CTE in Hockey

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Re: CTE in Hockey

Post by goldy313 » Sun Jun 16, 2019 12:25 am

People, in general, are not aware of the seriousness of concussions. Parents of athletes are, in general, some of the most ignorant people. Almost like smokers in their denial.

There is no movement to ban contact sports. The goal needs to be to enforce the rules. The NHL does, the NCAA does. The NFL needs to move in that direction, the MSHSL needs to make dramatic improvements in that area. (The NFHS sets the rulebooks, the MSHSL then instructs their officials to not disqualify kids). There is a disconnect there.

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Re: CTE in Hockey

Post by MNHockeyFan » Sun Jun 16, 2019 9:47 am

NCAA/D1 does a better job of protecting players than either high school or the NHL. NCAA refs do not hesitate to call game misconducts and DQ's when the see them or when the review indicates they are warranted. This is especially true on blatant boarding and high hits in center ice.

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Re: CTE in Hockey

Post by goldy313 » Wed Jun 19, 2019 12:07 am

On ice the NHL does a bad job, they can review any goal for offsides but don’t have the capacity to review hits to the head in real time? They do, retroactively, suspend players though.

The head contact mantra of the NFHS is when in doubt kick them out. The MSHSL is just the opposite.

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Hockey’s Next Head-Injury Reckoning

Post by greybeard58 » Thu Jun 20, 2019 11:00 am

Hockey’s Next Head-Injury Reckoning

The National Hockey League is facing renewed scrutiny into the lasting consequences that violence in its sport has on players. On May 1, the league’s commissioner, Gary Bettman, appeared at Canadian Parliament to address questions about head and brain injuries in hockey—a topic of growing alarm among current and former players, but one that Bettman has frequently dismissed.

Bettman maintained this stance throughout the hearing. But circumstances surrounding the meeting raise the question of how long the NHL will be able to plausibly deny the sport’s potential risk.

The group questioning Bettman was part of a parliamentary subcommittee on sports-related concussion. The subcommittee came together as attention to fighting and hits to the head in hockey has increased, coinciding with rising awareness of the neurodegenerative disease chronic traumatic encephalopathy, or CTE. It is now widely believed that the disease is linked to the repetitive blows to the head that are common in sports that involve athletes crashing into each other at high speeds.

Because nuanced research into CTE is still in relatively early stages, many scientists urge greater caution in protecting athletes’ brains. Players themselves have joined this call for better safety measures, especially following a string of high-profile early deaths over the past decade among former players whose brains were found to have evidence of CTE. In 2013, a group of former players, many fearing they already had or would develop the disease, launched a class-action lawsuit against the NHL for negligence toward head injury.

Bettman and the NHL, meanwhile, have argued that changes to the game should not be made until the science of head injury and CTE is more complete. The NHL defended itself in the 2013 lawsuit by employing a group of CTE skeptics as expert witnesses who cast doubt on CTE science. Bettman echoed this group’s views during the subcommittee hearing. In response to a pointed question from a subcommittee member about the link between CTE and hockey, he responded, “Based on everything I’ve been told—and if anybody has any information to the contrary, we’d be happy to hear it—other than some anecdotal evidence, there has not been that conclusive link.”

The NHL stands out in its continued denial of a link between CTE and head injuries sustained during game-play. The National Football League joined the majority camp of opinion surrounding CTE when it acknowledged such a link between football and the disease in 2016.

A brewing set of lawsuits by former players and their estates will challenge the NHL’s position. A day before Bettman appeared before the subcommittee, Kelli Ewen, the widow of the late hockey enforcer Todd Ewen, filed a lawsuit against the NHL in relation to his death. Todd played 11 seasons in the NHL and fought in almost every one of his games. After retiring, he began experiencing memory issues and depression. He took his own life in 2015. I recently profiled Todd in a short video documentary: https://www.youtube.com/watch?v=T_VSieTCMXI

In the months before his death, Todd confided in Kelli that he believed he had CTE. After he died, Kelli had his brain sent to Lili-Naz Hazrati, a neuropathologist at the Canadian Concussion Centre, to be analyzed for evidence of the disease. To the family’s shock, Hazrati concluded that Todd didn’t have the condition. Three years later, however, another neuropathologist, Ann McKee, one of the world’s leading authorities on the condition, reexamined portions of Todd’s brain and concluded that he in fact did have CTE.

In the three-year interim between these diagnoses, the NHL employed Hazrati in its defense of the players’ ongoing head-injury class-action suit. In her report, she cited Todd’s negative CTE diagnosis to refute a causal link between hockey and CTE. In a subsequent deposition, Hazrati again claimed that there was no link between CTE and head trauma. “We don’t know if one causes the other,” she said. When asked whether she believes that CTE is a disease, Hazrati said it was rather “a pattern seen on a slide.”

Last month, in an email response to interview requests for my documentary, however, a representative provided a statement that appeared to conflict with this claim: “Dr. Hazrati does not deny that concussions can cause damage to the brain, potentially resulting in a progressive neurodegenerative disease.” (Hazrati declined multiple interview requests for my documentary and did not comment on Kelli Ewen’s allegations for this article.)

Kelli Ewen’s new lawsuit details both Hazrati’s and the NHL’s failure to correct the statements they made regarding Todd since news of his positive diagnosis was released. It goes on to allege that Hazrati and the NHL had an undisclosed relationship at the time Kelli first sent Todd’s brain to be examined, and that Hazrati falsely presented herself as “an independent and neutral neuropathologist who believed that CTE was a genuine disease.” Kelli says that if she had known of these extenuating factors, she would not have had Todd’s brain analyzed by Hazrati.

Last November, the NHL offered a settlement to the former players involved in the class-action lawsuit. It amounted to roughly $22,000 per player with up to $75,000 in medical treatment. According to a lawyer representing players in the case, most involved are expected to take the settlement.

Kelli Ewen’s new lawsuit, though, could set a precedent for players who don’t accept the settlement and instead pursue their own suits. The NHL used Ewen’s initial negative diagnosis as a shield during one of its most public confrontations with the demons circling hockey. With that shield gone, the league might have less to defend itself with in a looming next round of court battles, when players and their families could again press Bettman and his colleagues to reflect on the possibility of hockey’s danger—and to do more to guard against injury.

“Todd’s death can no longer be exploited to justify the NHL’s complete lack of concern over head hits and violence on the ice,” Kelli’s lawsuit notes. “Rather, his death and CTE diagnosis should be a motivating force for positive change in NHL gameplay, and is further evidence that repeated head hits experienced in the NHL by players lead to long-term neurocognitive deficits.”

In a press scrum that followed the subcommittee hearing, Bettman said he would not retract his statements regarding Todd Ewen. The NHL has not responded to further interview requests.

Hockey’s Next Head-Injury Reckoning
A new lawsuit could challenge the NHL over its alleged dismissal of the dangers of CTE.
Read more and see video at: https://www.theatlantic.com/health/arch ... te/588643/

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"The link between traumatic brain injury and CTE is incontrovertible," said neuropathologist Dr. John Crary

Post by greybeard58 » Thu Jun 27, 2019 5:57 am

"The link between traumatic brain injury and CTE is incontrovertible," said neuropathologist Dr. John Crary

Hayley Hodson fully admits she would never be considered a science geek.

Before the star volleyball player from Southern California went to Stanford as an English major, she completed her high school courses online. One of them was biology and entailed the usual dissection of an animal.

After a package on ice arrived at her home in Orange County, Hodson treated it as if it contained a live rattlesnake.

"I wasn't touching it," Hodson said with a laugh. "My mom was my lab partner.”

Given that, Hodson did something brave and extraordinary this spring. On a visit to the Brain Injury Center of Mt. Sinai in New York, she carefully cradled in her palms a sliced half of a human brain.

It was an emotional and surreal experience for a 22-year-old who had to medically retire from volleyball in 2017 because of post-concussion syndrome. The NCAA Freshman of the Year in 2015, Hodson has an ongoing lawsuit against Stanford and the NCAA for what she charges was a lack of proper medical care.

"You hold a brain in your hands and you remember that this was a person," Hodson recalled. "It's a reminder of how fragile we are in some ways, yet we're so strong in what we endure.

"I've had a lot of reconciling moments with what it means to be human through this entire process," she said. "Your brain makes you human. When something goes wrong with it, it affects the core of who you were … how you perform in the world, how you are perceived. When something goes wrong in somebody's brain, it changes who they are.

"That's really scary.”

Hodson's visit to Mt. Sinai, made alongside former NHL player and brain injury survivor Daniel Carcillo, was arranged by Kimberly Archie, a nationally recognized sports safety advocate and co-founder of Faces of CTE, a group of people whose family members were athletes diagnosed with chronic traumatic encephalopathy after their death.

Archie and Rancho Bernardo's Jo Cornell have a lawsuit against the youth football organization Pop Warner, with a trial scheduled for early in 2020. Their sons played youth tackle football into high school and were found after their deaths to be suffering from CTE.

Faces of CTE and another organization, PinkConcussions, have begun collaborating with Mt. Sinai's Brain Injury Center to assist with brain donations of those who recently died while also recruiting living participants for long-term studies.

Of the Mt. Sinai visit, "It was pretty powerful," Carcillo, a two-time Stanley Cup winner with the Chicago Blackhawks, said in a phone conversation recently as he made the long drive from Chicago to his hometown in Ontario, Canada.

