Join the Dr. Joseph Maroon and John Denny with the Chuck Noll Foundation for Brain Injury Research to learn how its work is helping to diminish the impact of sports-related head injuries.
Established through a seed grant from the Pittsburgh Steelers, the Foundation makes research awards for programs that help to address prevention, diagnosis and treatment of injuries to the brain.
Hall of Fame Coach Chuck Noll played a key role in helping to dramatically increase the understanding of concussions, and pioneered important changes to testing concussions in athletes. His inquisitive mind ultimately led to substantial safety changes across many different sports and levels of competition.
Transcription:
So good afternoon, everyone. This is Audrey Russo, President and CEO, the Pittsburgh Technology Council. And today is Wednesday cinco demayo. And we have great guest today as we do each and every day in a moment, I will more formally introduce the special guests who are here from the chuck Noll foundation for brain injury research. Before we start, I just want to tell everyone, Jonathan Kersting is with us today, he will manage the chat. He is vice president of all things media at the tech Council. And I want to thank Huntington bank for being incredible partners for us over this past year, as well as the support from 40 by 80, which is a wholly owned subsidiary of the Pittsburgh Technology Council. So we've muted your microphones. And we've allowed to have a chat, we'll put some information in there in terms of how to get in touch with our guests and the programs that they are representing. So we're pretty excited about today. And the topic at hand is I think we're gonna go wide and deep. So I'm pretty excited by that. So I want to first say that I'm going to introduce our good friend, john Denny. He has been a good friend to the tech community, the philanthropic community, he has been active for a very long time in several iterations of his life, including the Helmand Foundation, and he's just been one of the biggest champions of Pittsburgh and driving change in equity that I can think of. So I'm really thrilled that he is joining us today as well as we have the end. He also serves as the executive director for the chuck Noll foundation that we're going to be talking about today. And then I'm going to introduce Dr. Joseph Maroon Joe Maroon, he is the professor and vice chairman. He's the heindel scholar neuroscience Department of Neurology, and neurological service surgery at the University of Pittsburgh Medical Center. I twisted that around. So I apologize about that. And he's also a member of the foundation's National Science Advisory Committee. So welcome to the program. Thank you so much for being here. JOHN, you're obviously no stranger to the work that we do at the tech council or the series, I would just like people to learn about who is john. So in terms of your background, I gave a little bit of a sneak peek. In terms of the work that you've done while I've been in Pittsburgh. But let's just talk about who is john Denny. And first,
let me just say I am also a huge fan of the tech Council, and advisory personally, you all do a fantastic job. And this series has been just a great idea that you started launch. Very quickly, focusing on this current part of what I do. I serve through Denny civic solutions. Our company, as the executive director of the chuck Noll Foundation, have been doing that since 2017. I have had quite a career and traveling through different sectors of Pittsburgh, whether it's been the public, private, philanthropic, but I think that probably if there's something that tells the story, it has been my lessons learn from longtime connection to and work for the late lc hilman.
Right. You are a lucky man. You're a lucky man to have that kind of upfront view. And in terms of the work that she did, both behind the scenes and at the helm of many things. So it's it's You're very lucky. So let me just jump to Dr. Maroon I'm looking forward to our discussion in your role and the Science Committee and also your leadership. You've created a company called that that was called impact but you got before we get into that topic. And those topics. Let's talk about your own journey. Who are you? Where'd you go to school in Pittsburgh? What are you passionate about?
I'm from Wheeling, West Virginia, 60 miles south, Bridgeport, Ohio, john Hagel check and Phil niekro and I all grew up together, right on the same baseball team. I went to Indiana University on an athletic football scholarship, actually, and then the University of Georgetown University of Vermont, and Oxford University in England and then finally ended up here at Pitt, and have been at the University of Pittsburgh and then Allegheny general for a while. And now back to Pitt towards this part of my career,
so you've like come back home almost even just
physically your journey. That's exactly right. It has been homeward bound.
That's great Homeward Bound, but it's great. What a great esteem journey that you've had to date. So pretty excited about that. So john, you you grew up in Pittsburgh, and I guess this is for the both of you really. If you You grew up in Pittsburgh or followed football closely in the 70s. And even the 80s people everyone knew the Hall of Fame coach shop. No, you know, as the legendary coach of the Steelers, he's I guess he's still considered the coach for the Steelers. Right? No disrespect to any of the other coaches. But I do believe that's that that's the legend that he has created. But some people might not realize other things about him and about his life, which includes that he was an early advocate. And, you know, for brain injury just for the injury research and Dr. Maroon, can you speak to that? Can you jump in and talk about these early days of advocacy when many people were not thinking about brain injury? Yeah, yeah.
