Orig Post www.laboratoryequipment.com | Re-Post Duerson Foundation 1/21/2016
On Christmas Day, Sony Pictures released Concussion, a biographical sports medical drama film based on research by Dr. Bennet Omalu identifying chronic traumatic encephalopathy (CTE) in retired NFL players. While the movie may be classified as entertainment, the story is real, and the scientific research behind it is very real.
CTE is a type of traumatic brain injury associated with repeated blows to the head. The progressive degenerative disease can be spurred on by symptomatic concussions as well as sub-concussive hits to the head that do not cause immediate symptoms. Thanks to Omalu’s work, CTE has most commonly been found in the brains of professional athletes participating in football, but is also associated with other contact sports, such as ice hockey, wrestling and boxing and cheerleading. The disease is characterized by degradation of brain tissue and the accumulation of tau protein, causing symptoms such as memory loss, aggression, confusion and deep depression that generally appear years after initial brain trauma.
Omalu first encountered CTE in 2002 during the autopsy of former Pittsburg Steelers center Mike Webster when he was a forensic pathologist with the Allegheny County, Penn. coroner’s office. With the help of former Steelers team doctor Julian Bailes, Omalu published a paper on his findings, which was initially dismissed by the NFL. Concussion follows the “David v. Goliath” story of Omalu trying to reveal the truth with the NFL being less than cooperative. Eventually, Omalu is vindicated and amid growing scrutiny from retired players and Congress, the NFL is forced to take the concussion issue more seriously.
Although the circumstances have changed mightily since 2002, the same problem exists today for CTE research—it can only be diagnosed posthumously. However, thanks to continued research by Omalu and fellow researchers at UCLA, as well as significant research out of Boston University, we are getting closer and closer to the goal line of more accurate diagnosis.
UCLA’s PET Imaging Technique
CTE is characterized by the accumulation of the protein tau in regions of the brain that control mood, cognition and motor function. Tau is also one of the abnormal protein deposits found in the brains of people with Alzheimer’s, sometimes making it difficult to image the difference between CTE and Alzheimer’s.
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In 2013, Gary Small, Director of the Geriatric Psychiatry Memory and Aging Research Center at UCLA, conducted a study that became the first to identify the abnormal tau proteins associated with CTE in five retired NFL players who were still living.
The study—which included Omalu and Bailes as authors—relied on a chemical marker Small and collaborator Jorge Barrio previously created for assessing neurological changes associated with Alzheimer’s disease. The marker, FDDNP, binds to deposits of amyloid beta plaques and tau tangles, which are the hallmarks of Alzheimer’s.
After the players received intravenous injections of FDDNP, the researchers used positron emission tomography (PET) imaging to perform brain scans on the living players. Compared to healthy men, the NFL players had elevated levels of FDDNP in the amygdala and subcortical regions of the brain. According to the study, the FDDNP binding patterns in the players’ scans were consistent with tau deposit patterns that have been observed at autopsy in CTE cases.
“Early detection of tau proteins may help us understand what is happening sooner in the brains of these injured athletes,” Small told Laboratory Equipment.
Small and his colleagues further elaborated on this work in an April 2015 paper published in PNAS. The new, larger study included 14 retired NFL players (including the five previously used), in addition to 12 men and 12 women with Alzheimer’s disease and 19 men and nine women with healthy brains as controls.
The researchers identified four distinctive patterns of brain FDDNP PET signal in the 14 retired NFL players, each of whom has suffered at least one concussion. The four stages of deposits could signify early to advanced levels of CTE.