"Holding the brain and talking about it, you're in shock for a little while. You learn a lot, too. They pointed to the different regions of the brain that are most affected in athletes with competitive head trauma.”

According to the Brain Injury Center's director, Dr. Kristen Dams-O'Connor, Mt. Sinai is doing the most extensive work in the world on the brains of people who have suffered traumatic brain injury. Research surrounding TBI in the past has been limited, she said.

"With this program we're making a longer-term investment," Dams-O'Connor said in a phone interview. "I think a lot of this is treatable in the short-term. We need to be able to access interventions, and our center is active in that space.

"We view the brain donor program as a long-term investment. It's a critical one. We need to find a pathway to be diagnosed in this life and be able to treat it.”

On the front lines of the work is Dr. John Crary, a neuropathologist who has extensive experience in studying neurodegenerative diseases such as Alzheimer's and Parkinson's. At Mt. Sinai, he has turned his focus to TBI and CTE and is using historical, genetic, biochemical and molecular approaches.

"The link between traumatic brain injury and CTE is incontrovertible," Crary said.

Among the cutting-edge methods is the use of artificial intelligence and highly sensitive computer imaging to capture microscopic details in the brain. Crary said the use of post-mortem MRI has become a critical tool.

For the first time, Crary said in an interview, Mt. Sinai researchers are dissecting brains and labeling various parts of the brain with bar codes, so as to make future studies more efficient.

"An investigator can say I need the dorsolateral prefrontal cortex from 45 patients, and it could be 10 minutes from the freezer to working on it," Crary said. "That could take months in the past.”

The study of the long-term effects of TBI is still very much on the "Wild West" frontier, Crary said. He compared it to the early stages of cancer research and noted it took decades for scientists to discover cancer wasn't a single disease, but a series of unique mutations. The study of CTE and brain trauma, he said, "is still at the beginning of Stage 1.

"Cancer took 60 years," McCrary said. "I'd say we're 60 years behind the cancer folks.”

Crary and his colleagues are adept now at identifying tau proteins — the "villains," Crary termed them — and the cloudy tangles they create in the brain. But they don't yet know why they develop in some people and not in others.

"Is it genetics, your immune system, your environment, something you ate, something you smoked, some pesticide?" he said. "We're still stuck. The good news is we're working on it and we have some powerful tools.”

Hodson said the tour at Mt. Sinai was "eye-opening.”

"As someone with brain injuries, it's really hard to be well-educated about all of this stuff," she said. "It was really cool to see how they're doing this in the brain science lab, and the various ways they look at brains from all sorts of different angles.

"It was also disappointing to learn how few resources in the medical world there are in terms of brains. There is still so much to be confirmed and discounted. There's so much disagreement. There's tremendous nuance that hasn't been fully addressed yet.”

For current and former athletes who have suffered from brain trauma, being educated on the subject, while also feeling that they're contributing to further research, gives them a sense of purpose.

When Carcillo, 34, retired in 2015 after a decade in the NHL, he knew there was something seriously wrong with his brain. Known as "Car Bomb" for the ferocious hits he both took and delivered, he said he suffered seven diagnosed concussions. He figures there were many more that were never identified.

Carcillo dealt with alcohol and substance abuse issues during his career.

"In the NHL, they don't talk about concussions or brain injuries," he said. "Not when I played, anyhow. There was no education on the matter. I had to figure out why I felt the way I did. … When you're playing, you don't want to look at it. But at some point you have to. It's stealing your quality of life. If you want to regain that, you have to face it.”

The tragic turning point for Carcillo came when his very close friend from the Blackhawks, Steve Montador, died unexpectedly in 2015 at the age of 35. Montador had suffered numerous head injuries in hockey and was diagnosed with CTE after his death.

Carcillo started a foundation for those suffering from post-concussion syndrome, and he took action in his own life. He has worked with specialists in Florida at the Carrick Institute and Plasticity Brain Center.

In April, Carcillo said doctors in functional neurology identified regions of his brain that were shut down due to trauma. They're exploring ways to build new pathways.

"It changed my life. I've regained the quality of my life," said Carcillo, noting that he still has difficult days. "It's had the biggest impact on me.”

The 6-foot-3 Hodson was among the most revered youth volleyball players in her class. She was still in high school when she began training with USA Women's Volleyball, and that's also where she says she suffered her first two concussions.

She would go on to suffer another concussion in practice as a freshman at Stanford, taking a smashed shot to the side of her head. Hodson suffered another blow to the head in a match against UCLA, but played on. She said it took months for her to understand the extent of the symptoms she suffered because of her brain injury.

Hodson contends women in college athletics feel as if they can't speak up about injuries. She implores them to do so.

"One of the travesties I've seen surrounding Title IX is that when women play sports, we're supposed to be thankful just to be there. Like it's a gift," Hodson said. "Whether it's implicit or explicit, there's a pressure not to cause problems.”

While women's soccer has been recognized as a sport in which concussions occur frequently, Hodson said volleyball is wrongly thought to be safer. She said that bigger, stronger athletes have the ability to fire balls at high speeds, and that defenders have little time to react.

She recalled being at national youth tournaments in which hundreds of players competed on dozens of courts, and contends she saw head injuries frequently.

"I look back at these things and they are chilling," Hodson said. "I was part of that culture — 'It's no big deal; it's just your brain. It'll take a couple of days and you'll be fine.’ "

After retiring from volleyball while retaining her Stanford scholarship, Hodson studied abroad at Oxford University and more recently in New York. She has worked as a filmmaker, but also is considering law school.

She has pledged her brain to PinkConcussions, and she hopes that in the very distant future it ends up in the hands of Mt. Sinai doctors.

Carcillo has yet to commit his brain to a research center and admitted it can be an unnerving topic of conversation. A few scientists already have asked him for the organ that most defines who he is.

"It's something now that's a part of my life," he said. "It can be strange, but that's my reality.

"I would like it to go somewhere and be in someone's hands who knows what they're doing. I have faith that John (Crary) does. We'll just cross that bridge when it presents itself."

Athletes with brain trauma have emotional, eye-opening visit to Mt. Sinai
Read more: https://www.mcall.com/cte-sports-brain- ... story.html

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Re: CTE in Hockey

Post by rainier2 » Thu Jun 27, 2019 8:02 am

Mild Chronic Traumatic Encephalopathy Neuropathology in People With No Known Participation in Contact Sports or History of Repetitive Neurotrauma.
J Neuropathol Exp Neurol. 2019 Jul 1;78(7):615-625. doi: 10.1093/jnen/nlz045.


It has been asserted that chronic traumatic encephalopathy (CTE) pathology is only present in former athletes and others who have been exposed to repetitive concussions, subconcussive blows, or both. We hypothesized that CTE pathology would be present in men who had no known history of repetitive neurotrauma. Comprehensive medical record reviews and health surveys completed by a family member were available for the 8 men in this case series, none of whom had known exposure to repetitive neurotrauma but 2 of whom had a history of traumatic brain injury (TBI). Postmortem tissue was immunostained for hyperphosphorylated tau (p-tau) to assess for CTE pathology, Braak stage, and aging-related p-tau. The neuropathologist was blind to age, personal history, and clinical history. Six of the 8 cases (75%) showed p-tau in neurons, astrocytes, and cell processes around small blood vessels in an irregular pattern at the depths of the cortical sulci. The changes were focal and limited in terms of overall extent, and some of the cases had a clearer pattern of pathology and some could be considered equivocal. Two of the 8 cases had a history of TBI and one of them showed CTE pathology. Five of the 6 cases with no known history of neurotrauma appeared to meet consensus criteria for CTE. This study adds to the emerging literature indicating that CTE pathology is present in people not known to have experienced multiple concussions or subconcussive blows to the head.

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Re: CTE in Hockey

Post by rainier2 » Thu Jun 27, 2019 8:05 am

Homicidal Violence Among National Football League Athletes

Acad Forensic Pathol. 2018 Sep;8(3):708-711. doi: 10.1177/1925362118797742. Epub 2018 Aug 31


Given the concerns regarding chronic traumatic encephalopathy and its potential association with violent behavior in football players, we investigated the rates of deaths and arrests related to homicide among the National Football League (NFL) population. In order to accomplish this, we performed a retrospective analysis of the 27 155 individuals who had played, or are currently playing, professional football since its inception in 1920. The number of observed homicides in this cohort was compared to the number of expected homicides using the Centers for Disease Control and Prevention annual tables. Information regarding player cause of death was obtained from web-based sources. We identified 17 (0.27%) homicides among the 6356 NFL player deaths. The average age of individuals dying as the result of homicide was 31.4 years (range 24-50 years). Gunshot wound was the leading cause of death. The standardized mortality ratio for death by homicide was historically below 5%. As compared to the general US population, there were about 70% fewer deaths by homicide in the NFL population than would be expected. Our study also found only 0.04% of the NFL player population has ever been the focus of a homicide investigation, with only 0.02% of the NFL player population having been convicted. Our findings suggest homicidal violence among NFL players is rare, as NFL players have substantially lower rates of dying and being arrested as a consequence of homicidal violence compared to the general US population.

