By On September 27th, 2017

CTE experts say breakthrough findings may help diagnose the disease in living athletes

Dr. Ann McKee examines the brain of a former football player for CTE
Source: Stan Grossfeld/The Boston Globe

Since its discovery over a decade ago, chronic traumatic encephalopathy (CTE) has been a sort of boogeyman to both the worlds of professional sports (most notably football) and medical research.

The permanent degenerative brain disease was known to silently fester in the brains of people affected by repeated head trauma while gradually causing debilitating and dangerous symptoms ranging from mood issues, the inability to control emotions, violent outbursts, memory problems, and suicidal thoughts.

Worst of all, there has been no way to identify the brain disease until after death. To definitively diagnose CTE, brain pathologists must examine the brain tissue and cerebrospinal fluid to look for key signs of the disease. Thanks to a breakthrough finding published this week, however, that may be about to change.

Researchers from Boston University School of Medicine say they have pinpointed a crucial biomarker that could allow them to diagnose and potentially treat the neurodegenerative disease in living athletes and others at risk for CTE.

Dr. Ann McKee, the senior author of the study and a neuropathologist seen as one of the leading experts on CTE, described the finding as “the first ray of hope” in a long, drawn-out fight to understand the disease.

“To me, it feels like maybe now we can start going in the other direction,” she said. “We’ve been going down, and everything has just gotten more and more depressing. And now it’s like, ‘Yeah, we’re going to actually find some answers here.’”

In the new study published in the journal PLoS One, a team of researchers from Boston University worked with the VA Boston Healthcare System to study the brains of 23 deceased former football players who were diagnosed with CTE after their deaths. They also studied 50 non-athletes who had been diagnosed with Alzheimer’s disease and 18 non-athlete control patients.

According to the findings, the former football players had significantly higher levels of a protein associated with inflammation called CCL11 when compared to the non-athletes. Notably, the athletes who played the sport the longest also had the highest levels of the protein.

While McKee strongly cautions leaping to any conclusions based on the early findings, the researchers say they are hopeful that further tests can replicate the findings and provide more evidence that the biomarker can be used to detect the disease in living players.

“It’s a unique disease, and it’s going to have unique proteins that are modified in this disease, and this is the first indication that we’ve found one of the unique proteins,” said McKee.

As the director of BU’s CTE Center, McKee has personally helped diagnose numerous former football players with CTE, including Aaron Hernandez – the former Patriots tight-end who committed suicide while serving a life sentence in prison for murder.

“This has really been our purpose: to give back to future generations,” she said. “It wasn’t just to categorize the disease and to find what these individuals had when they died. It’s really to understand CTE at the molecular and biochemical level, so we can figure out ways to detect it and more importantly, treat it.”

Because CTE can only be diagnosed in living people currently, the team of researchers was limited to post-mortem autopsies to study the brains of the athletes, but McKee says this approach “gives us clues that we might be able to detect it in living people.”

While the findings are irrefutably limited and shouldn’t be considered definitive proof that CTE can be diagnosed in living players, McKee says it has made another great accomplishment – simply proving CTE exists.

“I’ve been frustrated for years that we keep discussing or debating whether or not this disease exists, whether or not it’s unique, whether it’s simply aging,” she said. “This is the first demonstration that shows it’s clearly not aging. It is a distinct disease, and we’re going to exploit the uniqueness of this disease to find treatment.”

In response to the report, an NFL spokesman told The Washington Post the new findings are “certainly important,” but more research is needed.

“Research around CTE must continue to move forward and fill in the gaps that remain around this important issue,” NFL spokesman Brian McCarthy said in a statement. “The NFL is committed to encouraging and supporting scientific research related to the diagnosis and treatment of concussion and associated conditions, including CTE.”

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