Fighter’s Brains Show Changes Before Symptoms Appear

The New York Times reports that preliminary findings from the year-old Professional Fighters Brain Health Study show that physical changes in the brain resulting from repeated blows to the head are detectable before memory loss and decline in cognitive function appear.

According to Dr. Charles Bernick, the focus on blows that result in concussion rather than on many lesser blows may be too narrow.

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Giffords TBI Media Coverage in 2011

It has been just over a year since US Congress Representative Gabrielle Giffords experienced a traumatic brain injury as a result of a shooting in Tucson, AZ. While Traumatic Brain Injury (TBI) is now estimated to affect over 1.5 million Americans each year, with many of those wounded from the Iraq and Afghanistan wars, Giffords case has helped shed some new light on the way the media is focusing on TBI.

A variety of stories were in the media after the January 2011 shooting focusing on Giffords recovery, sometimes quoted as “remarkable.” Her yearlong treatment has come through a mixture of the services of Memorial Hermann Medical Center in Houston, home based therapy, and an intensive therapy program based in Ashville, NC. These programs involved traditional therapy approaches common after a TBI such as occupational, physical, & speech therapy, as well as music and animal based therapy programs. Approximately 4 months after Giffords injury, her doctors placed her in the top 5th percentile for patients recovering from similar injuries.

At a recent vigil to honor the other victims of the Tucson shooting, which killed 6 and left 12 others injured, Gabrielle Giffords recited the Pledge of Allegiance in front of hundreds of people, as they quietly chanted “Gabby, Gabby” in encouragement. In a CBS interview with Diane Sawyer she was asked about her intentions to run for reelection this fall; her reply indicated that she will continue to focus on her recovery. In other interviews her husband, Captain Kelly, has been attributed to saying that some days he thinks she could do it; other days it seems it would just be too much.

Giffords’s ordeal has contributed to an already growing awareness about the need for treatment after experiencing a TBI. Many of the stories over 2011 have pointed out that most individuals do not have access to the same type of intensive recovery program as Giffords. While research in recent years has proved that these treatment programs are valuable in recovery after a TBI, insurance companies still rarely cover these services. “Cognitive rehabilitation services designed to improve cognitive functioning after a brain injury are not supported by reliable scientific evidence of efficacy,” according to a 2008 Tricare coverage manual.

Other aspects of recovery after TBI have been exemplified in the media using Giffords as a model, such as the effects of TBI on marriage, returning to work after a TBI, and generalizations made of persons who have experienced TBI.

While the January 2011 shooting was an awful tragedy which affects the lives of many, a positive side has emerged out of it; more people are becoming aware of how seriously TBI affects not just an individual but a family. Giffords case represents that having more programs to intensely focus on an individual’s recovery yields positive results, and that better funding gives more people hope that they will be able to return to a better quality of life after TBI. Hopefully Giffords example can continue to shed light on how TBI affects so many people each year, and can continue to push for better programs and funding for recovery.

Frequent Heading of Soccer Ball Can Cause Brain Damage

A new study of the brains of soccer players who have played since childhood and currently play in adult leagues shows that “the players who had headed the ball more than about 1,100 times in the previous 12 months showed significant loss of white matter in parts of their brains involved with memory, attention and the processing of visual information, compared with players who had headed the ball fewer times”.

Another study of college players at Humboldt State University in California shows a correlation between frequent heading and poorer performance on tests of visual memory.

There appears to be a threshold below which heading is safe, but a growing consensus holds that children younger than 12 “shouldn’t be heading … and [that] parents should monitor the number of heading repetitions and any accompanying symptoms in older children”.

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Derek Boogaard and Chronic Traumatic Encephalopathy

Derek Boogaard: A Brain ‘Going Bad’ at traces the decline and death of NHL left winger Derek Boogaard. Boogard died on May 13, 2011, as the result of an accidental overdose of drugs and alcohol.  He was 28 years old. Comments from teammates, friends, and family tell a story of a decline into personality change, drug and alcohol abuse, and depression.

Boogaard’s family donated his brain to the Bedford VA Medical Center in Bedford, Mass. Scientists at the center reported their findings to the family five months later:

Boogaard had chronic traumatic encephalopathy, commonly known as CTE, a close relative of Alzheimer’s disease. It is believed to be caused by repeated blows to the head. It can be diagnosed only posthumously, but scientists say it shows itself in symptoms like memory loss, impulsiveness, mood swings, even addiction.

More than 20 dead former N.F.L. players and many boxers have had CTE diagnosed. It generally hollowed out the final years of their lives into something unrecognizable to loved ones.


But this was different. The others were not in their 20s, not in the prime of their careers.
The scientists on the far end of the conference call told the Boogaard family that they were shocked to see so much damage in someone so young. It appeared to be spreading through his brain. Had Derek Boogaard lived, they said, his condition likely would have worsened into middle-age dementia.

These and other findings show that CTE can start early. They also stress the need for families of athletes to become more aware of executive dysfunction (especially problems with emotional dysregulation due to frontal lobe damage) and the importance of neurorehabilitation for high school and college hockey players who have had concussions.

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College Athletes File Class-Action Suit against NCAA over Concussions

The New York Times reports that a class-action suit claiming the NCAA has been negligent in addressing concussions suffered by athletes has been filed in the U.S. District Court for the Northern district of Illinois on behalf of Derek Owens, Adrian Arrington, Mark Turner, and Angela Palacios. Palacios is a former soccer player; Owens, Arrington, and Turner are former football players.

NYT writer George Vecsey interviewed Owens, who describes his history of concussions, the first two of which he sustained in high school. His most recent concussion, in 2010, resulted in depression, migraine, and poor academic performance.

The NCAA says that the suit is “without merit”.

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