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Re: CTE in Hockey

Post by rainier2 » Thu Jun 27, 2019 8:09 am

Chronic traumatic encephalopathy is a common co-morbidity, but less frequent primary dementia in former soccer and rugby players

Acta Neuropathol. 2019 Jun 1. doi: 10.1007/s00401-019-02030-y. [Epub ahead of print]


Chronic traumatic encephalopathy (CTE) is reported at high prevalence in selected autopsy case series of former contact sports athletes. Nevertheless, the contribution of CTE pathology to clinical presentation and its interaction with co-morbid neurodegenerative pathologies remain unclear. To address these issues, we performed comprehensive neuropathology assessments on the brains of former athletes with dementia and considered these findings together with detailed clinical histories to derive an integrated clinicopathological diagnosis for each case. Consecutive, autopsy-acquired brains from former soccer and rugby players with dementia were assessed for neurodegenerative pathologies using established and preliminary consensus protocols. Thereafter, next of kin interviews were conducted to obtain detailed accounts of the patient's clinical presentation and course of disease to inform a final, integrated clinicopathological diagnosis. Neuropathologic change consistent with CTE (CTE-NC) was confirmed in five of seven former soccer and three of four former rugby players' brains, invariably in combination with mixed, often multiple neurodegenerative pathologies. However, in just three cases was the integrated dementia diagnosis consistent with CTE, the remainder having alternate diagnoses, with the most frequent integrated diagnosis Alzheimer's disease (AD) (four cases; one as mixed AD and vascular dementia). This consecutive autopsy series identifies neuropathologic change consistent with preliminary diagnostic criteria for CTE (CTE-NC) in a high proportion of former soccer and rugby players dying with dementia. However, in the majority, CTE-NC appears as a co-morbidity rather than the primary, dementia causing pathology. As such, we suggest that while CTE-NC might be common in former athletes with dementia, in many cases its clinical significance remains uncertain.

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Alan Shearer: Dementia, Football and Me Documentary 2017

Post by greybeard58 » Fri Jun 28, 2019 1:04 pm

Alan Shearer: Dementia, Football and Me Documentary 2017
Watch at: https://www.youtube.com/watch?v=vMoDtIJ_b8I

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Brandi Chastain, Michelle Akers launch landmark CTE study for women's soccer: "We can't ignore this anymore"

Post by greybeard58 » Fri Jun 28, 2019 1:06 pm

Brandi Chastain, Michelle Akers launch landmark CTE study for women's soccer: "We can't ignore this anymore"

On Friday, Team USA will take on France in the Women's World Cup quarterfinal. But meanwhile, first on "CBS This Morning," former soccer stars Michelle Akers and Brandi Chastain reveal how they're raising awareness of a debilitating brain disease known as chronic traumatic encephalopathy, or CTE.

CTE is most often associated with football players who have repeated blows to the head and suffer from symptoms like memory loss. Now, these women are helping to launch a landmark study of former female soccer players.

"I was the one, the target. So I won every punt by the goalkeepers ... " said Akers, who scored both goals in Team USA's first championship in 1991. "As far as headers went … usually 50 a game."

Chastain, who helped lead the team to another title in 1999, had a similar experience. "Oh, I did a lot of heading the ball," she said. "And very proudly so and very determined and very aggressive."

Two decades after Akers and Chastain were celebrated for those championship plays, the former teammates are still close friends. Akers has suffered from migraines for decades -- and both women, now in their early 50s, wonder if their occasional memory lapses are out of the ordinary.

Chastain said that sometimes she "can't remember some details of a place we went ... or somebody's last name … But then my friends seem to reassure me that they, too, are experiencing that … So I'm thinking, 'Okay, maybe I'm all right.'"

"One of the difficulties is, 'how do you determine what's not normal and what is?'" Akers added.

Akers' questions mounted after she saw a 2017 documentary by British soccer legend Alan Shearer, who underwent testing to see if he had any early signs of CTE.

"I was watching that and going 'oh my gosh' …" Akers said. "That could be me … and it stopped me in my tracks."

To help find answers, Akers and Chastain have joined a long-term study into possible cognitive effects of those headers and collisions. The study, led by neurology professor Robert Stern, is run out of Boston University [School of Medicine]. Stern said that Akers and Chastain are now at the age where if there was going to be "worsening difficulty," it would become more visible.

The concern, Stern added, is the "subtler repeated hits" to the head – what's known as "sub-concussive trauma." The study will follow 20 former high-level female soccer players, 40 or older. Baseline testing includes an MRI of the brain and evaluation of cognitive function.

The findings could impact soccer all the way to college and youth levels. "I am concerned that this game played by hundreds of millions across the globe might be played in a way right now that could lead to later life brain disease," Stern said. "That's pretty scary."

Now a youth soccer coach, mother of two and a new grandmother, Chastain is determined to protect young players from unnecessary headers. "I have absolutely done a 180° on that," she said, adding "Heading five-story punted balls, no, not gonna happen. We're not doin' that."

"We can't ignore this anymore," she said. "It's not something we can just say, 'okay, tough it out.' it's not that."

While raising her 14-year-old son, Cody, and cheering on the next generation of soccer superstars, Akers is wondering about her own future. "As I'm getting older … I want to have a great life. I'm planning on that …" she said. "And if not, then I need to, like, prepare."

If she could go back and do it again, Akers said she "would not be heading a million balls like that."

"There's no way on earth I would do that again," she added.

FIFA, the world soccer federation, says it is actively studying and monitoring player health. The organization said that "to our very best knowledge, there is currently no true evidence of the negative effect of heading or other sub-concussive blows" – but Stern said that there have been MRI studies showing subtle brain damage linked to competitive heading.

To learn more about head impacts go to: https://concussionfoundation.org.

Brandi Chastain, Michelle Akers launch landmark CTE study for women's soccer: "We can't ignore this anymore”
Watch the video and read more at: https://cbsn.ws/31VPzTp

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Re: CTE in Hockey

Post by goldy313 » Fri Jun 28, 2019 11:39 pm

USA women’s soccer advocating anything is a losing proposition at this point.

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Where are the women's brain injury studies?

Post by greybeard58 » Tue Jul 02, 2019 8:35 am

Where are the women's brain injury studies? Two-thirds of those who get Alzheimer’s disease are women

In 1994, the National Football League formed a Committee on Mild Traumatic Brain Injury to study an alarming trend: Players were retiring early because of what seemed to be concussion-related problems, including persistent headaches, vertigo, cognitive impairment, personality changes, fatigue and difficulty performing ordinary daily activities. Around the same time, Eve Valera, then a Ph.D. student in clinical psychology at the University of Illinois, began to volunteer in a domestic-violence shelter and wondered how many of the women there might be experiencing comparable post-concussive symptoms as a result of head injuries inflicted by their partners.

When Valera could not find any published studies on brain trauma related to such violence, she decided to conduct one herself, by interviewing the women where she volunteered. She published the results in 2003 — two years before Bennet Omalu, then a pathologist at the University of Pittsburgh, reported the first known case in a deceased N.F.L. player of chronic traumatic encephalopathy (C.T.E.), a neurodegenerative disease characterized by some of the same symptoms plaguing the retired players. Three-quarters of the women, Valera found, had received at least one traumatic brain injury (T.B.I.); half had sustained multiple mild traumatic brain injuries.

In the U.S., the Centers for Disease Control and Prevention estimates that one in three women over the age of 15 has experienced what it categorizes as “intimate partner violence.” When Valera extends her sample to the overall population, she gets estimates that as many as 31 million women might have had a T.B.I. and 21 million might have had multiple mild ones. “Using annual estimates of severe physical violence,” Valera notes in a study published last fall in the Journal of Neurotrauma, “1.6 million women can be estimated to sustain repetitive T.B.I.s in comparison to the total annual numbers of T.B.I.s reported for the military and N.F.L. at 18,000 and 281 respectively.”

Yet most of what scientists know about the potential prevalence and consequences of mild traumatic brain injury has come from studying contact sports, especially football — so, mostly men and boys — over the past 15 years. It’s a vivid illustration of a broad and pernicious problem in medical research, which is that some groups of people get far more attention than others — often leading to important gaps in medical understanding, even around conditions that the public regards as “widely studied.”

For her study in the Journal of Neurotrauma, Valera, now a neuroscientist at Harvard Medical School, imaged areas of white matter thought to be involved in learning and memory in the brains of 20 women subjected to partner violence. The brain injuries were associated with what she believes reflects abnormalities in these brain regions. But she says that the study had significant limitations because of meager funding: a small sample size and no control group of women who were assaulted by partners but did not have head trauma. Understanding the effect of such changes over time would require expensive long-term studies. Yet, the news that thousands of women might be dealing with undiagnosed brain damage did not garner much attention: According to Altmetric, which tracks the online activity generated by scientific studies, Valera’s findings were tweeted four times.

In contrast, a 2015 study of football players’ white matter, conducted by researchers at Boston University and published in the same journal, was tweeted 50 times and received more widespread notice. (“Are You Ready for Some Football Brain Damage?” a USA Today headline asked.) It compared the white matter in areas of the brain of 20 former N.F.L. players who began playing football before age 12 with that of 20 who were the same age and started at or after age 12 and found many more abnormalities in the brains of the younger group, suggesting for the first time that the age a person is first exposed to football may influence his later susceptibility to brain injuries. It, too, acknowledged the limits of its sample (small and specific) and called for further research, much more of which has now been done, including on youth players who never reach elite levels. “We’ve shown over and over that it isn’t just concussions,” Ann McKee, who is the director of Boston University’s C.T.E. Center, told me. “It’s number of playing years.” She adds: “It’s the lower-level hits, what we call subconcussions, that are asymptomatic, that the player plays right through without even recognizing that he’s had an injury. Those are the low-level hits that we’ve shown increase the risk and severity of C.T.E.”

