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Concussion: A game changer study

By Michael Brant-Zawadzki, M.D., F.A.C.R.

Categories: Articles

Recently, the New England Journal of Medicine published an article by Stern, et al., regarding fascinating findings in the brains of former NFL players. Those players studied who suffered with cognitive and neuropsychiatric symptoms were found to have deposits of a certain type of “tangle” called Tau, and not another type of tangle called beta amyloid in their brain. Both tangles are deformed proteins that can gum up nerve cell activity. Beta amyloid has been associated with Alzheimer’s disease (AD), as has Tau, being found in a large number of AD patients’ brains upon autopsy. This early data just published suggests a difference between chronic traumatic encephalopathy (CTE), the disease found in autopsies of former football players, and Alzheimer’s disease itself. Both proteins were evaluated in the brains of living players, with positron emission tomography (PET), an imaging technique where a newly developed tracer labeled with an X-ray emitting molecule is injected into the circulatory system, the tracer then tagging to the specific type of protein being evaluated. CTE is thought to result from repeated concussions, and its discovery was featured in the hit movie “Concussion.”

Of interest, Dr. William Shankle, the Director for Hoag’s Memory and Cognitive Disorders Program, as well as its Voltmer Endowed Chair, co-authored the very first paper in the world demonstrating the use of PET imaging for tagging this type of Tau tangle. Also, Hoag has been involved with the National Football League Players’ Association in the Mind Body program for several years, helping former players be proactive in their approach to health. The type of research presented in the New England Journal, and the experience we are gaining with the NFL players at Hoag, can hopefully translate to earlier detection of chronic traumatic encephalopathy, and possibly its mitigation. Having a tool to detect early stages of CTE, as this new PET tracer offers, in living people is a game changer, literally and figuratively – as far as contact sports are concerned.