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Concussions Linked to New Disease that Mimics ALS?
Scientists have found evidence linking traumatic head injuries to motor neuron diseases such as amyotrophic lateral sclerosis, or Lou Gehrig’s disease. The findings will be published in the September issue of the Journal of Neuropathology and Experimental Neurology.

Ann McKee and her colleagues at the Center for the Study of Traumatic Encephalopathy at Boston University’s School of Medicine made the discovery while examining the brains and spinal cords of 12 athletes donated by family members to CSTE’s Brain Bank. When they died, all 12 showed evidence of chronic traumatic encephalopathy, a disease linked to head injuries that causes cognitive decline, abnormal behavior and dementia.

McKee found toxic proteins in the spinal cords of three athletes — former professional football players Wally Hilgenberg and Eric Scroggins, plus a former pro boxer whose family asked that he not be identified — who suffered head injuries and later died from ALS. Those proteins also were discovered in the brains, but not the spines, of athletes with CTE who did not have ALS. And they were not seen in the spines of non-athletes who died from ALS.

This finding suggests that the motor neuron disease that affected Hilgenberg, Scroggins and the boxer is similar to, but distinct from, sporadic ALS and represents a disease never previously described in medical literature — one that McKee and her colleagues now refer to as chronic traumatic encephalomyelopathy (CTEM), likely caused by the repetitive head trauma experienced by athletes in contact sports.

Although Gehrig is not mentioned in the journal’s report, the CSTE states that it’s now worth considering whether head injuries may have contributed to Lou Gehrig’s motor neuron disease, and whether he suffered from CTEM. Gehrig, nicknamed the “Iron Horse,” played football at Columbia University before joining the New York Yankees and playing in 2,036 consecutive games. Gehrig suffered at least five documented concussions and reportedly was knocked unconscious for five minutes after taking a pitch to the head while not wearing a helmet. He played the next day.

“Here he is, the face of his disease, and he may have had a different disease as a result of his athletic experience,” McKee, director of the neuropathology laboratory for the New England Veterans Administration Medical Centers and the lead neuropathologist on the study, told The New York Times.

The research was made possible by a $1 million donation from the NFL to financially support the CSTE’s research of the long-term effects of repetitive brain trauma in athletes. The NFL in recent months has taken a proactive stance on concussions, urging players to report concussions or symptoms, and warning that repeated concussions "can change your life and your family's life forever.”

New concussions-related materials also are available for athletes in youth sports and high school.
Posted At 2:59 PM • Comments (1)

Hopefully this new research will continue to emphasize caution with our athletes going back to competition to soon after significant head trauma.

We as health care practitioners must remain vigilant to inform and protect athletes from uneeded harm.

Congratulations to the research at Boston Univesity and the continued work of our sports medicine experts.
Comment By Pat D'Arco PA-C At 8/25/2010 9:04 PM
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