The media has raised alarm about these findings — so much so that other experts worry that the media is overstating the absolute risk of developing C.T.E. and understating the substantial health benefits that team sports, including football, offer. In a 2017 editorial in The Journal of Neurology, Neurosurgery and Psychiatry, Alan Carson, a professor of neuropsychiatry at the University of Edinburgh, points to a 2012 study of 3,439 former N.F.L. players. It found that they died from neurodegenerative diseases at three times the rate of the general population, but were half as likely to die of any other cause.

The trouble with comparing N.F.L. players with the general population, however, is that people who go on to become elite athletes may be a healthier cohort to begin with. Their superior health may lead them to play football, rather than it being the case that playing football improves their health. Last month, a new study by researchers at Harvard sought to control for this bias by comparing N.F.L. players with Major League Baseball players. It found that the football players had higher levels of mortality from all causes, including cardiovascular and neurodegenerative diseases, than the baseball players did, which could indicate that football itself was detrimental.

All available evidence suggests that reducing exposure to tackle football would reduce the incidence of C.T.E., which meets the criteria of a public health concern, the authors of a paper last year in the journal Human and Ecological Risk Assessment wrote. It is hard to say how much of the lingering debate over the risks of tackle football are a result of the N.F.L. becoming a major donor to concussion research; in the past, the league has attempted to defund researchers whose work shows that the accumulation of lesser hits may be even more detrimental. “In many ways, it’s to their advantage if the debate continues,” Philip M. Rosoff, of the Trent Center for Bioethics, Humanities & History of Medicine at Duke University, told me. But the paper also noted a “large and growing disconnect” between how public health scientists read the data and how clinicians do: a pediatrician whose young patients suffer from obesity, for example, may see football as a risk worth taking.

But if these risks are important to understand and mitigate for the million-plus boys playing tackle football — clearly they are — then why have we not put equal resources into studying them in women, a potentially vast number of whom could have been exposed to head trauma? The implications could be profound. For example, researchers hope that learning how C.T.E. works could help them diagnose and treat other neurodegenerative diseases, like Alzheimer’s, in which abnormal proteins in the brain may appear decades before they eventually damage tissue and lead to symptoms; unlike Alzheimer’s, which has no known cause, C.T.E. now appears to have a clear starting point in head trauma, which makes it possible to study its progression over time. (Researchers are still searching for a way to definitively test for both diseases in a living brain.) This progression, however, may be different in men and women. In fact, the little research on head injuries in female athletes and service members suggests that their brains may be more susceptible to trauma than men’s are. Two-thirds of those who get Alzheimer’s diagnoses are women.

Unfortunately, they may never benefit from adequate research. Part of the problem is that women hurt by intimate partners tend to hide that fact, making them hard to identify and study. But the bigger issue is that public outrage and advocacy play a major role in determining what research gets funded. In the case of head trauma, almost all the attention is going to football — and so, by extension, to only one gender.

Do Brain Injuries Affect Women Differently Than Men?
Read more: https://www.nytimes.com/2019/06/26/maga ... n-men.html

How Does Alzheimer’s Affect Women And Men Differently?
Read more: https://www.alzdiscovery.org/cognitive- ... ifferently

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CTE: The Hidden Risk of Playing Contact Sports

Post by greybeard58 » Tue Jul 23, 2019 5:16 pm

Please use the link at the bottom of the article for pictures and figures.

CTE: The Hidden Risk of Playing Contact Sports
Authors and reviewers

Hamad Yadikar is an Assistant Professor at Kuwait University, in the Department of Chemistry and Emergency Medicine. His research project involves understanding traumatic brain injuries (TBIs), and CTE. He is continuing his studies as a post-doc with Professor Wang at the University of Florida and hopes to aim to find a cure for people that suffers from different types if brain injuries. *hamadayadikar@chem.ufl.edu

Connor Johnson is a fourth-year undergraduate at the University of Florida majoring in Chemistry with a focus on Biochemistry. He is a Researcher at the McKnight Brain Institute in Gainesville, Florida under the supervision of Dr. Kevin Wang, Ph.D. and Ph.D. candidate Hamad Yadikar. He hopes to attend medical school and ultimately become an emergency physician or a trauma surgeon.

Edwin Mouhawasse is a third-year Health Science major at The University of Florida. He does research at the McKnight Brain Institute on traumatic brain injuries, under Ph.D. student Hamad Yadikar and Dr. Kevin Wang. He is a member of the volunteer organization Dream Team, where he volunteers in the pediatric intensive care unit and the pediatric cardiac intensive care unit. He is following the pre-medical track and would like to go to medical school and become a physician one day.
Milin Kurup is a freshman studying at the University of Florida, majoring in Microbiology and Cell Sciences and minoring in Health Disparities. He has been working with Dr. Kevin Wang and Ph.D. candidate Hamad Yadikar on tauopathies for the last two years. After experience in neurological research, he hopes to pursue a career in Pediatric Neurosurgery and inspire children in medical sciences.

Lynn Nguyen is in her fourth year studying at the University of Florida. She majors in Microbiology and Cell Science and minors in Environmental Sciences. She studies tauopathies at the McKnight Brain Institute under the supervision of Dr. Kevin Wang and Ph.D. candidate Hamad Yadikar. Once she graduates, she plans to apply to dental school and eventually become a prosthodontist.

Niko Pafundi graduated from the University of Florida with a B.S. in biology in 2018. Under the supervision of Dr. Kevin Wang and Ph.D. candidate Hamad Yadikar, he has assisted in experiments and analyzing the results to further understand tau protein. In May of 2018, he plans to apply to Pharmacy School.

Dr. Kevin Wang is the Director of the Program for Neurotrauma, Neuroproteomics & Biomarkers Research and Associate Professor of Emergency Medicine at the University of Florida and the McKnight Brain Institute in Gainesville, Florida, USA. He is also Health Research Neuroscientist and Merit Award Principal Investigator at the Brain Rehabilitation Research Center at the Malcom Randall VA Medical Center (Gainesville, FL).

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If you have ever played contact sports, you may have heard about chronic traumatic encephalopathy (CTE). CTE is caused by repetitive head injuries leading to a progressive loss in memory and other brain skills. The lack of proper skull protection has become a leading cause of brain problems in athletes. When playing sports, we focus on competition rather than the impact of repetitive injuries. Physical sports, like football, hockey, and boxing, have all been associated with CTE. When the brain hits the skull with an intense force, a substance in brain cells called tau proteins can malfunction in a way that leads to harmful changes in thinking, behavior, and mood. Tau proteins can collect between brain cells and form structures that disrupt normal communications between the cells. We can protect our brains from CTE by limiting the number of head injuries we experience. Giving ourselves adequate recovery time following an injury, receiving medical clearance before returning to normal activities, and keeping up with our social lives throughout recovery can help prevent or minimize the negative effects of CTE.

Have you ever played a sport and hit your head by accident, maybe colliding with the ground or with another person? You might have experienced a ringing pain or a headache in the short term, but have you ever considered what repetitive hits to the head might do to your brain in the long term? When we play sports, we tend to focus on the fun parts, like the competition, teamwork, and the joy of winning. However, people usually do not consider the possible consequences of sports injuries on their mental health. Contact sports like football, soccer, boxing, as well as domestic violence and bomb blast waves, might damage the human brain more than expected, even after all the initial symptoms of the injury are gone (Figure 1) [1].

Figure 1 - Which sports can cause CTE? High-impact sports, such as soccer, football, boxing, and hockey, can lead to the development of CTE.

Tackling in football, hitting the head on the ice in hockey, and hitting the ground or another person’s head in soccer can all lead to head trauma and result in CTE if not appropriately treated. Although some protective gear has been created for sports, such as football and hockey, players are still susceptible to CTE. Sports administrators have added padding to arenas and courts to prevent head injuries. Additionally, coaches have emphasized good sportsmanship and proper techniques to avoid head injuries.
When a strong force hits the skull, the brain suffers damage. When the brain is damaged by a single injury, called a traumatic brain injury (TBI)Damage in the brain caused by a sudden hit to the head. TBIs can occur from accidents, sports, or other physical traumas., the body is affected in many different ways, depending on the intensity of the damage. When there are repeated injuries to the brain, those people are at a higher risk for developing something called chronic traumatic encephalopathy (CTE)A disease developed after multiple traumatic brain injuries, through the breakdown of brain cells.. Chronic stands for “long-lasting,” traumatic means “intense,” and encephalopathy refers to any process that alters the function or the structure of the brain. Severe hits can injure opposite sides of the brain, through the coup and countercoup model.A model representing how an initial injury (coup) can have enough force to cause damage on the opposite side of the brain (countercoup). How do opposite sides of the brain get injured? Well, the coup is the initial injury that occurs from a hit, while the countercoup injury occurs on the opposite side of the brain as the brain hits the inside of the skull (Figure 2). When the injury is intense, the brain can develop long-term damage in multiple areas that can significantly impair brain function, possibly leading to memory loss and, in a few cases, even death.

Figure 2 - One hit can damage two parts of the brain: the coup and countercoup model.

