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What is the Center for the Study of Traumatic Encephalopathy (CSTE)? The CSTE was created in 2008 as a collaborative venture between Boston University School of Medicine and Sports Legacy Institute (SLI). The mission of the CSTE is to conduct state-of-the-art research of Chronic Traumatic Encephalopathy, including its neuropathology and pathogenesis, the clinical presentation and course, the genetics and other risk factors for CTE, and ways of preventing this cause of dementia. CSTE in the News WCVB-TV, 3/18/09: "Take An Exclusive Look Inside The Brain Bank" featuring Dr. McKee (video) NPR All Things Considered, 1/30/09: "Sports Injuries May Cause Lasting Brain Damage" featuring Dr. McKee (print and audio) CNN.com American Morning, 1/29/09: "Young athletes and concussions" featuring Dr. McKee (video) WBZ-TV, 1/28/09: "Concussions Can Have Serious Long-Term Effects" featuring Dr. Stern (video) Boston Herald, 1/28/09: "NFL called on concussions: No more head games" The Takeaway, 1/28/09: "Does pro football cause brain injury?" featuring Dr. Stern (audio) New York Times, 1/27/09: "New Sign of Brain Damage in N.F.L." CNN.com, 1/27/09: "Dead athletes' brains show damage from concussions" featuring Dr. McKee and Chris Nowinski (print and video) ESPN Outside the Lines, 1/27/09: "Brain Trauma Study" featuring Dr. Cantu (video) TSN Sports Network Canada, 1/25/09: “Sports Legacy Institute CSTE on TSN” featuring Chris Nowinski, Dr. McKee, and athlete advisors Ted Johnson and Pat LaFontaine (YouTube video) ReachMD, 1/5/09: “Chronic Traumatic Encephalopathy in Elite Athletes” featuring Dr. McKee (audio, requires registration) NPR Morning Edition, 12/29/08 (audio via RealPlayer) NPR On Point, 12/19/08: "Concussions and the NFL" featuring Dr. Stern (audio) New York Times, 9/23/08: "12 Athletes Leaving Brains to Concussion Study," announcing the CSTE What is Chronic Traumatic Encephalopathy? Chronic Traumatic Encephalopathy (CTE) is a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive concussions. CTE has been known to affect boxers since the 1920s. However, recent reports have been published of neuropathologically confirmed CTE in retired professional football players and wrestlers who have a history of head trauma. This trauma, which includes multiple concussions, triggers progressive degeneration of the brain tissue, including the build-up of an abnormal protein called tau. These changes in the brain can begin months, years, or even decades after the last concussion or end of active athletic involvement. The brain degeneration is associated with memory loss, confusion, impaired judgment, paranoia, impulse control problems, aggression, depression, and, eventually, progressive dementia. Who are the Co-Directors and Founders of the Center for the Study of Traumatic Encephalopathy? The multidisciplinary team that initiated the CSTE include the following: Robert Cantu, M.D., Clinical Professor of Neurosurgery at BUSM; Chief of Neurosurgery Service at Emerson Hospital; and a world-renowned expert on concussion. Ann McKee, M.D., Associate Professor of Neurology and Pathology at BUSM, and Director of the BU ADC Neuropathology Core, which involves conducting neuropathological analyses of brain tissue and maintaining the ADC Brain Bank. Chris Nowinski, a former Harvard football player and professional wrestler who retired at age 24 due to multiple concussions; Co-Founder of Sports Legacy Institute and author of the book, Head Games: Football's Concussion Crisis. Robert A. Stern, Ph.D., Associate Professor of Neurology at BUSM, Acting Director of the BU ADC Clinical Core, and Co-Director of the BU Alzheimer’s Disease Clinical and Research Program (ADCRP). The non-profit Sports Legacy Institute was founded by Mr. Nowinski and Dr. Cantu. in order to advance the health and wellness of athletes and the safety of sports and athletic endeavors. SLI promotes medical and scientific research, prevention and advocacy of sports injury issues, and education. The organization was conceived after SLI and their colleagues discovered four cases of CTE in professional athletes. At the time of their deaths, all four athletes, who were under 50 years of age, had remarkable early cell death and excessive amounts of the protein, tau, throughout their brains, indicative of CTE. For a description of these athletes and a detailed overview of SLI, Click Here. Initial Support and Funding The CSTE is grateful for financial and academic support from the BU School of Medicine, as well as the BU Departments of Neurology, Pathology, and Neurosurgery, the Health and Disability Research Institute at the BU School of Public Health, and the VA New England Geriatric Research, Education, and Clinical Center. In addition, Drs. McKee and Stern received a $100,000 award to support CTE research from the National Institute on Aging as a supplement to the BU Alzheimer’s Disease Center. And, more recently, they received a $250,000 grant from the National Operating Committee on Standards for Athletic Equipment (NOCSAE). Selected CSTE Publications McKee AC, Cantu RC, Nowinski CJ, Hedley-Whyte ET, Gavett BE, Budson AE, Santini VE, Lee H-Y, Kubilus CA, Stern RA. Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy following Repetitive Head Injury. J Neuropath Exp Neurol, 2009, in press. What will the new Center for the Study of Traumatic Encephalopathy (CSTE) be working on? The CSTE will begin by working on three interconnected projects:
This project is a living brain donation program for current and retired college or professional athletes who agree to donate their brains upon death to the CSTE brain bank for neuopathological analysis. Subjects will also complete a yearly interview with study staff during their lifetime describing their athletic and concussion history, their educational and occupational history, as well as medical history and current cognitive, behavioral, and mood symptoms. If you are interested in participating in the CONTACT brain donation registry, please contact Megan Wulff at 617-638-6143 or mawulff@bu.edu.
Family members of deceased athletes may also agree to donate their loved one’s brain and spinal cord after their death to CSTE brain bank to be examined neuropathologically for evidence of CTE or other disorders of the central nervous system. The family member(s) will be interviewed for a history of their loved one, including their loved one’s athletic and concussion history, educational and occupational history, medical history and history of cognitive, behavioral, and mood symptoms.
In the next year, it is expected that approximately ten living current or former athletes who wish to donate their brain upon death to the CSTE brain bank will be enrolled in a more involved research study involving neuropsychological assessment (memory and other cognitive tests), MRI scans of the brain, and examination of cerebrospinal fluid. It is expected that this study will begin recruitment in early 2009.
The first deceased athlete examined by the CSTE researchers was John Grimsley, former Linebacker for the Houston Oilers and Miami Dolphins, who died in February 2008 at the age of 43 from an accidental gun shot wound. Examination of Mr. Grimsley’s brain confirmed extensive CTE. In both sets of photographs, below, the brain tissue has been immunostained for tau protein, which appears as a dark brown color.
Figure 1: Tau immunostained sections of medial temporal lobe from 3 individuals Top left: Whole brain section from a 65 year old control subject showing no tau protein deposition
Figure 2: Tau immunostained sections of frontal cortex from 3 individuals Top left: Whole brain section from a 65 year old control subject showing no tau protein deposition
The CSTE examined the brain of nine-year NFL veteran, former Tampa Bay Buccaneer Tom McHale. They found that he was suffering from chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by head trauma, when he died in 2008 at the age of 45. McHale, a Cornell University graduate, former restaurateur, husband and father of three boys, is the sixth former NFL player to be diagnosed post-mortem with CTE since 2002.
Figure 3: Thomas McHale brain tissue Top left: Whole mount section of neocortex immunostained for tau protein showing extensive deposition of tau protein as neurofibrillary tangles throughout the neocortex
Figure 4: Thomas McHale brain tissue Top left: Whole mount section of inferior orbital cortex immunostained for tau protein showing dense, patchy deposition of tau protein
The CSTE has discovered early evidence of CTE in the youngest case to date, a recently deceased 18-year-old boy who suffered multiple concussions in high school football.
Figure 5: 18 year old brain tissue Top left: Whole mount section of frontal cortex showing very focal deposition of tau protein around small blood vessels (red box)
Figure 6: Control brain tissue Top left: Whole mount section of medial temporal lobe immunostained for tau protein showing no immunoreactivity Contact Us For additional information about the CSTE or about how to participate in current or future research studies, please contact Megan Wulff at 617-638-6143 or mawulff@bu.edu.
Thank you for helping make sports safer for future generations! |
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