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NIH Research on Concussion and the Brain

Dr. Anne McKee

Dr. Anne McKee is a pioneer in the study of athletes' brains and the damage to them by repeated blows to the head.
Photo courtesy of Boston University

In 2012, the National Football League (NFL) donated $30 million to the Foundation for the National Institutes of Health (FNIH) for research studies on injuries affecting athletes—with brain trauma, including concussions, being the primary area of focus. The National Institutes of Health (NIH) selected eight projects to receive funding support to answer some of the most fundamental problems on traumatic brain injury, including understanding long-term effects of repeated head injuries and improving diagnosis of concussions.

Traumatic brain injury (TBI) is a major public health problem that affects all age groups and is the leading cause of death and disability in children and young adults. Recently, concern has been raised about the potential long-term effects of repeated concussions, particularly in those most at risk: young athletes and those engaged in professions associated with frequent head injury, including men and women in the military.

Current tests cannot reliably identify concussions, and there is no way to predict who will recover quickly, who will suffer long-term symptoms, and which few individuals will develop progressive brain degeneration, called chronic traumatic encephalopathy (CTE).

"Boxing, Football and the Brain"

One study, funded in part by NIH, is to help determine the connections between repeated head trauma and CTE. The research is led by neuropathologist Ann McKee, M.D., director of the CTE Program at Boston University School of Medicine.

Dr. McKee has extensive experience in neurodegenerative disease, particularly in traumatic brain injury. She has identified the CTE disease in dozens of former college and professional football players. But, she notes, there is CTE among members of the military and athletes in other sports—anywhere where there are repeated blows to the head.

She recently gave the Joseph Leiter Lecture at the Medical Library Association's annual conference. Her topic was "Boxing, Football, and the Brain."

Dr. McKee noted that the first recognition of what we now label CTE was in research among retired boxers in 1928—what later came to be called punch drunk. More recently, CTE has become the standard term.

As her research has become more widely known, dozens of former football players have made arrangements to have their brains, after death, sent to Dr. McKee for study.

Among the wide range of CTE symptoms are depression, anger, violent mood swings, memory problems, depression, slowed thought and speech, and dementia. Increases in suicides are correlated to CTE, as well. Clinical symptoms of CTE often occur years and even decades after the trauma, but not always, Dr. McKee noted.

Fast Facts

  • Traumatic brain injury (TBI)—including concussion—occurs when a sudden trauma causes damage to the brain. Symptoms of TBI can be mild, moderate, or severe, depending on the extent of damage.
  • About 1.4 million people suffer a TBI each year in the United States. Of those, 50,000 die, 235,000 are hospitalized, and 1.1 million are treated and released at an emergency room.
  • The leading causes of TBI are falls (28 percent), motor vehicle crashes (20 percent), other events in which the head strikes or is struck by an object (19 percent) and personal assaults (11 percent).
  • U.S. hospital emergency rooms treated about 319,000 sportsrelated head injuries in 2006 (latest figures). That was an increase of 10,000 injuries from 2005.
  • Over the last few years, tens of thousands of soldiers have suffered traumatic brain injuries from blasts due to improvised explosive devices (IED) in Afghanistan and Iraq.

Among the findings is that CTE can appear in some players while they are still very young: "Ex-Missouri State player Michael Keck had severe CTE by the time of his death at 25," said Dr. McKee. "High school football and rugby player Eric Pelly died 10 days after his fourth concussion. He was 18 years old, and his brain should have been pristine, but his brain showed early-stage CTE."

"Of the brains we have in the Brain Bank, there are 87 that are former NFL players. And 83 of those—95 percent—had CTE."

"There is a huge effort afoot to educate," she said. "There's concussion management: policies in most of the states to not return an athlete to play unless they've been cleared by a medical professional."

This research has important cultural implications related to the perception of concussion as an injury. "Since I have been working on this, there has been such a change," she said. "When I first began talking to athletes, they talked about their concussions as a badge of honor. But that has changed now."

Read More "Concussion" Articles

Sports and Concussion / NIH Research on Concussion and the Brain / Doug Flutie: "Be on the Safe Side." / Concussion and Traumatic Brain Injury

Summer 2015 Issue: Volume 10 Number 2 Page 11