One hit to the brain results in a force on the skull that causes the brain to move back and forth. This motion leads to dual injuries, one in the location of the initial hit (coup) and a secondary hit on the opposite side, where the brain bounces off the inside of the skull (countercoup). Such injuries can be very damaging to the structure and function of the brain [1, 2].
So, it seems that repeated brain injuries will begin to damage the brain permanently. In sports like football, players can have contact on almost every play. Head contact is frequent in soccer, especially when players slide tackle to get possession; frequent head-to-head contact going for a ball can knock players out. In boxing, getting hit in the head repeatedly is inevitable. Looking at these sports from this perspective, it is easy to see why so many athletes are developing CTE, and most do not realize the consequences. Some sports have less of a risk for CTE, including swimming, tennis, and even basketball. We should all consider the risks and think about brain safety before we play any activity or sport. There are always emergencies that no one can control, like bike or car accidents, but when it comes to contact sports, we need to make the right decisions for a healthier life [1–4].

The level of intensity of each hit influences how quickly the brain starts to deteriorate. CTE can come from one strong hit or multiple smaller hits over time. Multiple factors influence the development of CTE in response to a head injury, including genes, diet, alcohol, drugs, etc. Different people are affected in different ways, and no specific number of hits dictates whether the CTE will develop [1].

The human brain needs healthy proteins for the brain cells to work and function properly. There are some proteins that we get from our diets and other proteins that are produced inside our bodies, such as the tau proteinA protein that holds brain cells together to keep the brain structure intact.. Tau proteins are the connecting pieces that hold brain cells together. Imagine the brain is a Lego city, with thousands of tall buildings, each one representing a brain cell. If a head injury occurs while playing sports, it disrupts the brain cell structures, like an earthquake causing the Lego buildings to fall apart. Continuous hits shake the brain cells, breaking them into smaller pieces and creating a mess that we call protein aggregates. When these aggregates collect within cells, it is difficult for the tau protein to function properly. Think of a traffic jam on the streets between the Lego buildings, caused by all the fallen debris. Over time, larger protein aggregates collect through the breakdown of other brain cells. As people age, these messes become so severe that the Lego city of brain cells in the brain can no longer function in a healthy way. Diseases related to problems with tau function are called “tauopathiesDiseases caused by the breakdown of tau proteins; Alzheimer’s disease is an example..” Tauopathies do not occur in an instant but happen after multiple brain injuries occur over time. Playing contact sports can speed up this process [1, 2, 5] (Figure 3).

Figure 3 - How do tau proteins relate to TBI/CTE? A brain sends messages (synapses) through brain cells or neurons.

A neuron is made of a long central strand known as an axon, which helps carry synapses in the brain. An axon is made of smaller proteins (microtubules) represented by the red and yellow balls. Similar to Lego pieces, tau protein holds onto the microtubules to hold the neurons together. When tau proteins are broken down as in TBI or CTE, they cause destruction of the brain neuronal structure. These broken parts of tau form a mess. Too much destruction makes it hard for the body to clean up the mess. When the messes obstruct brain functions, this leads to memory loss and other problems.

CTE is hard to diagnose compared with other brain diseases. The methods usually used to look at the brain and diagnose brain diseases are called MRI and CT scans [6]. Unfortunately, these techniques are not able to show whether or not the brain has experienced CTE. You can predict that a person might have CTE if he or she has been a sports player for 10–15 years and suddenly starts acting differently or expressing unusual emotions, such as suicidal thoughts and depression. Scientists usually identify CTE after death because the brain has to be removed and examined for tau clusters to accurately diagnose CTE. Observation of degraded brain structures and decreased brain size may indicate that a person had CTE. Most of the symptoms associated with CTE also occur in people who suffer from diseases related to memory loss, including Alzheimer’s disease.

Researchers are trying to find new and efficient ways to diagnose CTE in living patients so that these people can be treated. Many methods are being studied, but one of the most promising methods is a brain-scanning technique known as positron emission tomography (PET). PET scans the brain a radioactive substance is injected into a vein. The radioactive substance allows any problems with the brain tissues to be seen. PET researchers would like to discover a specific radioactive substance that can find issues with the tau proteins in the brain. Another important method for diagnosing CTE involves identifying broken-down forms of tau in body fluids, including blood, cerebrospinal fluid (CSF)The brain or spine fluid that scientist use to study tauopathies., mucus, saliva, or urine. Detection of tau in these fluids could indicate whether CTE is likely in the patient.

How can you know if you might have a brain injury from hitting your head? Immediate symptoms, which can happen right after the injury or take up to a day to occur, include: loss of consciousness, feeling dizzy, severe headaches, blurry vision, nausea/vomiting, fatigue, trouble speaking, difficulty sleeping, loud ringing in the ears, or even a bad taste in the mouth [3, 4].

CTE is a progressive, long-term, harmful process. At this point, there no reliable treatments for CTE. However, scientists are hoping to find some biological molecules, known as biomarkers that can be used to detect and decrease the chances of developing CTE. These biomarkers are produced by the cells of the brain, specifically when the brain is injured, and they may someday allow us to diagnose CTE and potentially cure the diseased brain.

Since there is no cure for CTE, preventing it is the best way to stop yourself from getting it. Headgear and body pads are examples of preventative methods that are meant to lower the chances of head injuries in many sports and jobs. Although helmets do not fully prevent TBI, they reduce the amount of impact. Hard surfaces on the outside of helmets are used to prevent skull fractures, while inner sections contain padding to reduce the amount of shock that the head experiences when hit. Scientists and sports medicine analysts are working on improving helmet paddings to prevent coup and countercoup injuries.

In addition to protective gear, sports administrators continue to take preventative measures to ensure the safety of players. For example, placing pads on hard surfaces in wrestling arenas and on basketball courts, to prevent head injuries. Coaches also teach players how to respect each other through sportsmanship, to avoid aggression and unnecessary injuries. Coaches have also incorporated neck stretches before, during, and after practice, to release neck tension and provide head support.

Although preventative methods are used, brain injuries still occur on a daily basis. When these injuries do happen, they must be appropriately treated. Around 85% of TBIs need about 3 weeks of recovery. One should take care of oneself until fully recovered, to prevent additional injury. Cut back on physical activity, get plenty of rest, avoid computer time, write things down, and avoid drinking alcohol. During recovery, light exercise and brain-stimulating activities are recommended to help the brain and body heal. Some examples include stretching exercises and puzzles. Following the recovery process, your doctor may have you undergo physical and mental tests to make sure your brain has gone back to its original state. These tests will ensure that you have recovered enough before you to go back to your day-to-day activities [1, 2].

Traumatic Brain Injury (TBI): ↑ Damage in the brain caused by a sudden hit to the head. TBIs can occur from accidents, sports, or other physical traumas.

Chronic Traumatic Encephalopathy (CTE): ↑ A disease developed after multiple traumatic brain injuries, through the breakdown of brain cells.

Coup and Countercoup Model: ↑ A model representing how an initial injury (coup) can have enough force to cause damage on the opposite side of the brain (countercoup).

Tau Protein: ↑ A protein that holds brain cells together to keep the brain structure intact.

Tauopathies: ↑ Diseases caused by the breakdown of tau proteins; Alzheimer’s disease is an example.

Cerebrospinal Fluid (CSF): ↑ The brain or spine fluid that scientist use to study tauopathies.

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

1. ↑ Gaetz, M. 2017. The multi-factorial origins of chronic traumatic encephalopathy (CTE) symptomology in post-career athletes: the athlete post-career adjustment (AP-CA) model. Med. Hypotheses 102:130–43. doi: 10.1016/j.mehy.2017.03.023

2. ↑ Weston, S. 2015. School of Hard Knocks, Concussions by the Number, Center for Disease Control. Available online at: http://media.nj.com/hssportsextra/photo ... f937e1.jpg

3. ↑ Aldag, M., Armstrong, R. C., Bandak, F., Bellgowan, P. S. F., Bentley, T., Biggerstaff, S., et al. 2017. The biological basis of chronic traumatic encephalopathy following blast injury: a literature review. J. Neurotrauma 34:S26–43. doi: 10.1089/neu.2017.5218

4. ↑ McKee, A., Stein, T. D., Kiernan, P. T., and Alvarez, V. E. 2015. The neuropathology of chronic traumatic encephalopathy. Brain Pathol. 25:350–64. doi: 10.1111/bpa.12248

5. ↑ Turner, R. C., Lucke-Wold, B. P., Robson, M. J., Omalu, B. I., Petraglia, A. L., and Bailes, J. E. 2012. Repetitive traumatic brain injury and development of chronic traumatic encephalopathy: a potential role for biomarkers in diagnosis, prognosis, and treatment? Front. Neurol. 3:186. doi: 10.3389/fneur.2012.00186

6. ↑ Donald, CLM., Mukherjee, P., and Yuh, E. 2019. How to See Into the Brain Without Surgery! Front. Young Minds. 7:14. doi: 10.3389/frym.2019.00014

Article information
Yadikar H, Johnson C, Mouhawasse E, Kurup M, Nguyen L, Pafundi N and Wang K (2019) CTE: The Hidden Risk of Playing Contact Sports. Front. Young Minds. 7:93. doi: 10.3389/frym.2019.00093
Amy Markowitz
Publishing dates
Submitted: February 19, 2019; Accepted: June 20, 2019; Published online: July 17, 2019.
Copyright © 2019 Yadikar, Johnson, Mouhawasse, Kurup, Nguyen, Pafundi and Wang
This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) and the copyright owner(s) are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.

