Saturday, December 8, 2012

New evidence links repeat concussions to permanent brain injury

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n a study published in the December 3 issue of the journal Brain, researchers from Boston University School of Medicine reported that examination of deceased athletes’ brains showed that most had signs of chronic traumatic encephalopathy (CTE), an Alzheimer’s-like condition, after sustaining repeated head injuries.
The study “extends our knowledge concerning the spectrum of the clinical and pathological abnormalities associated with CTE,” said Ann McKee, MD, lead researcher, professor of neurology and pathology, director, neuropathology core, at Boston University School of Medicine, and co-director of the Center for the Study of Traumatic Encephalopathy, in a December 3 news release.
An accumulation of blows
As reported in the Boston Globe, the study was based on brain samples taken posthumously from 85 donors who had histories of repeated head injuries. This new research adds to the mounting evidence linking CTE to repeated hits to the head in such sports as football and hockey. CTE is a progressive degenerative disease whose symptoms include memory loss, paranoia, confusion, impaired judgment, impulse control issues, depression, and dementia.
Among those in the study, 80 percent – 68 men, ages 17 to 98 and nearly all of whom played sports – showed evidence of CTE. Of the 85 donors, 50 were football players, including such NFL stars as Dave DuersonCookie Gilchrist and John Mackey. Also in the group were six high school football players, nine college football players, seven professional boxers and four NHL hockey players.
The four stages of CTE
Researchers interviewed families of the brain donors to learn more about the behaviors they exhibited as the disease progressed. In stage I, CTE victims suffered headaches and had trouble concentrating. In stage II, victims were depressed, had explosive tempers and short-term memory problems. Victims in stage III had cognitive impairment and difficulty with planning, organizing and handling multiple tasks. By final stage IV, full dementia was present.
In addition, the study found that damage to the brain was far more extensive in athletes who played professional contact sports and died after the age of 50. These patients were also more prone to severe memory loss and personality changes before they died.
The volume of cases in the study “allows us to see the disease at all stages of severity and how it starts and spreads in the brain, which gives us an idea of the mechanism of the injury,” McKee told the New York Times.
Protecting young football players
The study’s results are sure to renew calls for more restrictions like the Massachusetts concussion law which prohibits young football players who have sustained concussions from returning to a game on the same day of injury.
Robert Cantu, MD, study co-author, clinical professor of neurosurgery at Boston University School of Medicine and co-director of the Center for the Study of Traumatic Encephalopathy, told the Boston Globe he would like to see tackle football replaced by flag football for all children under the age of 14. He also favored high school teams limiting contact practices to once a week during the regular season.
“There’s no talk of setting up formal rules for limiting contact practices,” said Paul Wetzel, spokesperson for the Massachusetts Interscholastic Athletic Association. “But most football coaches will tell you two or three games into the season, they’re limiting contact practices to avoid injuries.”

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