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  • The word concussion evokes a fear these days more so than it ever has,

    譯者: Conway Ye 審譯者: May Cheung

  • and I know this personally.

    現在聽到腦震盪這詞 比起以往更加恐懼,

  • I played 10 years of football,

    這是我個人感受。

  • was struck in the head thousands of times.

    我打美式足球已經有十年了,

  • And I have to tell you, though, what was much worse than that

    頭部被擊中數千次。

  • was a pair of bike accidents I had where I suffered concussions,

    不過我想告訴你, 比起這事還有更糟的

  • and I'm still dealing with the effects of the most recent one

    就是被兩架單車撞致腦震盪,

  • today as I stand in front of you.

    這件事近期仍然影響我日常生活

  • There is a fear around concussion

    幸好今日我可如常站在你們面前。

  • that does have some evidence behind it.

    對於腦震盪仍然圍繞著恐懼

  • There is information that a repeated history of concussion

    因為背後確實有些證據。

  • can lead to early dementia, such as Alzheimer's,

    還有一些資訊 重複顯示腦震盪的歷史

  • and chronic traumatic encephalopathy.

    可能會導致早期老年癡呆症, 例如:阿爾茨海默氏症,

  • That was the subject of the Will Smith movie "Concussion."

    以及慢性創傷性腦病。

  • And so everybody is caught up in football and what they see in the military,

    由威爾‧史密斯主演的《震盪效應》是一部2015年美式足球傳記劇情片,就是今日的主題。

  • but you may not know

    電影中講述每個人都要了解美式足球 就好像在軍中所看到平凡事一樣,

  • that bike riding is the leading cause of concussion for kids,

    可能你未必知道

  • sports-related concussion, that is.

    對於兒童來說踏單車 是引致腦震盪的主要原因,

  • And so another thing that I should tell you

    那麼,運動與腦震盪是有關連。

  • that you may not know

    還有另一件事我應該告訴你

  • is that the helmets that are worn in bicycling and football

    可能你未必知道

  • and many activities,

    踏單車也好,踢美式足球也好 都必須配戴頭盔

  • they're not designed or tested

    還有其他戶外運動亦需要配戴,

  • for how well they can protect your children against concussion.

    由於現時的運動頭盔 並沒有仔細設計或進行測試

  • They're in fact designed and tested

    故此難易保護兒童防止腦震盪發生。

  • for their ability to protect against skull fracture.

    實際上在設計及測試方面

  • And so I get this question all the time from parents,

    應要有預防及保護頭骨骨折能力。

  • and they ask me,

    所以每時每刻 我都從家長那兒得到這個問題,

  • "Would you let your own child play football?"

    他們問我,

  • Or, "Should I let my child play soccer?"

    "你會讓你的孩子踢美式足球嗎?"

  • And I think that as a field,

    又或者會問,"我應該讓我的孩子踢美式足球嗎?

  • we're a long way from giving an answer with any kind of confidence there.

    作為一個前美式足球員,

  • So I look at that question from a bit of a different lens,

    當中要找到答案 的確還有很長的路要走。

  • and I want to know, how can we prevent concussion?

    稍為從不同的角度 去看這條問題,

  • Is that even possible?

    我們應如何預防腦震盪?

  • And most experts think that it's not,

    真的有可能嗎?

  • but the work that we're doing in my lab

    大多數專家認為這是不可能的,

  • is starting to reveal more of the details around concussion

    不過在這項研究已經在我的實驗室進行中

  • so that we can have a better understanding.

    我會開始披露更多 與腦震盪有關的細節

  • The reason we're able to prevent skull fracture with helmets

    讓我們有更好的理解。

  • is because it's pretty simple. We know how it works.

    我們之所以配戴頭盔 主要用來預防頭骨破裂

  • Concussion has been much more of a mystery.

    就是這麼簡單。 我們明明知道頭盔的作用。

  • So to give you a sense of what might be happening in a concussion,

    可惜腦震盪仍然充滿著謎團。

  • I want to show you the video here

    你會覺得腦震盪沒可能發生的,

  • that you see when you type into Google,

    我想在這裡放影少少片段

  • "What is a concussion?"

    你亦可以鍵入到谷歌,

  • The CDC website comes up,

    鍵入"什麼是腦震盪?"