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Dementias beyond CTE including Alzheimer's and Parkinson's linked to sport, study finds

Post by greybeard58 » Tue Aug 06, 2019 9:14 am

Dementias beyond CTE including Alzheimer's and Parkinson's linked to sport, study finds

The link between contact sports and dementia extends beyond chronic traumatic encephalopathy (CTE) to a much wider range of neurological diseases, according to new studies of the brains of former football and rugby players.

Although there has been an enormous focus on CTE following the neurological problems facing American footballers, the evolving weight of research, including the groundbreaking work at the University of Glasgow, is finding a mixture of brain disease among those participants with a long history of head trauma.

A new review of international scientific evidence has also reinforced a study in Italy which showed that footballers were more than six times more likely to suffer from motor neurone disease (MND).

Don Revie, Jimmy Johnstone, Fernando Ricksen, Len Johnrose and Stephen Darby are among the higher profile former footballers to have been diagnosed with MND.

Patrick Grange, the former Major League Soccer player whose brain was examined at Boston University in 2012, was found to have MND as well as CTE.

CTE is the type of dementia that is most commonly linked to head trauma and was still found in around three-quarters of the 11 former footballers and rugby players with dementia in the Glasgow study.

Most striking, however, was the prevalence of other dementias and neurological diseases within individual brains, including Alzheimer’s, Parkinson’s disease, chronic cerebrovascular disease and dementia with Lewy bodies.

The findings have led researchers at Glasgow to use the term 'Traumatic Brain Injury-related neurodegeneration' or simply ‘TReND’, within which CTE might be just one variant.

All of those studied had played football or rugby over a significant period of time, ranging from 11 to 32 years, and were not regularly exposed to other contact sports. The vast majority first showed dementia symptoms in their fifties or sixties and died before the age of 80.

“The focus has been too narrow on CTE, which we show might be a ‘passenger’ pathology, and not the primary driver of dementia,” said Dr Willie Stewart, the lead investigator at Glasgow. “If doctors treating former footballers or rugby players or boxers with dementia assume that CTE is the only problem, then they may be falsely assuming that the patient’s Alzheimer’s or Parkinson’s etc. is nothing to do with sport.

“What is striking is the degree of mixed pathologies. This is something that we are increasingly aware of in wider dementias, but typically found in ‘very old’ patients. Typically these former footballers and rugby players are not ‘very old’, and so it does raise a question why they have such complex pathology.”

Dr Bennet Omalu, the doctor who was credited with identifying some of the first CTE cases in American football, is aware of the Glasgow research and also believes that there should now be new terminology to describe a wider range of neurological diseases that are linked to brain trauma.

“I have been following the research,” he said. “We need to begin to move away from the monolithic way of thinking. CTE is not the only type of brain damage you suffer. It is one of a spectrum. We now call it the Traumatic Encephalopathy Syndromes. TES. This includes dementias, Parkinson’s, Alzheimer’s, Lewy body dementia and others. We shouldn’t become myopic and focus on CTE alone. It is one of many diseases in this spectrum.

“Brain trauma increases your risk of suffering a variety of brain diseases. There is a need for greater research. It was very Hollywood, how CTE was discovered, it was an unfortunate consequence. It is a spectrum of diseases.”

Dementias beyond CTE including Alzheimer's and Parkinson's linked to sport, study finds
Read more: https://www.telegraph.co.uk/sport/2019/ ... ns-linked/

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Football, CTE, and Dementia: 5 New Answers | The Brink | Boston University

Post by greybeard58 » Thu Aug 15, 2019 2:53 pm

Five New Answers about the Link between Football, CTE, and Dementia
AUGUST 5, 2019

When it comes to our brain health, both gray and white stuff matter. The brain’s white matter is made up of all the connections linking together the brain’s working neuron cells, which are collectively known as gray matter. Traumatic brain injuries and concussions have long been known to contribute to white matter injury, which breaks down the connections between the brain’s neurons and is associated with dementia. But more recently, subconcussive repetitive head impacts—like the kind of hits experienced by football players—have also been attributed to causing white matter injury.

Now, for the first time, researchers from Boston University’s Chronic Traumatic Encephalopathy (CTE) Center have discovered a link between dementia, white matter, and the neurodegenerative disease CTE in former American football players. Published August 5 in JAMA Neurology, their study is one of the first to reveal the biological mechanisms that link years of playing football to white matter injury, which might contribute to dementia in people with CTE.

The Brink spoke with study lead researcher Michael Alosco, a BU School of Medicine assistant professor of neurology and codirector of the clinical cores at BU’s Alzheimer’s Disease Center and the CTE Center, to learn more about the connection between CTE and dementia. Here’s what we learned.

The Brink: Many former football players who suspect they have CTE—as well as their family members—have said dementia is one of the symptoms that made them concerned about their brain health. How does this study provide solid evidence that the dementia seen in CTE patients truly is caused by years of football play?

Alosco: CTE is characterized by an abnormal buildup in the brain of a protein known as p-tau. Consistent with some of our past findings, we found a greater amount of p-tau in the brain was associated with dementia and the number of years a person had played football. But one of the really cool and new findings about this study is the white matter piece. Scientific literature has long shown that white matter changes can be the result of traumatic brain injury and/or concussion. However, in this study, we found a direct association between the number of years someone played American football and the severity of white matter changes; the more years of football someone had played, the more likely they were to have more severe white matter changes, which contributed to dementia. Based on this study, we know that p-tau is not the whole story.

We also found other factors contributing to dementia in people with CTE that were not related to a person’s exposure to repetitive head impacts. Specifically, we found that arteriolosclerosis, a hardening of the brain’s small vessels due to cardiovascular disease risk factors like high blood pressure, also contributed to dementia.

Do these findings mean that football can directly lead to dementia?
It’s really the first study to bring together the buildup of p-tau, white matter changes, as well as arteriolosclerosis and link them all together as contributing to dementia in people with CTE. Years of American football play was indeed associated with dementia through its relationship with p-tau and the white matter changes.

From clinical interviews, you found that nearly two-thirds of the study participants, who were all diagnosed with CTE, also had dementia. Why doesn’t everyone who has CTE also have dementia?

We do see a lot of variability between individuals in how CTE develops and who gets dementia. Our study suggests that this is likely a result of several different factors that can affect people with CTE, such as a combination of p-tau buildup, white matter changes, as well as arteriolosclerosis.

What do these findings mean for the bigger picture of CTE research? Is this another huge strike against football?

Our study provides concrete support for the link between head impacts, white matter changes, buildup of p-tau, CTE, and dementia, bringing all these factors together into one story. But there’s still a lot left to do. There are important limitations to consider—we only looked at the brains of football players that have already been diagnosed with CTE. In that group, we looked at white matter brain disease using a subjective scale. What we really need to do is get more granular assessments of white matter to see the extent of white matter injuries and better understand the relationship between head impacts and dementia. We also need to bring in people from other comparison groups, such as looking at how people with Alzheimer’s might have a different white matter story than people with CTE. We expect, for example, that we would see more white matter damage in people with CTE.

Most importantly, although these pathology studies—where we are looking at the brains of deceased people—are really informative in terms of understanding disease symptoms and the biological mechanisms that cause them, we really need to have more longitudinal studies in living people—following someone throughout their life to see how symptoms change over the course of time. Some factors we’ve identified, like having arteriolosclerosis, could accelerate the course of CTE and make the symptoms more severe.

For you, what are the biggest takeaways from these findings?

P-tau is one contributor to CTE, but we need to consider what’s a consequence of that. How much of dementia and other clinical outcomes are due to tau, and how much to white matter changes or other factors like arteriolosclerosis? It’s a more complex story that we need to understand. We also have to be mindful of the limitations of this study—these findings can’t be generalized to look at the broader population since we only looked at former football players with CTE.

This work was supported by grant funding from the National Institute on Aging, the National Institute of Neurological Disorders and Stroke, a Department of Veterans Affairs Merit Award, the Nick & Lynn Buoniconti Foundation, the National Center for Advancing Translational Sciences, the Fonds de recherche du Québec–Santé, and the Alzheimer’s Association.

Football, CTE, and Dementia: 5 New Answers | The Brink | Boston University

http://www.bu.edu/articles/2019/footbal ... -dementia/

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Re: CTE in Hockey

Post by elliott70 » Wed Aug 21, 2019 2:27 pm

No doubt in my mind his actions were a result of CTE.
Sad thing is something will need to be done as it is too risky to not let him go free and unmonitored.
Putting him in jail will not help anything either.

His poor neighbor. The public will feel bad for the 'American Hero' and the neighbor will be recovering on his own.

Perhaps the NHL needs to come to the aid of both people.

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Re: CTE in Hockey

Post by goldy313 » Thu Aug 22, 2019 11:56 pm

Pavelich has been an odd duck for decades, though someone I envied for his ability to essentially disappear on his terms. CTE may be the cause but so can a lot of other things like mental illness.

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Re: CTE in Hockey

Post by greybeard58 » Sat Sep 14, 2019 10:34 pm

Study shows Hall of Famer Mikita had CTE
Sep 13, 2019
Associated Press

CHICAGO -- A posthumous study of Stan Mikita's brain shows the Hockey Hall of Famer suffered from chronic traumatic encephalopathy at the time of his death a year ago.

Dr. Ann McKee, the director of the BU CTE Center, announced the findings during the Concussion Legacy Foundation's Chicago Honors Dinner on Friday night at the request of Mikita's family.

