brain injury

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Study: Higher Cognitive Risk For NFL Vets Who Start Football Under Age 12

New England Patriots helmets are seen in the team locker room at Gillette Stadium last year. (Michael Dwyer/AP)

New England Patriots helmets are seen in the team locker room at Gillette Stadium last year. (Michael Dwyer/AP)

This post originally appeared on Boston University’s Research News Website as “Football: Child’s Play, Adult Peril?”

By Barbara Moran

As the 100 million viewers tuning in to this Sunday’s Super Bowl can attest, Americans adore football. And for many, the love affair begins in childhood: Pop Warner Tiny-Mites start as young as age 5, and many adults retain warm memories and friendships from their youth football days.

But a new study from BU School of Medicine researchers points to a possible increased risk of cognitive impairment from playing youth football. The National Institutes of Health–funded study, published online in the Jan. 28 edition of the journal Neurology, finds that former National Football League players who participated in tackle football before the age of 12 are more likely to have memory and thinking problems as adults.

The study contradicts conventional wisdom that children’s more plastic brains might recover from injury better than those of adults, and suggests that they may actually be more vulnerable to repeated head impacts, especially if injuries occur during a critical period of growth and development.

“Sports offer huge benefits to kids, as far as work ethic, leadership and fitness, and we think kids should participate,” says study lead author Julie Stamm (MED’15), a PhD candidate in anatomy and neurobiology. “But there’s increasing evidence that children respond differently to head trauma than adults. Kids who are hitting their heads over and over during this important time of brain development may have consequences later in life.”

“This is one study, with limitations,” adds study senior author Robert Stern, a MED professor of neurology, neurosurgery and anatomy and neurobiology and director of the Alzheimer’s Disease Center’s Clinical Core. “But the findings support the idea that it may not make sense to allow children—at a time when their brain is rapidly developing—to be exposed to repetitive hits to the head. If larger studies confirm this one, we may need to consider safety changes in youth sports.”

In the study, researchers reexamined data from BU’s ongoing DETECT (Diagnosing and Evaluating Traumatic Encephalopathy Using Clinical Tests) study, which aims to develop methods of diagnosing chronic traumatic encephalopathy (CTE) during life. CTE is a neurodegenerative disease often found in professional football players, boxers and other athletes who have a history of repetitive brain trauma. It can currently be diagnosed only by autopsy.

For this latest study, scientists examined test scores of 42 former NFL players, with an average age of 52, all of whom had experienced memory and thinking problems for at least six months. Continue reading

Could Boxing Brain Damage Have Triggered Tsarnaev?

This combination of undated photos shows Tamerlan Tsarnaev, 26, left, and Dzhokhar Tsarnaev, 19. (AP)

This combination of undated photos shows Tamerlan Tsarnaev, 26, left, and Dzhokhar Tsarnaev, 19. (AP)

Historical note: The name of the older Tsarnaev brother, Tamerlan, comes from the medieval Central Asian conqueror Tammerlane, also known as Timur the Terrible, who called himself “The Sword of Islam.”

And Tamerlan Tsarnaev, the deceased marathon bombing suspect, fashioned himself into a modern version of a warrior — as a boxer. But in modern times, we’re also increasingly aware that repeated blows to the brain, in boxing or other athletic combat, can cause serious damage known as Chronic Traumatic Encephalopathy, or CTE — and that in some people, that brain damage has been linked to violence unsanctioned by sports.

Might such brain damage have helped turn Tamerlan Tsarnaev into a terrorist? Sunday’s Boston Globe featured a call from two leading experts on CTE — Boston University’s Dr. Robert Cantu and Dr. Robert Stern — for a special autopsy on Tamerlan Tsarnaev’s brain to examine it for boxing damage. They also expressed “serious doubt” that such damage was to blame.

The early symptoms can include personality change, impulsivity, explosiveness, a short fuse, rage and aggression.

But as we all puzzle over what could have triggered the marathon attack, I pressed Dr. Stern, a professor of neurology and neurosurgery at the Boston University School of Medicine and co-founder of the university’s Center for the Study of Traumatic Encephalopathy: What do we know about the connection between sports-related brain damage and violence? Tamerlan Tsarnaev had incurred a charge of domestic violence; that reminded me of NFL linebacker Junior Seau, who was also accused of domestic violence before he committed suicide last year, and was later found to have CTE.

Dr. Robert Stern (Vernon Doucette/BU)

Dr. Robert Stern (Vernon Doucette/BU)

Dr. Stern: “In boxers, what we know from 80 years of case reports — and I say 80 years because the first article came out in the Journal of the American Medical Association in 1928, and ever since there’s been a lot of focus on boxers and being “punchdrunk,” or dementia pugilistica, which is the same as Chronic Traumatic Encephalopathy — what we glean from all of that, plus my own research at BU, is that the early symptoms of CTE can include personality change, impulsivity, explosiveness, a short fuse, rage and aggression.

So these things happen. They happen frequently, they’re a major part of CTE, this brain disease that doesn’t affect everyone who hits their heads over and over again, but when the disease is there, those are some of the early symptoms, especially in boxers. That is the connection.