  • and this video essentially tells the whole story.

    也可在疾病預防控制中心的網站上找到,

  • What you see is the head moves forward,

    整個足本的影片。

  • the brain lags behind,

    現在留意這個頭部向前移動,

  • then the brain catches up

    大腦先向後撞到,

  • and smashes into the skull.

    然後大腦再向後傾

  • It rebounds off the skull

    並撞向頭骨。

  • and then proceeds to run into the other side of the skull.

    再回彈到頭骨

  • And what you'll notice is highlighted in this video from the CDC,

    然後繼續進行 到了另一邊的頭骨。

  • which I'll note was funded by the NFL,

    由疾控中心提供這影片當中 顯然你都注意到,

  • is that the outer surface of the brain,

    這是國家美式足球聯盟贊助,

  • where it was to have smashed into the skull,

    那是大腦表面的四周,

  • looks like it's been damaged or injured, so it's on the outer surface of the brain.

    頭骨明顯被撞擊,

  • And what I'd like to do with this video

    看起來大腦表面周邊, 像已損毀或受創。

  • is to tell you that there are some aspects that are probably right,

    我估計做這段影片

  • indicative of what the scientists think happens with concussion,

    目的想告訴你 某些觀點可能是對的,

  • but there's probably more that's wrong with this video.

    表明了有科學家認為 曾經產生過腦震盪,

  • So one thing that I do agree with, and I think most experts would,

    不過這段影片中 有很多地方弄錯了。

  • is that the brain does have these dynamics.

    有一件事我與大多數專家都認同的,

  • It does lag behind the skull

    就是大腦曾有動力學的變化。

  • and then catch up and move back and forth and oscillate.

    確實頭骨先向後

  • That we think is true.

    再向前繼而前後擺動。

  • However, the amount of motion you see in the brain in this video

    我認為這是事實。

  • is probably not right at all.

    然而,從影片中 可以看到大腦擺動次數

  • There's very little room in the cranial vault,

    但這點可能沒根據。

  • only a few millimeters,

    在大腦與頭頂骨之間 有一個很細的空間,

  • and it's filled entirely with cerebral spinal fluid,

    只有幾毫米,

  • which acts as a protective layer.

    而且完全充滿腦脊髓液,

  • And so the brain as a whole probably moves very little inside the skull.

    這角色就是要充當一個保護層。

  • The other problem with this video

    因為整個大腦 在頭骨內變化得很少。

  • is that the brain is shown

    這影片內另一個問題

  • as a kind of rigid whole as it moves around,

    是大腦的顯示

  • and that's not true either.

    作為一種堅硬的整體 怎可以四處移動,

  • Your brain is one of the softest substances in your body,

    而事實並非如此。

  • and you can think of it kind of like jello.

    你的大腦是你的身體上 最柔軟的物質之一,

  • So as your head is moving back and forth,

    你能想到的它有點像果凍。

  • your brain is twisting and turning and contorting,

    所以當你的頭部來來回回移動著,

  • and the tissue is getting stretched.

    你的大腦就會彎彎曲曲的 旋轉和被扭曲,

  • And so most experts, I think, would agree

    及組織會被拉長。

  • that concussion is not likely to be something that's happening

    所以大多數專家,我想,都會同意

  • on this outer surface of the brain,

    腦震盪不太可能 像這樣子發生的

  • but rather it's something that's much deeper

    在大腦表面周邊,

  • towards the center of the brain.

    對比起其他東西 這是更深層

  • Now, the way that we're approaching this problem

    接近大腦中心點。

  • to try to understand the mechanisms of concussion

    現在,用我們的方式 去解說這個問題

  • and to figure out if we can prevent it

    嘗試去理解 腦震盪的機制

  • is we are using a device like this.

    假設我們可以預防 便更要弄清楚

  • It's a mouthguard.

    我們使用類似的設備。

  • It has sensors in it that are essentially the same

    這是一個牙套。

  • that are in your cell phone:

    牙套上有一個感應器 本質是相同的

  • accelerometers, gyroscopes,

    這是在你的手機上:

  • and when someone is struck in the head,

    加速度計,陀螺儀,

  • it can tell you how their head moved

    當有人頭部被擊中,

  • at a thousand samples per second.

