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NFL, U.S. Soccer Athletes Donate Brains to BU

New center to study concussions and permanent damage

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brain_micros.jpg

(Above left) Microscopic brain section from a 65-year-old control subject, showing no abnormal deposit of tau protein; (middle) section from former NFL player John Grimsley’s brain, showing abundant deposits of tau protein, an indicator of the degenerative brain disease CTE; (right) section from a 73-year-old world-champion boxer with end-stage CTE and dementia, showing severe tau protein deposition. (Below) Whole brain sections from the normal 65-year-old, from Grimsley, 45 years old at the time of his death, and from the 73-year-old world-champion boxer. Images courtesy of Ann McKee

Last fall, when former Houston Oilers linebacker John Grimsley forgot about the engagement party for his son and future daughter-in-law that he’d been helping plan for months, his wife, Virginia, knew something was gravely wrong.

“We’d been talking about the party for weeks, then every day the week before,” Virginia Grimsley says. “It was the big event. And then, the day before, my husband was running an errand and came back and said he’d run into so-and-so and that they were going to get together the next day. I was shocked.”

Grimsley is convinced that her husband’s alarming memory trouble, and perhaps even his untimely death from a firearms accident earlier this year, was linked to the nine concussions he suffered during nine seasons on the gridiron. Now, thanks to a groundbreaking study under way at BU’s new Center for the Study of Traumatic Encephalopathy (CSTE), she may be closer to a definitive answer.

When John Grimsley died, his wife donated his brain tissue to CSTE, where it was analyzed by BU pathologists. The results, released this week, showed that Grimsley’s brain exhibited pronounced chronic traumatic encephalopathy (CTE), a condition that is often seen in retired athletes, such as boxers, who have a history of repeated concussions. CTE is a progressive, degenerative disease associated with memory loss, confusion, impaired judgment, paranoid and aggressive behavior, depression, dementia, and parkinsonism. Grimsley, who played in the NFL from 1984 to 1993, is the fifth former player diagnosed with CTE since 2002. All five died untimely deaths.

Last February, Grimsley accidentally shot himself in the chest while cleaning his gun. He was 45 years old. “He’d grown up with guns his whole life,” says his wife. “Did he forget there was a bullet in the chamber? Was his visual perception off?”

Ann McKee, an associate professor of neurology and pathology at BU’s School of Medicine and codirector of the new brain-study center, analyzed Grimsley’s brain tissue sample. McKee says that while she cannot tie his condition directly to concussions suffered as an NFL linebacker, the pattern of degeneration is classic for CTE. “It could be mild trauma from any number of different sources, and concussion is one of them. The only thing I can say is that this pattern of change is associated with multiple mild brain traumas, and he had a history of concussion — one medically documented case and eight more that were not. So most likely that had something to do with it.”

The new center at BU, financed primarily by the University and a grant from the National Institutes of Health, will operate in collaboration with the Sports Legacy Institute, a nonprofit run by Chris Nowinski, a former Harvard University football player and professional wrestler and the author of Head Games: Football’s Concussion Crisis, and Robert Cantu, codirector of the Neurological Sports Injury Center at Brigham and Women’s Hospital in Boston.

Nowinski, seen as a driving force behind the new center, suffered at least six concussions during his collegiate and professional sports career and has struggled with massive memory loss, depression, and headaches.

“I’d never been made aware in 11 years of collision sports that concussions can have such significant long-terms problems and that as an athlete you can protect yourself by getting out of play and resting your brain,” he says. “Our goal is to put this issue on the map and let scientists know there’s a population of people who need a unique type of treatment. I’d like to see the culture of concussions change so much in five years that there isn’t an athlete or coach who doesn’t know what the proper thing to do is when they get a concussion.”

The center will develop a multidisciplinary research program aimed at understanding the mechanisms of CTE, including neuropathology and risk factors. A second goal of the center is to sign up former athletes for clinical research studies to probe the link between their symptoms and their history of concussions. Finally, the center has launched a brain donation program for athletes, current and retired, with and without a history of concussions. A dozen athletes have already agreed to donate their brains after they die. That list includes former NFL players Ted Johnson, Frank Wycheck, Isaiah Kacyvenski, and Ben Lynch. Noah Welch, who played hockey for the Florida Panthers, and Cindy Parlow, a former member of the U.S. national soccer team, have also signed up.

Robert Stern, a MED associate professor of neurology and codirector of the School of Medicine Alzheimer’s Disease Clinical and Research Program, analyzed Grimsley’s behavior in the years prior to his death. He says he hopes the work at CSTE will “lead to education and policy changes and provide impetus for improved protective head gear.”

“We really don’t know that much about this disease,” says McKee. “It’s been under the radar for years. We’ve known about it in boxers. People just thought if you stayed away from boxing or wore a helmet, you wouldn’t get it. But CTE can occur in a variety of different activities, and one of them is football.”

Virginia Grimsley says she plans to reach out to more NFL players, urging them to consider participating in the BU study. “The stigma needs to go away that you’re a sissy if you come out of the game and don’t go back in," she says. "A concussion is a big deal. It’s not just a ding.”