CTE is a degenerative brain disease associated with repeated blows to the head. It is known to cause memory loss, violent moods and other cognitive difficulties. It can be diagnosed only after death.

Mikita is the eighth former NHL player diagnosed with CTE at the VA-BU-CLF Brain Bank, a list that also includes Derek Boogaard, Bob Probert and Reggie Fleming.

"The NHL is nowhere on this," McKee said. "They have completely denied a link. They have denied any responsibility, and it's clear that they are just protecting the bottom line."

NHL commissioner Gary Bettman has consistently denied there is a conclusive link between repeated blows to the head and CTE. A message was left late Friday night seeking comment from the league about Mikita's diagnosis.

The NHL formed a concussion study group in 1997, cracked down on certain hits after the 2004-05 lockout, instituted a formal protocol and a rule against head contact in 2010, and added spotters in 2015.

McKee said she feels the concussion spotters are being too lax in having players examined.

"They need to really, really just be very conservative about what represents a hit," she said, "because what looks like a minor hit to you or me when we're looking at it can be a devastating hit to the player, and we need to keep these players safe. That's how these leagues got to be what they are."

Mikita, who helped Chicago to the 1961 Stanley Cup title, died last August at age 78. He had been in poor health after being diagnosed with Lewy body dementia, a progressive disease that causes problems with thinking, movement, behavior and mood.

McKee said Mikita had Stage III CTE and Lewy body disease.

"What was interesting was he didn't just have CTE, which we know is associated with contact sports," she said, "but we're finding out that there are other neurodegenerative diseases, in particular Lewy body disease, which is a Parkinson's sort of disease that spreads through your brain, believe it or not, that's associated with contact sports."

Mikita spent his entire career with the Blackhawks, beginning with his NHL debut in 1959 and running through his retirement after playing 17 games in the 1979-80 season. He is the franchise's career leader for assists (926), points (1,467) and games played (1,394), and is second to Bobby Hull with 541 goals.

He was inducted into the Hockey Hall of Fame in 1983. He also was the first player to have his jersey retired by the Blackhawks in 1980.

Mikita's family declined to speak with the media at the dinner. Mikita's daughter Jane accepted the 2019 Courage Award on behalf of the family.

"While my dad's professional hockey accomplishments were many, we are most proud of his legacy of giving back and caring for others," Jane said during her speech.

https://www.espn.com/nhl/story/_/id/276 ... ta-had-cte

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Former Gopher Football Player Recruiting Players for CTE Study

Post by greybeard58 » Fri Oct 11, 2019 9:06 am

Former Gopher Football Player Recruiting Players for CTE Study

May 01, 2018 06:29 PM

A former Minnesota Gopher and NFL football player is recruiting other former players to participate in new medical research that aims to diagnose a degenerative brain disease known as CTE while people are still alive.

Ben Utecht, who played tight end for the Gophers from 2000-2003 before being drafted by the Indianapolis Colts, hopes the expanded research will provide players with answers that right now can only be found after death.

Chronic Traumatic Encephalopathy, CTE, has been diagnosed in the brains of former professional athletes, including football players like the late Junior Seau and Aaron Hernandez.

RELATED: Kyle's Story: Minnesota Family Raising Awareness about CTE

Utecht is trying to convince former players to participate in a federally funded project called "Diagnosis CTE."

"The players I talk to who are generally struggling right now are just trying to make it through a day," Utecht said.

Mayo Clinic is one of several research centers participating in the study that requires subjects to undergo MRI scans, blood draws, and spinal taps among other tests over a three-year period.

Researchers are looking for a build-up of a protein called Tau that they say leads to a lack of impulse control, early onset dementia and memory loss.

Boston University recently gave 5 EYEWITNESS NEWS rare access to its CTE laboratory where researchers have identified the protein in the brains of former athletes, combat veterans and young kids who suffered repeated head trauma.

Their findings led to a billion-dollar concussion settlement between the NFL and former players that was finalized last year.

Utecht's personal health struggles have been well documented since he retired from the NFL in 2009 after suffering a fifth concussion.

"I experienced some significant gaps in my long term memory --- those issues definitely weighed heavily on my shoulders," Utecht said.

He says his memory has improved in recent years thanks to cognitive therapy but he feared early in retirement that he had suffered permanent brain damage.

"What if the worst case situations happen to me," Utecht remembers wondering.

He hopes other players will not have to live with the same fear, and will instead be given concrete explanations for their health struggles thanks to the expanded CTE research.

"Over time, we can pull out medical evidence that can make the game safer; more importantly provide answers at every level."

Joe Augustine

Updated: May 01, 2018 06:29 PM
Created: May 01, 2018 01:08 PM

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Colin Meany Obituary

Post by greybeard58 » Fri Oct 25, 2019 11:12 am

Colin Meany
2001 - 2019
Colin Meany Obituary

Matawan - Colin Patrick Meany, 17, of Matawan, NJ, passed away on Friday, August 16, 2019 at his home.

Colin was born on September 7, 2001 to Michael and Karen Meany in Edison, NJ. He was a lifelong resident of Matawan. Colin graduated from St. John Vianney High School in 2019.

Colin was not only a gifted student-athlete, but he was also the person that everyone wanted to be around. He was extremely passionate about two things, ice hockey and spending time with the people that he loved. His love for others is a quality that drew so many people toward him. If you were around Colin, you knew that he was going to push you to be better and you would have a fun time doing it. His smile and laugh were contagious and will never be forgotten.

Colin is predeceased by his maternal grandparents, Jack and Barbara Surdoval; and his paternal grandfather, Edward Meany.

Colin is survived by his loving parents, Michael & Karen Meany, his brother, Jack; his paternal grandmother, Michele Meany; three uncles, John Meany, Ed Meany, and Paul Rossi; three Aunts, Kelly Meany, Danielle Meany and Lisa Rossi; and three cousins, Barbara Rossi, and John and Caroline Meany; and many, many close friends.

Visitation will be held at the Church of St. Clement, 172 Freneau Ave., Matawan, NJ. on Sunday, August 18, 2019 from 4:00 pm to 8:00 pm.

A Funeral Mass of Christian Burial will be celebrated on Monday, August 19, 2019 at the Church of St. Clement at 10:00 am.

In lieu of flowers, Colin's family is asking for donations to be made to The Concussion Legacy Foundation, concussionfoundation.org. Online condolences can be given at www.waittfh.com

https://www.legacy.com/obituaries/app/o ... &fhid=3212

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Miracle on Ice' player Mark Pavelich found incompetent to stand trial

Post by greybeard58 » Tue Oct 29, 2019 11:35 am

Miracle on Ice' player Mark Pavelich found incompetent to stand trial

A judge suspended the assault case against the 1980 "Miracle on Ice" hockey star.
By Pam Louwagie and Paul Walsh Star Tribune staff writers OCTOBER 29, 2019 — 7:01AM

GRAND MARAIS, MINN. – A player on the 1980 “Miracle on Ice” U.S. Olympic gold-medal hockey team has been found incompetent to stand trial in a criminal case involving charges that he beat a friend with a metal pole.

The case against Mark Pavelich, 61, of Lutsen, Minn., was suspended Monday as Cook County authorities petitioned to have him civilly committed to treatment.

In a hearing earlier in the day, District Judge Michael Cuzzo told Pavelich that a psychologist’s report “indicates you need some assistance to fully understand” the criminal proceedings.

Pavelich was booked into the Cook County jail on Aug. 15. His friend James T. Miller, 63, told authorities he was struck with a 3- to 4-foot-long metal pole by Pavelich after returning from a day of fishing to the hockey star’s home, down a dirt road near Deer Yard Lake. Pavelich had accused Miller of “spiking his beer,” the criminal complaint read.

Miller, Pavelich’s neighbor for 20 years, suffered cracked ribs, a bruised kidney and a fracture to one of his vertebrae, the charges detailed. The beating also left bruises on his arms and legs and a large mark across his back.

Pavelich was charged with second- and third-degree assault, possession of an illegal shotgun and possessing a gun with a missing serial number.

Wearing a black-and-white striped jail suit, his hands cuffed, Pavelich sat quietly Monday during the hearing in the courtroom with windows overlooking Lake Superior.

Prosecutors asked to raise his bail from $250,000 to $5 million, citing a “significant risk to public safety,” based on the psychologist’s report.

Defense attorney Christopher Stocke disagreed and argued that Pavelich would not have the means to bail himself out at the lower bail level.

Cuzzo set bail at $500,000.

In a written order, the judge concluded Pavelich is “incapable of participating in the defense due to mental illness or deficiency.” The order also states that proceedings against Pavelich will be dismissed in three years unless prosecutors give the court notice that they intend to prosecute when he regains competency.

The psychologist’s report found that Pavelich is unable to demonstrate a rational, reasonable degree of understanding of basic legal proceedings and requires “intensive psychiatric treatment with neuroleptic medications,” according to the judge’s order.

The psychologist’s opinion was that Pavelich would present a “direct threat of harm and danger to others” if released because he would not voluntarily follow treatment recommendations.

Pavelich’s sister, brother, mother and other family and friends were in the courtroom Monday to offer their support.

His sister, Jean Gevik, has said his family is convinced that “all the concussions and the blows he had” in the National Hockey League left Pavelich suffering from CTE, or chronic traumatic encephalopathy, a degenerative brain disease that has been linked to erratic behavior and deaths among hockey and football players and others in sports that inflict trauma to the head.

