the disease. It was later termed“ dementia pugilistica,” meaning dementia of a fighter. 7
But the symptoms of CTE— including painful headaches— are not exclusive to boxers. They’ ve been reported in football players, hockey players, professional wrestlers, soccer players, jockeys, soldiers exposed to blasts and even a frequent parachutist. 8 Further, head trauma isn’ t exclusive to professional athletes. The New York Times recently reported that a Tulane University football player broke his neck in September during a tackle, and countless other high school athletes are likely enduring concussions that could result in longterm decline. 9 To account for this widespread impact of head trauma, dementia pugilistica was renamed“ chronic traumatic encephalopathy”( i. e., a chronic disease of the brain caused by trauma) in the 1960s. Fifty years later, CTE research remains in its infancy and there is still much to be learned about the disease. Prevention is currently the only way to avoid the downward spiral. 7
CHRONIC HEADACHES AND SIGNS OF DEMENTIA
Matthew McCoyd, MD, remembers being shocked by the news of Duerson’ s suicide but says Duerson’ s history was“ fairly characteristic of the disease.” Dr. McCoyd is a Notre Dame alumni himself and a neurologist at Chicago’ s Loyola Medical Center where he runs a concussion clinic for athletes.
The downward spiral of CTE can start years or even decades after the head trauma. In athletes, symptoms typically emerge in mid-life, after they’ ve retired from sport. In the first phase of CTE, individuals notice problems with concentration and memory, disorientation, dizziness and chronic headaches. Over time, those individuals become more irritable and confused, may show aggressive or violent behavior, and may have speech disorders. 8
Family and friends often speak of a change in personality. Duerson exhibited worsening cognitive
GOVERNMENT, ATHLETICS SUPPORTING CTE RESEARCH
CTE research has grown exponentially in recent years. 7 On September 5, 2012, the NFL donated $ 30 million in funding to the Foundation for the National Institutes of Health for research into brain injuries and degenerative diseases. 20
In addition to studies among athletes, the Veterans Administration( VA) is researching CTE among veterans.
“ Imagine someone who just had an improvised explosive device set off near them: first, there’ s the actual blast and then there’ s a wind that can be upwards of a few hundred miles per hour,” Dr. McCoyd says.“ You can imagine the type of force that’ s going to put on the brain.”
The VA recently performed a neuropathological analysis to compare the brains of four military veterans exposed to blasts or concussive injury with the brains of football players and a wrestler who had experienced repetitive concussive injuries. Published in the May 2012 issue of Science Translational Medicine, the study found that all four veterans had tau tangles indicative of CTE, similar to the CTE indications found in the brains of the four athletes. 21( Learn more about repetitive concussions on page 14.)
In the same study, the researchers immobilized the head of a mouse and found that such immobilization protected the mouse from brain injury during a blast. NASCAR has tried a similar approach to prevent head injuries by mandating better seatbelts and harnesses for racecar drivers. 22“ If you could do the same thing for football, you’ d probably reduce the risk of concussion,” says Dr. McCoyd,“ but then you can’ t play the game.”
7. Saulle et al.“ Chronic Traumatic Encephalopathy: A Review.” Rehabilitation Research and Practice. 2012:816069. 8. McKee et al.“ Chronic Traumatic Encephalopathy in Athletes: Progressive Taupathy Following Repetitive Head Injury.”
Journal of Neuropathology and Experimental Neurology. 2009; 68( 7): 709-735. 9. Cook.“ Dying to Play.” The New York Times. Sept. 11, 2012.
26 HEAD WISE | Volume 2, Issue 4 • 2012