I was. I was appointed to be the first team neurosurgeon for the Steelers by Dan Rooney, back in the late 80s. And it's a great story. You know, it's everybody on this line is one interested in data. And as we know, data tells stories sell, so to speak. And the story starts in 1990, when I told coach Noll that his starting quarterback bubby Brister could not play against the Dallas Cowboys the next week, and he said, why not? He didn't he knows his plays, he can run. It looks perfect to me. I said, Well, coach, the guidelines say that because he had a concussion. He had to stay out for at least a minimum for two weeks. Why not? Three? Why not one, why not six, he said, Look Maroon. And that's just how he kind of looked down at me as the Emperor did as he was referred to look Maroon. If you want me to keep an athlete out of football, I went data, not specious guidelines that are not evidence based. That's a true story. Wow. So I was shocked. You know, who is this to tell me a brain surgeon that I don't know what I'm talking about. But he did and he was right. So I linked up with Mark Lovell. And Mark level is a brilliant neuropsychologist. And he said, Joe, let's put together a test that we can baseline athletes. And, and then if they do have a concussion, we can see if they get back to baseline. So Mark, and I and subsequently, Mickey Collins, a brilliant, another brilliant neuropsychologist, who heads the concussion Center at the University of Pittsburgh, put together the test impact. And quite frankly, the Technology Council was very instrumental, early on. We shared space with you,
I remember
element of this and it's really a startup. It was a startup company by three, two neuropsychologist at a neurosurgeon who knew nothing about business, who knew nothing about finance. And we went to UPMC, who knew a lot about business and as finance, became an angel, the angel investor, and did what all angel investors do in terms of a pound of flesh. And so they they funded us but subsequently, you know, there was about a 25 times return on investment in terms of beginning in 1990 going up till 2020. But more importantly, we develop impact. I went back to Mr. Rooney and also coach Nall and I said, Look, we have to baseline the entire team. If you want data, we have to know what's going coming in. So we we did just that I said okay. And subsequently the the test was picked up by the Eagles, and then the browns and other teams and, and by 2005 2006, there was the standard of care in the NFL, NHL 12,000 high schools and we now have tested over 20 million 20 million kids baselined and there's a pediatric version now. So any kid down to five or six years of age, who's in any contact sport, should have this test prior to being subjected to potential falls, falls from a bike, scooter or whatever, and participating in any contact sport. So, Coach no was really the impetus. The perspicacious impetus to prompt us to really see what we could do to improve on brain health. And and it subsequently became obvious that the most important thing in in the treatment, if you would of patients with concussions is to not permit them to go back before the brain has healed It's now most important because the brain is still vulnerable to trauma. And, and subsequent disarray and harmful of the 100 billion neurons that 5000 connections between each neuron and the 200,000 fiber tracks that are enclosed in, in this structure, the human brain, which is the microcosm within our skull, like the 100 billion stars in the Milky Way, which is the macro skaza of the universe. So this is all about in this, two and a half pound gelatinous custard like mass, that is who we are, what we think how we feel, and it controls everything we do.
So, you know, I'm not even going to pretend that I that I have understand all the intricacies of what you just presented. But when one of the things that you talked about in terms of impact, and then we'll sort of get into the foundation, your Are you still using what was created by impact?
It's been Yes, absolutely. It's, it's the standard of care and Okay, in all sports that in all contact sports, and it's been modified, upgraded, of course, but it's a 20 minute, computer based test. You could take it online now. Oh, good that measures accurately, a 2020 symptoms, score, headache, nausea, vomiting, photophobia, unsteadiness, and the ability to process information use information, memory and cognitive function of the brain.