    這兩部儀器可以告訴你 他們的頭部是怎樣移動

  • The principle behind the mouthguard is this:

    舉例說每秒一千樣。

  • it fits onto your teeth.

    背後的原理 該牙套是這樣的:

  • Your teeth are one of the hardest substances in your body.

    將牙套套在你的牙齒上。

  • So it rigidly couples to your skull

    你的牙齒是身體上最堅硬的物質之一。

  • and gives you the most precise possible measurement

    也是堅固地連接到你的頭骨

  • of how the skull moves.

    並為你提供最精確合適的測量

  • People have tried other approaches, with helmets.

    頭骨是如何移動的。

  • We've looked at other sensors that go on your skin,

    人們嘗試 其他的方法,配帶頭盔。

  • and they all simply move around too much,

    或會利用其他感應器 就是你的皮膚,

  • and so we found that this is the only reliable way

    因為左右走動太多,

  • to take a good measurement.

    所以我們發現,牙套感應器 是唯一可靠的方法

  • So now that we've got this device, we can go beyond studying cadavers,

    也是取得最好的測量方式。

  • because you can only learn so much about concussion

    這個設備我們現在已經擁有了, 並利用屍體作為研究,

  • from studying a cadaver,

    因此想了解更多關於腦震盪

  • and we want to learn and study live humans.

    就是只能從屍體上學習,

  • So where can we find a group of willing volunteers

    如要從活生生的人類當中研究的話。

  • to go out and smash their heads into each other on a regular basis

    需要找一群志願者

  • and sustain concussion?

    定期去粉碎他們的頭部

  • Well, I was one of them,

    並要認定已遭受了腦震盪?

  • and it's your local friendly Stanford football team.

    對吧,我就是他們其中之一,

  • So this is our laboratory,

    你們本地友好 斯坦福大學美式足球隊。

  • and I want to show you

    就在我的實驗室在中,

  • the first concussion we measured with this device.

    我想展示給你們看

  • One of the things that I should point out is the device has this gyroscope in it,

    我們用這設備進行了 第一次腦震盪測量。

  • and that allows you to measure the rotation of the head.

    我想指出今次是利用 陀螺儀裝置設備,

  • Most experts think that that's the critical factor

    來測量頭部旋轉情況。

  • that might start to tell us what is happening in concussion.

    因為大多數專家認為 這就是關鍵因素

  • So please watch this video.

    正式開始告訴我們 腦震盪是如何形成。

  • Announcer: Cougars bring extra people late, but Luck has time,

    請先觀看這段影片。

  • and Winslow is crushed.

    評述員︰ 美洲獅遲遲才帶人來, 但盧克仍有時間,

  • I hope he's all right.

    可惜與溫思勞撞過正面。

  • (Audience roars)

    我希望他沒事。

  • Top of your screen,

    (影片中觀眾怒吼一聲)

  • you'll see him come on just this little post route,

    請留意螢光幕上方,

  • get separation, safety.

    他好像沿著一條小小的路線衝過去,

  • Here it comes at you in real speed. You'll hear this.

    被撞到彈開了,幸好沒大礙。

  • The hit delivered by --

    聽說就在這裡才會感受到真正的速度。

  • David Camarillo: Sorry, three times is probably a little excessive there.

    交由命運安排 --

  • But you get the idea.

    大衛卡馬里奧:對不起,撞擊三次 實在有一點過分。

  • So when you look at just the film here,

    你有什麼想法。

  • pretty much the only thing you can see is he got hit really hard and he was hurt.

    當你只是在這裡看著的影片時,

  • But when we extract the data

    幾乎你可以看見唯一的事情 就是他們真正被撞擊和受傷。

  • out of the mouthguard that he was wearing,

    但當我們提取資料時

  • we can see much more detail, much richer information.

    發現原來他有配戴牙套的,

  • And one of the things that we noticed here

    我們可以看到更詳細的, 更豐富的信息。

  • is that he was struck in the lower left side of his face mask.

    以及我們在這裡看到其中的一件事情發生

  • And so that did something first that was a little counterintuitive.

    就是他面具左下方被撞擊到。

  • His head did not move to the right.

    第一時間覺得有點不合常理。

  • In fact, it rotated first to the left.

