In Case You Missed It…

Last week I tweeted about a story on Deadspin.  It was a very well written article, one that should make us hopeful and fearful at the same time; at the very least it is thought-provoking.  Even after reading it several times I still feel that Kyle Wagner absolutely did everyone a service by publishing this piece;

The question, after a decade of brain-slicing autopsies, is when any of this will help players before they’re dead. Doctors can’t just crack open living patients’ skulls and lop off slices of their brains to stick under a microscope.

But new research at UCLA is using a cutting-edge biomarker that can attach itself to tau protein tangles so that they show up on PET scans of living subjects. Dr. Gary Small is currently running a pilot study on retired NFL players, imaging their brains in place. If he is successful, his work would reorient the science of head injuries around saving lives instead of merely contextualizing deaths.

“I’ve always sort of thought of tau imaging as the holy grail on the issue of chronic brain damage, especially CTE,” said Dr. Julian Bailes, one of the founders of the Brain Injury Research Institute (BIRI).[…]

PET imaging tech is half a century old, and though FDDNP is relatively new, it’s still been around for years. So it’s strange to think about the marker being on the cutting edge of a fairly recently discovered brain disease. If the marker can find and pinpoint CTE, why hadn’t anyone tried it before now? And for that matter, why isn’t it already in use?[…]

In Las Vegas, Dr. Charles Bernick is attacking the same problem from a different angle. Instead of looking for CTE itself, Bernick wants to know how the disease spreads and changes its victim over time. He’s wrapping up the first year of an ongoing study tracking the cognitive health of over 100 boxers and MMA fighters, some of whom enlisted at the urging of a family member or spouse who’d started to notice changes in behavior. The goal of the study is to pinpoint when, exactly, a fighter should hang up the gloves.[…]

Brain injuries in football happen because of a phenomenon that Bailes, now co-director of NorthShore Neurological Institute, calls “brain slosh.” “That’s where the brain is free to move around inside the skull, regardless of helmets or external protection, because it floats inside a bath of fluid called Cerebral Spinal Fluid (CSF),” he explained. “Despite the fact that sports and the military looks at brain protection from the outside, we think you have to look at it from the inside.”

In fact, Bailes is working on an absurdly simple accessory that could protect brains from being injured in the first place.[…]

As with the search for a tau protein biomarker, there just isn’t the widespread need for continued research in CTE the way there is for other forms of brain deterioration. A representative at one company who asked to not be named explained that, while recent talk about pulling the military into the ongoing brain-injury discussion could go a long way toward making the financials work, it still wouldn’t be enough. Despite all the attention it’s gotten, a health crisis affecting wealthy young celebrities in America’s most popular sport is still only a niche concern.

“It’s not like cancer, where your constituency is everyone, or even Alzheimer’s, where there are millions,” he said. “We just don’t get hit in the head very often.”


4 thoughts on “In Case You Missed It…

  1. joe bloggs June 26, 2012 / 10:14

    The marker will only be used in research. Too expensive and does not give enough inference. Small’s tried to sell this in Adult Dementia of Alzheimer’s type and failed. No one is going to move until there is a treatment. Second, the detection of p-TAU is not sufficient to make any inference about whether it is propagating.

    Bailes seems like he is off the reservation. Increasing cranial pressure 30% with what consequence. Likely to be a banner case of laws of unintended consequences.

    • A Concerned Mom June 26, 2012 / 12:03

      Obviously, I don’t have any medical experience … but the thought of increasing cranial pressure was an immediate concern for me.

      I’ve been watching some of the Sixth Annual National Summit videos that SportsConcussion TV put out on, and the problems stemming from bomb blast injuries seem concerning – just the number of service personnel exposed to these types of injuries at relatively young ages is going to be a big issue for the military.

      • Joe Bloggs June 26, 2012 / 12:38

        Blast injuries are on a totally different plane of severity than sports injuries.

        It is a bad story that will get much worse.

  2. Jake Benford June 26, 2012 / 12:08

    Hopefully the research will continue, because until we really understand what is happening we can not work on a treatment.

    I heard Dr. Bailes talk last week, and he seems like a smart guy who gets it. I am not sure if we can increase ICP that much without some negative consequence though.

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