Caleb Daniloff can be reached at cdanilof@bu.edu.

4 Comments

4 Comments on NFL, U.S. Soccer Athletes Donate Brains to BU

  • Karen Chenausky on 09.26.2008 at 9:19 am

    Other sources of "mild" TBI

    Interestingly, another source of so-called “mild TBI” (TBI = traumatic brain injury) is roller-coaster riding. It’s the sudden deceleration that is the problem; your brain basically sloshes around inside your skull. This is a problem in several areas. The sides of your brain scrape by bony protrusions in the skull near the temporal lobes. The leading edge of the brain mashes into the skull because the skull stops moving before the brain does, and then the brain rebounds so that the back edge of it mashes into the skull as well. And finally, the stretching and/or twisting of the tissues causes neurons to break and die, so that the resulting damage is diffuse and wide-ranging.

    Unfortunately, most tests for brain injury and mental function aren’t sensitive enough to detect such “mild” symptoms. Few people have baseline cognitive data anyway to compare with — that would require having a battery of cognitive tests performed before any damage occurred, and who has time for that? Generally it’s the family of the affected person who notices most, compensates most, and suffers almost as much.

  • Anonymous on 09.26.2008 at 11:39 am

    in full support.

    This is very “small potatoes” compared to what you are doing but our high school is finally becoming aware of the consequences of concussions and trying to educate our small community about it. Implementing a concussion management program is a small start.
    Awareness and education is key. I’ll be interested in all youir work.

  • Anonymous on 09.26.2008 at 5:08 pm

    The majority of the N.E.

    The majority of the N.E. Patriots are screened for cartilage damage in the TMJ complex, then corrected with an orthotic appliance, this has resulted in a reduction of concussion in players with prior concussion. Two peer reviewed papers indicate more research is needed in this area. Concussion from force truama may be the origin of a “hidden brain injury” the military has diagnosed in sodiers with MTBI from multiple IED exposure. Ruptured eardrums the marker. Forces transfered from the chin strap to the end of the jawbone, next to the eardrum, may be the cause. A paper thin bone separating the temporal lobe and the jawbone may become suceptable when the rubberized jaw cartilage has slipped out of position, found in 65% of the population, even higher in athletes. BU may be a great place for this type of research, the dental school is one of the best, Tufts and Harvard have already been informed. A multidisiplinary approach is needed, this procedure is only one approach, but worth a closer look. http://www.mahercor.com

  • Simone Ellis on 10.05.2008 at 3:06 am

    not only in sports... what about the rest of us?

    I am writing because I too have had several concussions and have been recently diagnosed with likely intermediate to advanced CTE. In fact I’d probably be very valuable for your experiments and study… if I weren’t a woman, and a professional writer, instead of a pro-Ball (game) player. (don’t get me wrong, I love the NFL! esp. Denver, Seattle and Green Bay until Brent left)
    I’ve had some dozen+ concussions (since 1972) after a major right frontal lobe contusion that happened when I fell off a fire escape (being used as an exit) and landed on my head, at age 20, sustaining life-threatening head injuries, but with a closed skull, in 1972.
    I was hospitalized for 6 months that time. A second serious TBI was in 1995…. the concussions were small potatoes but numerous, & increasingly debilitating. The slightest whack could knock me cold and put me down for weeks and even months. And this condition has gotten worse and worse… but it was only after what seemed to be a stroke hit… certainly a similar looking event to a stroke, put me in the hospital — literally out of the blue– no trauma, nothing but deadline stress that I was finally diagnosed with CTE by a neurosurgeon a neurologist and my primary care physician.

    I am a professional writer, wrote a book on Southwestern Art (originally published by Random House/Crescent Books) that has now sold more than a million copies world wide. I have worked as an educator, a film maker (my latest is of the Dalai Lama speaking on 9/11 seen on Link TV) and have published poetry books, plays, as well as working as an art critic for some 25 years. But all of that was done with a handicap… my head… my head-aches, my depression, and seizures that began after the re-injury in ’95 and have recently resurfaced after being under control for nearly a decade, have made my life one long uphill (or downhill) battle. (The multifarious concussions were bike accidents, most recently, a fan hitting me in the face, hits on the head in construction of a set for a play, a car accident, and so forth. Believe me, I do not exaggerate the number… those are only the ones I’ve been able to recall since the diagnosis .. for my neurologist… but to be honest, I’ve lost count. Before now, I’ve only counted the two that caused hemorrhaging. The reset were child’s play… concussion? try a contusion!)

    All these words are as back-story so that maybe someone in this Lab, will hear me that I AM DEVASTATED looking for help as well as making a complaint.. and give a crap. I am 56, and have not been truly well for many, many years… fight fatigue and headaches daily.

    If I were a million dollar friggin ball player, instead of a million book artist, I would have triggered research a long time ago!! how many of us are out here? Men and WOMEN, who now are in the beginning of the end stages of this devastating irreversible disease and have never once inspired a dime of research.

    I wish this Lab at Tufts great strides, and am very interested in it… as a journalist… but please, WAKE UP … and acknowledge the myopia of your focus. Pathetic.

    Sincerely,
    Simone Ellis

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