Sitting in the courtroom awaiting Monday’s hearing, Gevik called the case “heartbreaking.”

“He’s been an amazing brother. Fun. Loving,” she said. “This has been a total change.”

Refused help

Gevik and other family members said they started seeing changes in Pavelich a few years ago. They have been trying for some time to get help for him, family members said, but he has refused, believing there is nothing wrong.

Gevik has said that Herb Brooks, Team USA’s coach at the 1980 Olympic Games in Lake Placid, N.Y., and later in the NHL with the New York Rangers, once recalled that Pavelich had one especially severe head injury that could have ended his life.

“All the research is out there about CTE,” she said earlier. “This should not be a surprise here.”

The NHL has faced criticism for its handling of head injuries despite a long list of rules, studies and league-player committees focused on enhancing player safety. The league reached a court settlement last year with hundreds of retired players who claimed harm from head injuries while playing, but the NHL admitted no fault or wrongdoing.

Each player who opts in would receive $22,000 and could be eligible for up to $75,000 in medical treatment. Pavelich did not make a claim, his sister has said.

Pavelich, a center who starred for Eveleth High School and the University of Minnesota Duluth, assisted on Mike Eruzione’s winning goal in a stunning upset of the Soviet Union in the 1980 Olympic hockey tournament semifinals, a triumph that has long been referred to as the “Miracle on Ice.” Team USA went on to defeat Finland in the gold medal game, and its remarkable story was turned into the hit movie “Miracle” in 2004.

Pavelich played five seasons with the Rangers. He joined the Minnesota North Stars in 1986-87, but only for 12 games. After a brief pro stint in Italy, he was out of the game before a career-ending two-game stint with the San Jose Sharks in 1991-92.

Away from the game, Pavelich has been a virtual recluse. In 2012, his 44-year-old wife, Kara, died in an accidental fall from a second-story balcony at their home. Two years later, he sold his gold medal for $262,900 in an auction, explaining he wanted to provide financial security for his adult daughter.

Pam Louwagie is a regional reporter for the Star Tribune. She previously covered courts and legal affairs and was on the newspaper's investigative team. She now writes frequently about a variety of topics in northeast Minnesota and around the state and region.

pam.louwagie@startribune.com 612-673-7102 pamlouwagie
Paul Walsh is a general assignment reporter at the Star Tribune. He wants your news tips, especially in and near Minnesota.

pwalsh@startribune.com 612-673-4482 walshpj

http://www.startribune.com/miracle-on-i ... 563992862/

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Ex-NFL Player, Broadcaster Irv Cross Announces Brain Donation to Help Others Suffering

Post by greybeard58 » Mon Nov 04, 2019 12:20 pm

Ex-NFL Player, Broadcaster Irv Cross Announces Brain Donation to Help Others Suffering

November 18, 2018 10:22 PM

Football Sundays back in the 1970s all started the same way, as Irv Cross' deep voice echoed out of the television speakers, when he was reporting from the studio or on the sideline as part of CBS NFL Today’s coverage with Brent Musberger and Phyllis George.

Cross broke new ground back then, becoming the first African-American national sportscaster on television after his playing days in the NFL.

"I never thought about being the first of anything,” Cross said. “I just wanted to do the best job I could."

After a very public life, Cross opened up during the first and only sit-down interview he plans to do about a new personal health ordeal with 5 EYEWITNESS NEWS at his Roseville home.

“Like so many retired other pro football players, I’ve had some issues with my central nervous system, my brain," Cross said.

Now at almost age 80, Cross said he has mild cognitive dementia and the treatments aren’t helping.

“I've been doing this for two years almost, I can't get anything," Cross said.

In a newly published book, "Bearing The Cross," he talks about the never-ending headaches around the clock.

Cross wrote, "I don't drive a car anymore because I’m afraid I might not get back home. I lose track of where I am ... all it takes is one building being torn down, or something changing on a familiar route and I might as well be on Mars."

NFL Awarding More Than $35 Million to Brain Injury Studies

NFL Concussion Claims Hit $500 Million in Less Than 2 Years

Former Gopher Football Player Recruiting Players for CTE Study

Cross plans after his death to donate his brain through the Concussion Legacy Foundation to research at Boston University’s CTE Center.

"I did it, primarily did it was because I thought it would be a waste to not give it," Cross said.

Cross understands others are feeling pain while facing this new opponent to tackle with brain issues after concussions and other head injuries from playing days.

He shared a recent conversation he had with an NFL great, not saying his name, nor anything about him, only their chilling conversation.

"He said the only thing he had going for him now was a bullet, I said, 'What do you mean?'" Cross said. “He said, 'Well, I don't want to do it anymore.'”

At that moment, Cross knew he needed to get that former player help to put down the gun.

“I told him, 'Just take it easy, I can find some help for you,'" Cross said while tears dripped down his cheek. “He's still around but it was so sad to hear that."

By donating his brain to research for CTE, the neurodegenerative brain disease only found after death that has symptoms of dementia, impulse control and memory loss, he hopes it will eventually help treat those suffering while still alive.

After playing football while a student-athlete at Northwestern University, Cross went into the NFL in the early 1960s.

Cross delivered bone-crushing hits for the Philadelphia Eagles and later the Los Angeles Rams.

"We had plastic hard shell helmets that we used to split a lot - you have a helmet to helmet collision,” Cross said. “You'd split those darn things, you had problems with your brain bouncing around, everywhere in your skull."

Cross said he’d often be tasked with trying to stop the biggest threat on the opposing sideline, including the great running back Jim Brown.

"You know before it happens what's going to happen, you commit yourself to it, that's the way the game is played, you hoped after the collision is over you get up,” Cross said. “If you could walk, you'd play."

After stepping out of the broadcast booth, Cross left a mark on collegiate programs as athletic director at Macalester College and civic programs, including as executive director of Big Brothers, Big Sisters of Central Minnesota.

"I was raised that you give yourself to your community, you do what you can to help others. Probably when you come from a family of 15 you're always doing that," Cross said.

After his mother died at a young age, Cross helped his single father raise the younger children, all before he went off to college.

https://kstp.com/medical/ex-nfl-player- ... g/5148638/

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Kyle Raarup | Concussion Legacy Foundation

Post by greybeard58 » Tue Nov 12, 2019 3:11 pm

SEPTEMBER 24, 1995 - NOVEMBER 12, 2015
By Kayla, Tyler, Mike and Beth Raarup


Kyle loved all sports, all his life. He played as much and as many sports as he possibly could, with football and hockey being his favorites. He was a fiercely competitive and driven athlete. He was naturally gifted with speed, agility, and great eye-hand coordination. He was a running back for football, offensive player in hockey, and could play any position he was put in for baseball. Kyle loved it all and loved the friendships that playing sports offered him.

As it is with any dedicated athlete, Kyle was hit many times with only minor injuries. Concussions, in our mind, happened when you got knocked out from a hit, or got your "bell rung". As the injuries continued and we became more informed about concussions we realized that Kyle had suffered many minor concussions from about 4th grade on. It wasn't until Kyle was in 8th grade and experienced a check from behind into the boards in hockey when he started having lasting symptoms that we could not control. He waited the recommended two weeks before playing again, only to be hit from behind again when he returned to play. This time he had such severe headaches and other symptoms that he was unable to return to sports or school. Each bump to his head after that caused increasingly severe symptoms for an extended amount of time.

Over the years of seeing innumerable doctors and other medical professionals, Kyle was diagnosed with post concussive syndrome. While it was nice to have a name for what he was going through, Kyle wanted something that would help his symptoms. This seemed to be an elusive goal. He was a trooper and tried every therapy, testing, medication, vitamin, whatever we could find to try to alleviate the pain and memory/thinking difficulties he was experiencing. None worked well, which was a source of great frustration to Kyle. He wanted his brain to go back to normal.

Kyle was able to attend college where he flourished with the assistance of the student services program that allowed him accommodations for his anxiety and inability to handle a lot of sensory input during testing. Kyle loved college and the friends he made there. He was outgoing, cheerful, energetic, and fun to be around. His continued struggles with his anxiety/depression, memory problems and a new stomach ailment overwhelmed him and he took his life on 11/12/15. His brain was donated to the Boston University CTE study in order to find out the answer to his nagging question "what's wrong with my brain and why can't it be fixed?"

In December 2016, we found out that Kyle was diagnosed with Stage I CTE along with some brain abnormalities (micro hemorrhages and hippocampus damage) that helped his family get some answers to that nagging question of "what was going on in his brain?" His suicide and the Boston University brain study has helped raise awareness in our community of the lasting impact that concussions can have on the life of a young adult. The loss of a child, brother and friend to many has hit us all hard and will be something that we struggle with for a long time. We are grateful to the Concussion Legacy Foundation for their research and to finally give us some answers, and for their efforts to continue to find answers for future athletes. Kyle would be proud to be a part of this important research and the continued efforts made to understand the devastating affects concussions have on young lives.

We miss him every day, but are proud of who Kyle was and how he has helped us and others understand mental illness and concussions.

Watch: Kyle's Story: Minnesota Family Raising Awareness About CTE


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Re: CTE in Hockey

Post by O-townClown » Tue Nov 12, 2019 7:40 pm

John, these stories are depressing. Thanks for sharing them to raise awareness. So much more is know about brain injuries and the long term effects for those who sustain them. We're still not all the way there.
Be kind. Rewind.

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