Game Changers

“Brown Is Bad, Brown Is Cell Death.”  The “brown” is tau, a protein that accumulates in the brains of people, like professional football players and boxers, who have sustained repeat blows to the head. Learn about the research and education going on at the Center for the Study of Traumatic Encephalopathy, a collaboration between Boston University School of Medicine and the Sports Legacy Institute.

See all videos interviews with Dr. Ann McKee.

[♪Harvard's fight song playing♪] [female announcer] And making his way to the ring weighing in at 260 pounds, Christopher Nowinski! [male announcer] Stand up when you hear that. That's Harvard's fight song. [Christopher Nowinski] Thank you, everyone, for coming. Tonight we're going to discuss really everything that a parent and a coach needs to know about concussions. I want to give you all tonight an appreciation for what repetitive brain trauma means to athletes and how to keep athletes playing safe. But it all starts with my pro wrestling career. I actually have some of my concussions captured, which is nice. [♪♪] [male announcer] ...down on his neck. What is he doing?! [Christopher Nowinski] I had depression problems, I had short-term memory that was terrible for a year and a half, I kept sleepwalking for three and a half years and needed medication and I had headaches for five. That's when I decided maybe there was something wrong with my brain. [♪upbeat music♪] [Robert Stern] Our group here at BU School of Medicine started around two years ago in 2008. And since that time, we've been doing a variety of research studies, trying to understand the long-term consequences of repetitive head trauma in sports. [♪♪] [Ann McKee] One of the most important things that we've come up with with this center is studying the brains of retired professional football players and seeing in nearly all of them this very devastating neurodegenerative disease, CTE. Chronic traumatic encephalopathy, or CTE, is a progressive brain disease that is caused by repetitive blows to the head. [Christopher Nowinski] So essentially, a protein in your brain becomes toxic to the cell, and cells start dying at some point while you're an athlete. And usually by your 40s you're showing symptoms like memory problems, depression, personality change. [Robert Stern] Those symptoms get worse and worse and eventually the person will develop a full-blown dementia. [Christopher Nowinski] The NFL did not want to believe this existed for a long time. [Robert Cantu] The NFL was denying the connection between brain trauma in their athletes and some of them having chronic traumatic encephalopathy. [Christopher Nowinski] However, we've managed to kind of change the nature of the debate. We also provided a lot more research proving this was a bigger problem than we thought. This is a former NFL player. It's the first case we did at Boston University. John Grimsley was diagnosed with at least three concussions in college and eight concussions in the NFL. When we got his brain, we saw something very striking. What you see here, just so you understand, the brown is dead cells. When you stain the tissue, the tau protein shows up as brown. Brown is bad. Brown is cell death. A 65-year-old person from the Framingham Heart Study with an unknown trauma history has no tau. A boxer who is actually with dementia, you see enormous cell death. With Grimsley at 45, you see that he had nearly as much cell death as the boxer at 73. Entire parts of his brain were mostly dead. [♪mellow music♪] [male announcer] Concussions and other head injuries must be taken seriously. [Christopher Nowinski] The professional sports organizations have come around, specifically the NFL. They've luckily become kind of a leader on this. [Ann McKee] The changes that have gone on at the NFL have been extraordinary. They've made concussion and concussion awareness a public health topic. [Michael Strahan] You have to realize I have friends who are in the 30s who are taking Alzheimer's medicine because they've had issues with concussions. [Howie Long] Only now are we starting to see the effects of head trauma on our previous generations—the long-term effects. [Christopher Nowinski] It's very exciting to see the professional sports change and really the culture change that's come with it. [whistle blows] Go, go! [helmets crash] [crowd] Oh! Gosh! [player crying] [Christopher Nowinski] You start a kid at six years old playing football, he plays through high school, we're talking maybe 7,000, 10,000 hits to his head. Parents and kids need to take trauma in sports far more seriously than we ever have before. An 18-year-old that played multiple sports, had multiple concussions, was already showing these focal points of the disease. We're not telling people to run away from the field screaming. What we're saying is understand that there are risks to what you do. You can mitigate those risks by taking proper precautions. We're trying to tell coaches to scale back hitting by half now, today, stopping kids from hitting so much in practice. Become a better coach by getting them to be better football players without whacking their head. What's now law in Massachusetts is education. Every coach is educated, no kid is going back into the same game when they're suspected of having a concussion and I think that's going to go a long way towards making the game safer. What I hope will happen is twofold: First, we prevent sports from actually destroying kids' lives by finding ways to play the games safely for the brain; And on the second side, we really hope to find ways to treat and cure CTE in people who have already been affected. To make it personal, I hope this is the group of researchers that finds a cure for this disease while I can still use it. I figure if your average onset of symptoms for CTE is 43, I've got about 12 more years before I may need something, before I've lost so much tissue that there's really no turning back. [♪♪]
Posted on BrainLine December 1, 2010.

Center for the Study of Traumatic Encephalopathy at Boston University. Used with permission. Third-party use restricted.

About the author: Ann McKee, MD

Ann McKee, MD is the chief neuropathologist for the Framingham Heart Study and the Boston University-based Centenarian Study. She is also the chief neuropathologist for the Boston-based Veterans Administration Medical Centers and for the Sports Legacy Institute.

Ann McKee