Opinion: Thankful for CTE and Concussion Research

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Post & Courier (Charleston, SC)

 

Football has become almost synonymous with Thanksgiving. At some point this holiday weekend, we will hear discussions of a key player suffering a concussion and the dangers of head trauma in football.

Don't dismiss this as another column harping on the risks of football. In the spirit of the holiday, I want to express thanks to brain researchers around the country. This month alone has brought numerous scientific discoveries about concussions and CTE. The more we learn, the more informed our decisions as parents, coaches and athletes can be.

The first studies offer hope to current football players, athletes in other sports and members of the military regarding CTE. This is the degenerative brain condition believed to be caused by repetitive blows to the head over time. CTE presents with symptoms like memory loss, anger and mood swings. Athletes currently can only be diagnosed with CTE by autopsy after death.

Drs. Bennet Omalu and Julian Bailes and their team discovered CTE in a living player. Fred McNeill, a former Minnesota Vikings linebacker, was one of 14 living retired NFL players determined to have CTE through a special brain scan. McNeill's CTE was recently confirmed by autopsy after he died.

This new scan detects the presence of a protein, tau, in specific regions of the brain associated with CTE. Dr. Bailes told reporters he believes this discovery brings us closer to being able to diagnose players with CTE while they are still alive.

A few days later, Dr. Ann McKee and her team at Boston University announced a biomarker they believe is linked to CTE. They found significantly higher amounts of an inflammatory protein, CCL11, in the brains of deceased patients with CTE than in those without the condition. The more years a patient had played football, the higher the levels of CCL11 they found.

"Inflammation is normally a very helpful response in the brain, but when it goes on and persists for a long time, and gets out of control - that's what we think happens in CTE," McKee explained to reporters.

These are big steps to detecting this brain disease in athletes while they are still playing. Within a few years, we could be able to detect CTE, offer recommendations for retirement and even treat the condition.

Other studies this month provide helpful information for youth and high school athletes and their parents about concussions.

Researchers studied athletes between the ages of 13 and 18 treated for sport-related concussions. They performed computerized neurocognitive testing on the athletes, all of whom had said their symptoms were completely gone. Over 28 percent of them still had impairments on the computerized tests.

This study points to the value of baseline and post-injury computerized testing as part of the management of concussions. It also suggests we need to be extra cautious in returning an athlete to play as soon as he or she claims to be symptom-free.

As part of the treatment for concussions, most doctors prescribe a period of both physical and mental rest. Another study this month showed that after adolescent athletes were allowed to exercise, 12 percent of them showed a recurrence of symptoms. Athletes with a longer duration of symptoms and a previous undiagnosed concussion were more likely to experience a recurrence.

Studies like this one will help us tailor our return-to-play protocols to get athletes back to play as quickly as possible, but also as safely as possible.

Where will all this research lead? We will have to wait and see. It can only help us make better decisions. For all the talk of people trying to bring down the sport of football, I'm thankful this year for the concussion and CTE researchers trying to save the sport and the athletes who play it.

Dr. Geier is an orthopedic surgeon in Charleston and author of 'That's Gotta Hurt: The Injuries That Changed Sports Forever,' available in bookstores.

 

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November 26, 2017
 
 
 

 

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