So it's interesting because there used to be the standard of care of X amount of weeks. And now you're saying baseline recheck. And and it's all individualized, if I understand correctly, I mentioned the concussion center
is probably the most prominent center for concussion evaluation in the United States, if not the world, ready foo and I Freddie is the head orthopedics and I, in 2003, recruited Mickey Collins and Mark level to form the concussion center. On the south side. They now have seven neuro psychologist who see 10,000 new patients a year with concussions and and you know, what is a concussion? transient disturbance of neurological function. Steps read subsequent to mechanical forces that move the head too quickly in one way or another. And it leads to a syndrome five different forms of concussion. Number one, it can present with cognitive abnormalities. Number two, with emotional disturbances lay bile labile, mood disturbances, depression, it can present with memory impairment, and and also vestibular ocular problems in terms of balance and in gaze and unsteadiness with headaches, as I said, photophobia, nausea, difficulty thinking, processing focusing all of these, they've done remarkable work at the concussion center in defining and separating out the different types of concussions and how they're related to the frontal temporal, occipital, and parietal lobes of the brain and brainstem. And then designing individual treatment modalities for each type of concussion. And so it's a premier location for concussion management in the United States. And and through the chuck Noll Foundation, we've been able to raise funds to support many of the projects that they're doing, they're looking at biomarkers for concussion. Oh, wow. One of the things are, that the government has heavily subsidized as a pregnancy test, if you would, for a concussion. And meaning if you could take saliva or blood, or even sweat, and detect and biochemical abnormalities in these constituents that might reflect an abnormality that occurred in the brain and make a diagnosis promptly of a concussion. So we're funding projects like that. We're funding projects. At Allegheny general Allegheny Health Network is has a project now using vagal nerve stimulation to mitigate acute respiratory distress syndrome. One of the problems with head injuries, particularly mild correction, moderate to severe head injuries, is there's an increase in intracranial pressure. A release of agents called cytokines are Major amatory markers that when they hit the lung, it's like COVID. Yeah, amazing COVID you develop an acute respiratory distress syndrome.
One of the physicians at Allegheny general is using a vago nerve stimulation, the vagus nerve, the brainstem to all of your internal organs, and modulates the microbiome, which is another subject we could discuss. But basically, it goes to the heart, the lungs, and all the internal organs. And the vagus nerve is the largest nerve in the body, it's right here with a carotid artery in the jugular vein. And by externally stimulating this, it activates the parasympathetic nervous system, which is rest and digest, in contradistinction to the sympathetic nervous system, which is fight or flight. Both of these are autonomically controlled systems in our brainstem. So with this device, we funded this, they're starting work on it now to see in patients with severe head trauma, if it can reduce the cytokine storm, and perhaps suppressed the inflammatory response that leads to acute respiratory distress syndrome. You know, we're subsidizing other projects, we mentioned biomarkers. And we can you put patches on to actually record sweat content, which is related to some extent, to what happens in the brain when there's disruption of some of the synaptic connections and the fiber tracks that get into the blood through the blood brain barrier into the blood and detecting that. And at Pitt, we have a phenomenal neuro imaging center. It's just, you know, I mentioned, you know, the brain as 100 billion neurons, but there are 200,000 fiber tracks, that course in different directions through your brain. And if these fiber tracks that get disrupted in depression, and, and, and OCD in autism, and we now with very sophisticated High Definition fiber tractography can look at the brain, see these fiber tracks, and see where the disconnections come in. And now, with transcranial magnetic stimulation, with direct current stimulation, with photo bio modulation, we're able to modulate those fiber tracks transcutaneous Li, without entering the skull to rewire fiber tracks in the brain. We're supporting projects along these lines at WVU at Penn State, and here at Pitt. So
it's all part of the know Foundation, all part of the charter,
leading seed money for smaller projects that as as john alluded to, already, these seed projects have resulted in major grants from the NIH, and DARPA and other organizations and it's the same seed money that UPMC provided j impacts to make this impact if you've wood on on millions of kids in the United States. So it's terribly important that we're able to sponsor these kinds of projects. And and with your help, we will continue to do so.
Well, I think it's great. I'm going to get to john a second, but there's a woman who actually asked a question, there's a question out there about and essentially, it's about athletes use weight lifting and aerobics to condition their bodies. Is there any kind of physical conditioning for the brain? that perhaps we should be aware of?
Your ID john, that
no, I knew that I said before I got john.
Joe Maroon has taught me about epigenetics.
I love to talk about epigenetics totally.
