Can research develop early detection of CTE?
Over 700 mixed martial arts fighters and boxers have enrolled in a study at the Cleveland Clinic’s Lou Revo Center for Brain Health in Las Vegas over the last six years. The study involves both active and retired fighters and is looking for the early signs of trauma-induced brain injury based on subtle changes in blood chemistry, brain imaging and performance testing. These changes may start showing up decades before the visible changes and symptoms of cognitive impairment, depression and impulsive behaviors that are associated with CTE. Recently researchers at Boston University identified high levels of a protein called CC11 in deceased football players with CTE. The Cleveland Clinic study is looking at living fighters, both active and retired, through testing over a period of years which may hold the answers to the development of CTE. Over the past summer, the research team at the Lou Revo Center have identified higher levels of two brain proteins in active fighters. These proteins are neurofilament light and tau. The levels were higher in active fighters than in retired or non-fighters. The study also found that fighters with greater exposure to repetitive head trauma has lower brain volumes. Fighters were more likely to have a cavity in their brains. The study has also discovered seven specific features seen on a MRI which can identify which fighters are cognitively impaired.
Charles Bernick, MD, a Cleveland Clinic neurologist who is leading the study has said that his funders have not interfered with the science behind the study which is a massive undertaking given the numbers of fighters involved and retention issues over time. A social worker helps address the retention problem by assisting participants with social services or accessing medical care. For active fighters, the social worker helps arrange for the annual brain scan and blood tests required by the Nevada Boxing Commission. As of now, the study has funding to last for three more years. Dr. Bernick would like to keep the study going much longer than that and uses the Framingham Heart Study as an example of a long-running study which continued to produce meaningful health data over the course of time.
CTE is currently diagnosed after death, but the symptoms begin to occur and accumulate over time. This was recognized in the first cases of CTE like Mike Webster where his behavior changes occurred years before and has been seen in over athletes who later are found to have CTE. Through early detection we can prevent the damage from accruing by not allowing fighters, football players and soldiers to experience further repetitive damage once the early signs are recognized.