    他的腦部沒有移動到右邊。

  • Then as the neck began to compress,

    事實上,腦部應先轉動到左邊。

  • the force of the blow caused it to whip back to the right.

    然後隨著頸部開始受壓,

  • So this left-right motion was sort of a whiplash-type phenomenon,

    由衝擊力引致腦部迅速撞回右邊。

  • and we think that is probably what led to the brain injury.

    所以這個左右移動 類似那種揮鞭現象,

  • Now, this device is only limited in such that it can measure the skull motion,

    我們認為就是這樣 導致了腦部受傷。

  • but what we really want to know is what's happening inside of the brain.

    由於,這種裝置只局限於 測量頭骨移動,

  • So we collaborate with Svein Kleiven's group in Sweden.

    所以我們真的很想知道 在大腦內究竟發生了什麼變化。

  • They've developed a finite element model of the brain.

    故此我們在瑞典,與斯韋恩·凱文的研究小組合作。

  • And so this is a simulation

    他們已經利用有限元素法 去探討大腦。

  • using the data from our mouthguard from the injury I just showed you,

    這是一種模擬狀態

  • and what you see is the brain --

    研究數據主要來自損壞的牙套資料 就是我剛才這段影片,

  • this is a cross-section right in the front

    從這片段的大腦你可以看到什麼 --

  • of the brain twisting and contorting as I mentioned.

    前面就是大腦右邊橫切面

  • So you can see this doesn't look a lot like the CDC video.

    正如我所提及的 大腦有扭曲及被扭斷。

  • Now, the colors that you're looking at

    你們現在看到的 與疾控中心的影片完全不同

  • are how much the brain tissue is being stretched.

    現在,你看到的顏色

  • And so the red is 50 percent.

    有多少腦組織 被撐大了。

  • That means the brain has been stretched to 50 percent of its original length,

    所顯示50%紅色。

  • the tissue in that particular area.

    就是意味著大腦被撐大程度 比起原來的大出50%

  • And the main thing I want to draw your attention to is this red spot.

    這組織在該特定區域。

  • So the red spot is very close to the center of the brain,

    我想用這個紅點來引起你們注意。

  • and relatively speaking,

    紅點是非常接近大腦中心,

  • you don't see a lot of colors like that on the exterior surface

    相對來說,

  • as the CDC video showed.

    在外層表面並沒看到太多類似的顏色

  • Now, to explain a little more detail

    從疾控中心的影片中顯示。

  • about how we think concussion might be happening,

    但現在,我需要來解釋更多細節

  • one thing I should mention

    關於我們認為發生腦震盪的可能性,

  • is that we and others have observed that a concussion is more likely

    有一件事我必須要提及

  • when you're struck and your head rotates in this direction.

    就是我們和其他人已經觀察到 有傾向腦震盪的跡象

  • This is more common in sports like football,

    當你被撞擊時 你的頭部會從這個方向旋轉。

  • but this seems to be more dangerous. So what might be happening there?

    這種情況普遍性發生 在美式足球運動內,

  • Well, one thing that you'll notice in the human brain

    似乎相比其他運動更加危險。 那裡會有什麼事發生呢?

  • that is different than other animals

    好吧,有件事你要注意 就是人類的大腦

  • is we have these two very large lobes.

    與其他動物不同

  • We have the right brain and the left brain.

    我們有兩個非常大的額葉。

  • And the key thing to notice in this figure here

    我們有右腦和左腦。

  • is that right down the center of the right brain and the left brain

    請留意圖中最關鍵的事情

  • there's a large fissure that goes deep into the brain.

    就是右腦與左的腦的中間位置

  • And in that fissure, what you can't see in this image,

    這裡一個大裂縫 竟然深進入大腦。

  • you'll have to trust me,

    那裂縫, 你不能在此圖片中看到,

  • there is a fibrous sheet of tissue.

    請相信我,

  • It's called the falx,

    那是纖維組織表。

  • and it runs from the front of your head all the way to the back of your head,

    被稱為大腦鐮

  • and it's quite stiff.

    大腦鐮從你的腦前額開始運行 然後用盡任何方式走到你的後腦,

  • And so what that allows for is when you're struck

    而且非常僵硬。

  • and your head rotates in this left-right direction,

    當你受到撞擊你還等什麼

  • forces can rapidly transmit right down to the center of your brain.