Obviously, it's a major advance in medicine. That's an excellent question about what can you do about brain? right brain health as concussions? You know, there are 5 million people a year newly diagnosed with Alzheimer's disease. And the question we frequently asked, What can I do to avoid Alzheimer disease or prevent Alzheimer's disease or enhanced memory and there are several epi genetic things that can be done to slow obviate or maybe even prevent such things. Number one is diet. The Western diet is poison. And the incidence of obesity in this country is just horrendous and leads to diabetes, early development of Alzheimer's disease, cardiovascular disease, etc, etc. So the appropriate diet Exercise, use it or lose it, your body just like your brain. there's a there's a book behind me, entitled square one a simple guide to a balanced life. It's a book that I wrote that describes the four aspects of diet, exercise, avoiding environmental toxins are gotta watch our water, lead, smoking, drugs, alcohol, and also controlling stress. Stress is a neuro toxic phenomena. By increasing cortisol, it destroys brain cells, particularly in the hippocampus, which the part of the brain that subserves memory. So when you're overstressed over committed, overworked, overwhelmed, like 50% of the doctors in this country are now it's called burnout. You need to pick up my book, square one, the secret to a balanced
loan, put it in that we'll put it in the chat, we'll put it in the chat.
And, and, and it's a personal story, but it's really how I got here with john, in terms of the truck, no foundation, and, and, and, and, and living a, you know, I tell people, I want to die young, as late as possible, right. And that means you got to do the right things beginning fairly early mid life and even later, but it's never too late to get on the treadmill to take a walk around the block to to use bands weights for strength training to do a voice sarcopenia loss of muscle mass that occurs to everybody over 45 Mb,
so we just put the book in there in the chat so you can get it I'm sure it's simple to find. So thank you for that. So john, can I just jump back to you? And then I'm going to jump back to what are the what are as serving as the executive director for the foundation? What are some of the the services the programs that you want to highlight? And then tell people about?
Well, first of all, Audrey to our audience, it probably wouldn't surprise anybody to learn that Dr. Maroon at the age of 80 Plus is sturdy enough like, john, he's still doing triathlons and winning. So I don't know how many he's done this year, but he is incredible. Number two, we wouldn't do justice if we didn't point out the fact that the creation of the chuttan old Foundation and the recruitment of Dr. Maroon to be the chair of the National Science advisory committee was art Ronis content, which is wonderful. He looked for a way to actually advance the science but pay a real tribute to chuck Noll, and his wife, Mary onco. It was his idea and concept. He one of the first people we went to was Dr. Maroon, and said can you share this? And can you help put together a national science Advisory Committee, which consists currently of for probably a fifth member coming on up top notch neurosurgeons around the country. Their role in the foundation is to advise the board of directors on what are the current trends in the research area. They review all the proposals that come in when we do our grant cycles, evaluate them, and they recommend to the board which one should be funded and at what level. We are now in our we just completed our third grant cycle, where we've contributed over we make grants over a million and a half dollars to five in three grant cycles to five different institutions WVU CMU Pitt UPMC h n to a total of about 14 researchers. And as we've indicated that 5 million and cr 1.5 million seed funding is leveraged over $15 million in additional funding. So at this point, our focus is both in terms of early stage seed funding on research around detection, treatment and prevention of brain injuries as a result of sports related activities. And we are right now geographically focused in our area and including WVU with the Rockefeller neuroscience center.
Wow. So yeah, it's a lot and the thought of so much, having these products come to market, so to speak, because we're saying business is really exciting. Because when it gets out of research, and it gets into the hands of people, and physicians is really where it changes lives. So my hat's off to you, john, for serving as the executive director there and leveraging relationship. I want to get back to Dr. Maroon and Talk about what so you we have a lot of parents, right? A lot of parents who are just thinking about sports these days, right? They're thinking about, you know, all the different kinds of sports, right? It's not necessarily just football, what should they be thinking? What should what kind of advice? Should they have an assessment done, you know, at the onset of there's certain sports that you're saying, really aren't sports that we should be playing as we move into the, you know, 2030 2040?
