Doc who studied David Duerson's brain finds punches & tackles have similar effect in athletes as roadside bombs do to soldiers' brains in small study

Dr. Lee E. Goldstein et al. of Boston University’s School of Medicine publishes Chronic Traumatic Encephalopathy in Blast-Exposed Military Veterans and a Blast Neurotrauma Mouse Model in today's Science Translational Medicine journal. The researchers stated that 'blast exposure is associated with traumatic brain injury (TBI), neuropsychiatric symptoms, and long-term cognitive disability' and then examined the brains of post-mortem soldiers who had been exposed to said blasts and other injuries that had caused concussions. They write:

We found evidence of chronic traumatic encephalopathy (CTE), a tau protein–linked neurodegenerative disease, that was similar to the CTE neuropathology observed in young amateur American football players and a professional wrestler with histories of concussive injuries.

The group conducted studies of mice where they caused blast neurotrauma to the rodents (don't ask how). And the important finding is this: "Head immobilization during blast exposure prevented blast-induced learning and memory deficits."

Picture a whole new set of helmets coming to a rink, court, or field near you with complaints of how it effects player's games or how it looks funny...from the players. Also envision new drug therapies as well as diagnostic tests for CTE (which today can only be confirmed via autopsy.)

"Not long ago, people said N.F.L. players with behavior problems were just having problems adjusting to retirement," Dr. Goldstein said. "Now it’s more or less settled that there is a disease associated with their problems. But we do not have that consensus in the military world yet."

The researchers concluded:

The contribution of blast wind to injurious head acceleration may be a primary injury mechanism leading to blast-related TBI and CTE. These results identify common pathogenic determinants leading to CTE in blast-exposed military veterans and head-injured athletes and additionally provide mechanistic evidence linking blast exposure to persistent impairments in neurophysiological function, learning, and memory.

The NY Times' James Dao pointed out some important criticism of the paper. More brains wrote the paper than were examined:

Some experts who have read the paper questioned the authors’ conclusions, saying that there was not enough data to conclude that blast exposure leads to C.T.E. Dr. McKee [Dr. Ann McKee, co-director of the Center for the Study of Traumatic Encephalopathy at Boston University and co-lead author. Dr. McKee was the professional who found evidence of damage to David Duerson, the retired Chicago Bear who died of a self-inflicted gunshot wound to the chest last year after he sent a text message to his family saying he wanted his brain to be used for research at BU.] autopsied only four veterans, and three of them had head injuries from multiple sources, making it hard to determine the cause of the disease, they said.

"It’s too small of a sample size," said Dr. David Hovda, director of the Brain Injury Research Center at the University of California, Los Angeles, and a health adviser to the Pentagon.

But Dr. Hovda said that the growing body of research linking C.T.E. to multiple head injuries was "quite remarkable," adding, "whether you believe it or not, you have to stand up and take notice."

Dr. Daniel P. Perl, professor of pathology at the Uniformed Services University of the Health Sciences, the military’s medical school, said the study did not convince him that the injuries from blast exposure were identical to head injuries from sports, and he questioned whether data from the mouse research was applicable to humans. But Dr. Perl, who has just started his own project to study the brains of military personnel, called the paper “an important contribution.”

“We aren’t only finding C.T.E. in football players and in hockey players. We’re now finding it in military personnel,” he said. “We now need to find the extent of the problem, and what is causing it.”

Finding the extent of the problem and what is causing it might take a long time. Dr. McKee said it took four years to acquire the brains of the four veterans.

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L. E. Goldstein, A. M. Fisher, C. A. Tagge, X.-L. Zhang, L. Velisek, J. A. Sullivan, C. Upreti, J. M. Kracht, M. Ericsson, M. W. Wojnarowicz, C. J. Goletiani, G. M. Maglakelidze, N. Casey, J. A. Moncaster, O. Minaeva, R. D. Moir, C. J. Nowinski, R. A. Stern, R. C. Cantu, J. Geiling, J. K. Blusztajn, B. L. Wolozin, T. Ikezu, T. D. Stein, A. E. Budson, N. W. Kowall, D. Chargin, A. Sharon, S. Saman, G. F. Hall, W. C. Moss, R. O. Cleveland, R. E. Tanzi, P. K. Stanton, A. C. McKee, Chronic Traumatic Encephalopathy in Blast-Exposed Military Veterans and a Blast Neurotrauma Mouse Model. Sci. Transl. Med. 4, 134ra60 (2012)
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