westport, Conn., had a big triumph final 12 months when the F.D.A. authorized the Q-Collar on the market as a medical gadget within the United States.
The company declared that company-funded research had proven it’d restrict injury to mind tissue. In November, the International Bobsleigh and Skeleton Federation authorized the Q-Collar to be used in competitors. Meghan Klingenberg, who performs for the Portland Thorns of the National Women’s Soccer League, wears it. So do soccer gamers at over a dozen school groups together with Auburn and Alabama and 12 to fifteen N.F.L. groups. Several highschool groups have adopted the collar, too.
The gadget, a light-weight, cushioned collar that slips across the decrease neck, is cosy sufficient to constrict the slightest little bit of blood move however not too tight to trigger discomfort.
Head Injuries and C.T.E. in Sports
The everlasting injury attributable to mind accidents to athletes can have devastating results.
Drue Tranquill, a linebacker for the Los Angeles Chargers, began carrying the Q-Collar this season. A tough hit on a punt play final 12 months landed him within the NF.L.’s concussion commentary program.
“I wanted to protect myself,” Tranquill mentioned in a latest interview. In early October, although, the F.D.A. posted a abstract of its resolution that was way more measured than the February 2021 approval announcement. The abstract, which the company printed to doc its science, included a collection of purchaser beware caveats about the important thing examine that led to its approval.
The company cited uncertainty surrounding the imaging expertise that the research relied on. Those research revealed, below sure circumstances, refined modifications within the mind tissue of highschool soccer and soccer gamers who didn’t put on the Q-Collar, no matter whether or not they skilled concussion signs. Those modifications, detectable solely with high-tech imaging, differed from modifications within the mind tissue of the gamers who did put on it.
However, the F.D.A. said, a hyperlink between the modifications the research revealed and precise mind accidents has not been “validated.” Also, the company mentioned, the scientists discovered one thing they didn’t initially say they have been on the lookout for, probably making the outcomes extra unsure.
“They’re finding stuff, but it feels like noise,” mentioned Matt Tenan, a program director at West Virginia University’s Rockefeller Neuroscience Institute. He and different skeptics cite inconsistencies within the Q-Collar research and don’t settle for the idea on the coronary heart of the gadget — that compressing the jugular vein within the neck retains further blood within the skull, permitting the blood to operate just like the white surrounding the yolk of an egg.
The firm factors to the 18 printed research supporting the idea whereas additionally acknowledging there may be extra analysis to be finished.
At stake is a possible windfall from the greater than $30 million and numerous hours of analysis which have already been invested in making an attempt to determine the efficacy of the Q-Collar. Also, although, there may be the well being and security of tens of millions of athletes — professionals and amateurs of all ages — and presumably troopers who could ultimately put on a tool that will present little greater than a false sense of safety.
A curious origin story and the largest names in brains.
Dr. David Smith, an inventor and former practitioner of inside drugs, got here up with the thought for the Q-Collar after discovering what he believed was the important thing to a woodpecker’s mind well being — a neck muscle that contracts and traps blood of their brains once they peck, at timber, the bottom, the siding on your home.
The concept ran counter to accepted chicken analysis. Ornithologists have concluded that beaks and spongy skulls with distinctive musculature present the cushioning, not jugular vein compression. Also, the brains of deceased woodpeckers have proven indicators of mind injury.
And but the eager for tools that may stop traumatic mind damage and make harmful sports activities really feel protected is intense.
The F.D.A. consultants cited the pressing want for gadgets that “may” defend the mind from delicate impacts in sports activities and the low danger of the Q-Collar.
“The probable benefits outweigh the probable risks,” the company mentioned.
The Q-Collar’s high-profile supporters embody Dr. Julian Bailes, a NorthShore Medical Group neurosurgeon who was on the forefront of analysis into mind accidents in sports activities. Alec Baldwin portrayed Dr. Bailes within the film “Concussion.”
Dr. Smith started his analysis by tossing small metal casings that held varied quantities of blood from the roof of his workplace, however the preliminary small animal research on jugular vein compression and one giant animal examine have been carried out in Dr. Bailes’s lab.
Early on, Dr. Bailes, who’s a minority shareholder in Q30 Innovations, intuited that an additional teaspoon of blood within the mind may assist hold the physique’s most irreplaceable organ extra nonetheless.
“If the brain doesn’t move, it doesn’t get injured,” Dr. Bailes mentioned in an interview.
Scientists skeptical of the Q-Collar settle for that premise. It’s the analysis behind the Q-Collar that they query.
Martha Shenton is a professor of psychiatry and radiology at Harvard’s Brigham and Women’s Hospital and an skilled within the high-tech mind imaging that the Q30 scientists have relied on. At the request of The New York Times, she reviewed the findings of the important thing examine the F.D.A. cited when it authorized the Q-Collar.
Dr. Shenton raved about making an attempt to guard the mind from contained in the cranium, however was much less enthusiastic in regards to the conclusions of the examine.