Excellent question. I'd really, you know, I gathered my thoughts on this, because there's so much to be said, first of all, I think one of the greatest problems of the pandemic has been the elimination of sports over this period of time, which has affected the quality of life of so many kids. And I'm a very, I wouldn't be talking to you today, if I didn't play grade school football down in Bridgeport, Ohio, lessons learned of leadership, of loyalty of getting up when you're hurt of not quitting. We're best summarized by General MacArthur, who was calming down at West Point, and he had a plaque put up facing the playing fields of baseball, football, and it said on the fields of friendly strife, are sowing the seeds that on other days, and on other fields will lead to victory. The lessons of any sport, the flag football, be it lacrosse, football, basketball, the lessons learned on the fields of friendly strife are what leads to the success and the ability to persevere no matter what you do later in your life. So that we our goal, Hippocrates said the first role of a physician is to prevent disease, right, that being possible to cure it, that to being possible to relieve pain. The goal of the chuck Dole Foundation, the goal of the NFL, the goal of Pop Warner is to prevent head injuries to prevent injuries in these sports. It's never been safer to play youth sports than it is now. There's a tremendous amount of clickbait and sensationalism in the sports venue, just like there is in the political venue. And there are people with their own agendas that promote the sensationalism and the clickbait. So what we're trying to do is to fund projects, to look at this objectively as we possibly can to share data with other universities. We've subsidized the formation of the University of Pittsburgh, sports brain bank, which is a brain bank here at the University of Pittsburgh for athletes to donate their brains. And we're able to, and I'm donating mine, and we're I'm working on john now. He didn't know that
he didn't know that. But
imagine those who have participated in sports, when they ceased to look at the brain to see the correlation of changes versus normal people who haven't played sports to really understand and unravel this whole problem of CTE. You know, how prevalent is it? We don't know. But there are people say it's epidemic, is it? No, it's data that we knew that we really need to work on to tease out, we're promoting projects to try to understand this in association with 13 other universities collaborating with the University of Pittsburgh to look and share data to share information. So it's objective as possible with peer review.
So when should and should parents to baseline should you know what's your advice?
know, my advices? there, there's a pediatric impact test. It's available for kids down to age six.
Okay.
I think if you know, my kid would be for I wouldn't want that done regardless, and I'm no longer affiliated with impact. But I think that it's a tool if your kid falls off of a swing off of a horse off of a skateboard. It's still is how when it has a concussion, when is he okay to go back to school? When is he okay to to start working out or or doing these sorts of things, is a whole science behind this. And that's where Mickey Collins and Anthony kontos at the University of Pittsburgh, and also Allegheny Health Network has an excellent concussion center in which they proselytize, just like I'm doing right
now. know if I could add for a moment on this many, many many school districts here in this area and probably across the country, start in middle school, if your child signs up to play a sport, the athletic department will have them first take the impact test. As a baseline. I know that schools do that I don't know about, you know, younger Pop Warner, Little League baseball or things of that sort. And the one of the things that I have found that's most interesting, that hopefully we'll do more research on. So parents of girls, one of the things that we are learning is that girl athletes 18 and younger are twice as likely as male athletes to suffer a concussion, playing sports. You know, I think there's a number of hypotheses as to why that might be at this point in time, but certainly, if your daughter's going to be playing soccer, lacrosse, basketball, they ought to be baseline.
And one of the most, that the incidence of concussions is probably greatest in cheerleading, right? cheerleading, wrestling, hockey. These are all equivalent to football. But all we hear about really,
it's true. It's so true. And you know, the other thing and I know we're running out of time. The other thing is, you know, why not have this as part of an annual physical?
Well, I think it is in many schools, even
for adults, for adults, well,
yeah, I mean, it's it's a neurocognitive based like that with clearly a very reasonable
Listen, I can't thank you both enough. We are very, very lucky to have you Dr. Maroon to be circle back to boomerang. Boomerang, you know, from having travelled into different places and to be here, right, in Pittsburgh, it's just incredible. There's a lot to talk about, I have a lot of things that I'd like to follow up on with both of you that maybe we can do a little bit of a deeper dive, john Denny deep friend of the tech community, and the community at large and he's serving as executive director, we're gonna stay connected to him on these issues, as they have different things that occur, different announcements, different relationships, we will stay close to you, john. And, you know, not only be your safe to meter, but definitely be there to support and to create pathways, you know, life sciences. And and obviously, neurology is a big asset in our region, that we don't highlight enough that we don't brag about enough, and very often, it seems intimidating behind the scenes, because as you heard from Dr. Maroon, it's pretty, it's pretty significant. So I want to thank you both for being with us. I can't thank you enough. We will stay connected. We're gonna we have info on your book. We know that you're back in Pittsburgh, we love your partnerships, and we will stay connected to you both. So I want to thank you both. It's great. And also could we have tomorrow? Who do we have tomorrow? Is Jonathan or Brian on the I'm on the call? Oh, I didn't see you. Okay.
Yesterday because I was so excited about we have PPG Industries joining us tomorrow to talk about their sustainability report and their goals meeting it towards 2025 and Martin Silla stopping by so please tune in should be informative.
So thank you again, Dr. Maroon. Thank you, john. Danny. Everyone, stay safe. Happy cinco demayo.
Appreciate it. Bye now.
Transcribed by https://otter.ai