Researchers from Boston University, the Cleveland Clinic, Banner Alzheimer's Institute and Brigham and Women's Hospital in Boston, have been awarded a $16 million grant from the National Institutes of Health/National Institute of Neurological Disorders and Stroke (NIH/NINDS). This seven-year, multi-center grant will be used to create methods for detecting and diagnosing chronic traumatic encephalopathy (CTE) during life as well as examining risk factors for CTE.
CTE is a degenerative brain disease characterized by changes in behavior, mood and cognition, including the development of dementia. Currently it can only be diagnosed post-mortem through examination of an abnormal form of tau protein. CTE has been found most often in professional contact sport athletes (e.g., boxers, football players) who have been subjected to repetitive blows to the head resulting in symptomatic concussive and asymptomatic subconcussive trauma. Neuropathologically-confirmed CTE has been reported in individuals as young as 17 and in athletes who only played sports through high school or college. It also has been found in non-athletes who experienced repetitive head impacts, including military service members.
According to the researchers, although the neuropathological features of CTE have become further clarified in recent years, the clinical presentation of CTE is still not well characterized and there remains no method to diagnose it before death. "There are so many critical unanswered questions about CTE. We are optimistic that this project will lead to many of these answers, by developing accurate methods of detecting and diagnosing CTE during life, and by examining genetic and other risk factors for this disease," explained lead principal investigator, Robert Stern, PhD, professor of neurology, neurosurgery, and anatomy & neurobiology at Boston University School of Medicine, where he is Clinical Core director of the Boston University Alzheimer's Disease and CTE Center.
Through this grant, NINDS is funding a longitudinal study of former NFL players, former college football players and a control group of individuals without any history of contact sports or brain injury. Participants will be examined at one of four centers across the country, including Boston University School of Medicine; Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas; Mayo Clinic in Scottsdale, Ariz.; and NYU Langone Medical Center, New York City.
Participants in the study will undergo extensive clinical examinations, as well as state-of-the art PET scans, advanced MRI scans, experimental blood tests and other potential methods of detecting changes in the brain associated with CTE. Researchers also will refine and validate specific criteria for clinical diagnosis of the disease and will investigate genetic and head impact exposure risk factors for CTE in order to begin to determine why some people are more prone to get CTE than others. Project data will be shared with researchers across the country and abroad to facilitate a more complete understanding of this disease, ultimately leading to successful methods of preventing and treating CTE.
The other principal investigators are Jeffrey Cummings, MD, ScD, (director, Cleveland Clinic Lou Ruvo Center for Brain Health in Las Vegas and Cleveland; the Camille and Larry Ruvo Chair of the Neurological Institute of Cleveland Clinic; and professor of medicine, Cleveland Clinic Lerner College of Medicine at Case Western Reserve University); Eric Reiman, MD (executive director of the Banner Alzheimer's Institute, Phoenix) and Martha Shenton, PhD (director, Psychiatry Neuroimaging Laboratory and senior scientist, Brigham and Women's Hospital; professor of psychiatry and radiology, Harvard Medical School). The project involves a group of approximately 50 investigators, representing 17 research institutions.
"There is an urgent need to clarify the clinical and biological consequences of repetitive head impacts in athletics and to use this information to find the best ways to treat and prevent those consequences," said Reiman. "It is both a great privilege and responsibility to help in that endeavor."
"This research is an exciting and important opportunity to acquire new information about the potential devastating consequences of repetitive head impact including CTE," said Shenton. "We hope that by gaining this knowledge, new avenues of treatment will emerge for those who experience debilitating symptoms from repetitive brain trauma."
"We currently have no method to diagnosis CTE during life and it is crucial to take the next steps to better understand this disease," said Cummings. "This grant will allow us to take what we know about CTE and move to the next level of research, with the end goal of diagnosing these athletes at early stages of the illness when treatments may help prevent the progression of the disease."
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