“None of it makes sense,” Dr. Shenton mentioned.
Gregory Myer, director of Emory University’s Sports Performance and Research Center, who has led the Q30-funded human medical trials, allowed that a lot analysis stays to determine the Q-Collar’s true potential.
“It is not a magic bullet,” mentioned Dr. Myer, who along with being the first researcher has additionally acquired cash as a advisor to Q30 Innovations.
Dr. Myer mentioned the proof to this point suggests the collar is usually a piece of a security puzzle that features changes to guidelines.
“It all fits together into making sports safer,” he mentioned.
If Dr. Myer is true, the payoff may very well be important. Hoey, the Q30 chief govt, mentioned the corporate expects $100 million in gross sales throughout the subsequent 5 years from simply 1 p.c of its goal market.
More than two million college students within the United States performed highschool soccer, lacrosse, hockey or soccer final 12 months. All are thought-about actions with a excessive danger of subconcussive head impression. Millions extra play on the youth and school degree.
The firm has spent roughly $550,000 on lobbyists and consultants to assist in its dealings with the Department of Defense.
In October, Q30 introduced it had acquired a $2.8 million analysis contract from the U.S. Army to review whether or not the Q-Collar may also help decrease the chance of mind damage to troopers uncovered to explosions.
A pivotal examine garners a key approval — and questions.
Dr. Smith first studied woodpecker anatomy some 15 years in the past. He then started discussing Q-Collar prototypes with Dr. Joseph Fisher, a physiologist and skilled in mind blood move on the University of Toronto.
Along with Dr. Bailes, they spent three years constructing laptop fashions and finding out the results of jugular compression on pigs and rodents, ultimately rising satisfied the Q-Collar may very well be a sport changer. In 2012, Dr. Bailes contacted Hoey. Q30 Innovations had been making an progressive, flavored mouth guard, however after talking with Dr. Bailes the corporate determined to go all in on the Q-Collar.
“From the very beginning we decided the data had to drive the safety,” Hoey mentioned. “We reached out to the best thought leaders in North America.”
In 2015, Performance Sports Group, the corporate behind a number of well-known sporting items manufacturers, equivalent to Bauer in hockey and Easton in baseball and softball, licensed the Q-Collar for sports activities makes use of for $7 million. It additionally invested $1 million in Q30 Innovations. It placed on a presentation in Midtown Manhattan for potential buyers, trotting out the hockey legend Mark Messier to attest to the Q-Collar’s potential. A 12 months later it filed for chapter.
Q30 Innovations regained full management of the gadget in 2018. Scientists knew by then the Q-Collar couldn’t stop concussions. Athletes together with Luke Kuechly of the Carolina Panthers had had a minimum of one concussion whereas carrying it. Dr. Myer mentioned the corporate wanted to seek out an goal measure that confirmed carrying the gadget may a minimum of decrease the chance of mind injury.
In 2018, Dr. Myer and his crew started finding out 284 highschool soccer gamers on seven groups to see if scans of their brains earlier than and after the season would reveal any variations between gamers who wore the Q-Collar and people who didn’t.
The gamers wore accelerometers inside their helmets to rely the variety of hits and their impression. When the scans have been mixed right into a composite picture for every group, they revealed, at sure ranges of impression, microscopic modifications in a single space of the mind for some gamers who didn’t put on the collars and considerably totally different modifications for many who wore them.
However, consultants within the excessive tech imaging, often called D.T.I., cautioned towards drawing too many conclusions primarily based on these outcomes.
Derek Jones, a professor at Cardiff University’s Brain Research Imaging Centre, in Wales, described D.T.I. expertise as “very sensitive but not very specific.” He mentioned the info it produces is troublesome to interpret, particularly within the advanced areas of the mind that had produced probably the most important leads to the Q-Collar research.
Dr. Shenton, the Harvard specialist, questioned the Q30 scientists’ interpretation of the info from their research. She mentioned the numbers reported go in the other way of what a mind scientist may predict, and solely in a single slender vary of severity.
“They say, ‘We get a change and it doesn’t matter the direction,’” Dr. Shenton mentioned. “It’s so not what you would expect.”
Tom Talavage, head of the biomedical engineering division on the University of Cincinnati, who served because the mind imaging skilled for the examine, mentioned injury to mind tissue from subconcussive hits like those who athletes involved sports activities expertise can differ from different types of mind injury. He agreed, although, that deciphering information from this advanced space of the mind could be fraught.
Dr. Myer, the first investigator on the research, acknowledged researchers can’t but draw any concrete conclusions.
“Hard to explain exactly what the results mean but certainly a target for future research,” he wrote in a latest e mail.
Dr. Fisher, the co-inventor, mentioned the dearth of slam-dunk proof has allowed critics to “moan and groan,” as he put it, however nobody in his household rides a motorcycle or skis with out carrying a collar. “Let’s say it does nothing, then you lose nothing,” he mentioned.
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