    你的大腦左右旋轉的情況下,

  • Now, what's there at the bottom of this fissure?

    這個撞擊力迅速傳遞 直到你的大腦中心。

  • It's the wiring of your brain,

    那麼,裂縫的底部究竟有什麼?

  • and in fact this red bundle here at the bottom of that fissure

    這是你大腦的路徑,

  • is the single largest fiber bundle

    事實上紅色一束束 是裂縫的底部

  • that is the wiring that connects the right and left sides of your brain.

    是單一最大的神經纖維束

  • It's called the corpus callosum.

    聯繫左右兩側大腦的主要路徑。

  • And we think that this might be

    被稱為胼胝體。

  • one of the most common mechanisms of concussion,

    我們認為這可能是

  • and as the forces move down, they strike the corpus callosum,

    其中最常見的腦震盪機制,

  • it causes a dissociation between your right and your left brain

    當撞擊力向下移, 便會撞擊胼胝體,

  • and could explain some of the symptoms of concussion.

    你的左右腦之間會引致分裂

  • This finding is also consistent of what we've seen

    這樣可以解釋到一些 腦震盪的症狀。

  • in this brain disease that I mentioned, chronic traumatic encephalopathy.

    調查結果發現與我們見到的 也是一致

  • So this is an image of a middle-aged ex-professional football player,

    在這個腦疾病中提及到, 慢性創傷性腦病。

  • and the thing that I want to point out is if you look at the corpus callosum,

    圖中是一位中年人的腦部 前職業美式足球運動員,

  • and I'll page back here so you can see the size of a normal corpus callosum

    你看看他的胼胝體,我想指出一點,

  • and the size of the person here who has chronic traumatic encephalopathy,

    先回到這頁,你可以看到 正常的胼胝體的大小

  • it is greatly atrophied.

    與這位中年人的胼胝體的大小 那一位真正患有慢性創傷性腦病,

  • And the same goes for all of the space in the ventricles.

    大腦萎縮得非常。

  • These ventricles are much larger.

    也是這樣 對於所有的腦室的空間。

  • And so all of this tissue near the center of the brain

    這些腦室非常大。

  • has died off over time.

    因此,所有這類組織 當靠近大腦中心時

  • So what we're learning is indeed consistent.

    隨著時間便會死亡。

  • Now, there is some good news here,

    與我們學習的確實一致。

  • and I hope to give you a sense of hope by the end of this talk.

    不過在這裡還有好的消息的,

  • One of the things that we've noticed,

    我希望透過這次演說 帶給你們有希望的感覺。

  • specifically about this mechanism of injury,

    我們注意到一件事

  • is although there's a rapid transmission of the forces down this fissure,

    整體來說 這種受傷的機制,

  • it still takes a defined amount of time.

    雖然那種撞擊力 快速傳輸到這裂縫處,

  • And what we think is that if we can slow the head down just enough

    仍然需要用時間來定義。

  • so that the brain does not lag behind the skull

    我們的想法是,如果我們可以 剛好將頭部減速

  • but instead it moves in synchrony with the skull,

    大腦便不會落後於頭骨

  • then we might be able to prevent this mechanism of concussion.

    相反與頭骨同步移動,

  • So how can we slow the head down?

    我們也許能夠防止 這種腦震盪發生。

  • (Laughter)

    但如何將頭部慢下來?

  • A gigantic helmet.

    (笑聲)

  • So with more space, you have more time,

    一個巨大的頭盔。

  • and this is a bit of a joke, but some of you may have seen this.

    因此需要更多空間,更多時間,

  • This is bubble soccer, and it's a real sport.

    這一點開玩笑, 但你們當中可能已經看得出來。

  • In fact, I saw some young adults

    這是泡泡足球 也是運動的一種。

  • playing this sport down the street from my house the other day,

    事實上,我看到一些年輕人

  • and as far as I know there have been no reported concussions.

    在我家中附近的街道玩這運動,

  • (Laughter)

    並就我所知 沒有發生過腦震盪的報導。

  • But in all seriousness, this principle does work,

    (笑聲)

  • but this has gone too far.

    原則上這是高危運動,