Navy Times 8-13-12 Athletes, vets suffer same brain disease Kime

Athletes, vets may suffer same brain disease

By Patricia Kime – Staff writer
Posted : Tuesday Aug 7, 2012 18:36:45 EDT

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Boston University researchers have found at least 19 military veterans, including three exposed to head-jarring explosions in Iraq and Afghanistan, with the same brain-wasting disease as some athletes who play contact sports.

The condition, chronic traumatic encephalopathy, or CTE, was first discovered in boxers in the 1920s and recently diagnosed in several professional football and hockey players after their deaths. At least 110 cases have been seen worldwide since 2009, according to researchers who recently discussed the need for additional research funds.

“This is not a new disease … but more and more, we are seeing it in football players, hockey, other sports — and many cases in veterans, including World War II, Vietnam, Gulf War, and Iraq and Afghanistan,” said Dr. Anne McKee, a BU professor and neuropathology director for the New England Veterans Health Care System and Brain Banks.

Presenting compelling slides of what she described as “brain rot,” including deterioration and the buildup of a destructive protein in the brains of former NFL safety Dave Duerson, NHL winger Derek Boogaard and four service members, McKee said the research, combined with studies done on mice, indicate that veterans exposed to blasts or who suffered concussions are at risk for developing CTE.

Up to one-fifth of the 2.3 million troops who have served in Iraq and Afghanistan, an estimated 460,000 veterans, likely were exposed to blast trauma, research shows. But McKee cautioned that more research is needed to determine who is really at risk.

“We have quite a number of these cases in our brain bank, but that isn’t necessarily reflective of … our general population. What we are very interested in finding out [is] what is the incidence and prevalence … in our athletes and veterans,” she said.

CTE diagnosis is controversial among some doctors who treat brain injuries, as well as sports medicine experts who point out that many contact-sport athletes never develop early-onset dementia, a prime CTE symptom.

William Barr, director of neuropsychology at New York University’s medical school, noted — and McKee readily admits — that the BU research is biased because it only examines the brains of troubled NFL or NHL players and veterans who donated their organs.

But Barr also questions the attention drawn on a diagnosis similar to other degenerative neurological conditions, including Alzheimer’s disease or dementia.

“I believe such public exposure and going prematurely with this type of information might be more dangerous to the larger number of people than to those who actually will come down with CTE,” he said.

Dr. Steven Flanagan, chairman of NYU’s Department of Rehabilitation Medicine, said the science is still emerging on the link between concussion, mild traumatic brain injuries and neurodegenerative conditions.

“It’s not a definitive link, but the evidence is building that repetitive concussions may result in true structural changes in the brain with these abnormal proteins,” Flanagan said.

Symptoms include emotional and psychological problems such as aggression, anger, confusion and short-term memory loss, as well as physical and mental manifestations, including drug and substance abuse, tremors and dementia.

The Pentagon has launched a 15-year study of injured troops to track symptoms and neurological conditions with an aim to “ultimately cure this condition,” said Col. Jamie Grimes, director of the Defense and Veterans Brain Injury Center.

Grimes noted that the services’ concussion research has reduced the kind of repeat injuries that can lead to CTE or long-term cognitive problems. For example, troops within 50 meters of a blast are now screened for concussion, and those who demonstrate symptoms are required to rest before returning to service.

“If we take out the risk of getting another concussion, they are doing so much better,” Grimes said. “They are staying in theater, recovering and staying with their battle buddies.”

Diagnostic tests such as brain imaging or blood tests to detect the presence of proteins or brain deterioration would aid in further understanding CTE and Alzheimer’s and may lead to preventive measures and treatment, such as better helmets and medications, McKee said.