Where it falls apart is when there is a well-thought-out, highly planned act where it’s not an impulsive, out-of-control, short-fuse rage.

But where it falls apart is when there is a well-thought-out, highly planned act where it’s not an impulsive, out-of-control, short-fuse rage. So that’s the big distinction. There are very disturbed people out there who are terrorists and who do awful things and who plan things way in advance and have training and all that — that’s not a symptom of CTE.” Continue reading

When The Grim Prognosis Is Wrong: A Brain Injury With A Happy Ending

Jason Crigler, 7 months after his brain hemorrhage, and in 2008, with his wife, Monica and daughter, Ellie (Life. Support. Music.)

Doctors don’t always know best.

Just ask Jason Crigler, musician, father and survivor of a massive brain hemorrhage from which doctors said recovery would be unlikely.

In August 2004, Crigler, a much-sought-after New York City guitarist with a two-months pregnant wife, was playing onstage at a Manhattan nightclub when, suddenly, he had a brain hemorrhage. He threw off his guitar and jumped down from the stage. He was rushed by ambulance to St. Vincent’s Hospital where his family was told the bleeding was severe.

A neurosurgeon offered this grim prognosis: even if Jason lived though the night (and the chances of that were slim) he’d likely have little brain function left and the old, pre-injury Jason would probably never return. (The cause of the hemorrhage, the family would later learn, was an arteriovenous malformation, or AVM — an abnormal collection of blood vessels in his brain that burst.) “The doctor said he wouldn’t be the Jason we knew and loved,” Jason’s sister, Marjorie said this week, speaking to an auditorium full of brain science students and faculty at MIT. “Most of his doctors didn’t think this recovery was possible.”

At the time, Jason was 34 years old.

But Jason, a Manhattan kid who picked up the guitar at 16, proved the doctors wrong. Today, he’s back playing music, taking his daughter to school and speaking publicly about his medical odyssey. He credits three essential forces with pulling him back to life: his music, fatherhood and his family’s unyielding, persistent faith in his recovery. (I would also add a fourth factor: extremely good luck when it came to health insurance and the ability to move to Massachusetts for care. As one of Jason’s doctors put it: “If you’re going to have a brain injury, this is the state to do it in.”)

Indeed, from the very beginning, Crigler’s wife, parents, in-laws and sister (who kept a journal of the saga) refused to accept the bleak portrait doctors painted. Though at the beginning things did seem bad. “It is so disturbing to see my brother curled in a human knot,” Marjorie wrote shortly after his injury.

There were a barrage of medical complications both major and minor — infections, meningitis, seizures, recurring urinary tract problems, his skin flaking off in patches due to the long hospitalizations. For some time he lay in a coma (a tube draining fluid from his brain disconnected accidentally, exposing his brain to the air for two minutes.)

But despite these setbacks, family and friends stayed by his side, constantly managing the kind of small, tedious daily tasks that helped Jason — haltingly, painfully, over years — gain his autonomy back. When he was unable to talk or move, the Crigler clan played music for him, they read him the newspaper, made jokes and sat around his hospital bed cracking each other up.

The family would visualize Jason healthy and walking and playing the guitar and encouraged him to do the same. They told him they loved him over and over again. “Most importantly, we had an open mind,” Marjorie said.

About four months after the brain injury, Jason told me he reached the maximum $1 million cap on his New York health insurance. So his wife, Monica began searching for rehab centers that would both accept Jason and be affordable. She called Spaulding Rehabilitation Center in Boston and after hearing Jason’s case, an administrator agreed to admit him with Medicaid pending. Continue reading

Daily Rounds: Blood Test For Brain Injury; Lying CEO’s; Female Viagra Trial Stopped; Faith For Health? Partying With Caritas, Obama

Army finds simple blood test to identify mild brain trauma – USATODAY.com “The Army says it has discovered a simple blood test that can diagnose mild traumatic brain damage or concussion, a hard-to-detect injury that can affect young athletes, infants with "shaken baby syndrome" and combat troops.” (USA Today)

How To Tell When A CEO Is Lying : NPR The researchers say “lying executives tend to overuse words like "we" and "our team" when they talk about their company. They avoid saying "I."’ (npr.org)

Medical News: Company Halts 'Female Viagra' Development – in Product Alert, Prescriptions from MedPage Today “The German pharmaceutical company Boehringer Ingelheim announced it is halting development of flibanserin (Girosa), a pill to treat female hypoactive sexual-desire disorder. The decision to stop development of the drug dubbed "female Viagra" or "pink Viagra" follows.. an FDA advisory committee (meeting) during which the panel voted 9 to 2 that flibanserin doesn't seem to work any better at increasing female sexual desire than placebo.” (medpagetoday.com)

Healing faith? – The Boston Globe “Women who read Scripture passages and prayed together during their classes — and set goals for themselves — walked farther and potentially had lower blood pressure than women whose sessions didn’t emphasize faith.” (Boston Globe)

Caritas CEO hosting fund-raiser with Barack Obama – BostonHerald.com “Though several Democrats said de la Torre has shown little interest in the party, he is a friend of DSCC chairman and New Jersey senator Bob Menendez, with whom he shares Cuban roots. He has also been a public advocate of national health care reform.” (Boston Herald)