University doctors selected for new NFL treatment program
David Brody, Assistant Professor of Neurology, will lead Wash. U.’s treatment center of five medical faculty members and two administrators. Other medical centers participating include Morehouse School of Medicine, Mount Sinai, Doctors of USC and University of California and the San Francisco School of Medicine.
At Wash. U.’s treatment site, doctors will focus on clinical work, with a secondary goal of research in brain injury. Players’ treatment is financed under the Bert Bell/Pete Rozelle NFL Player Retirement Plan. Players who do not qualify for those benefits may apply to the NFL Player Care Foundation for a grant to cover treatment.
According to Brody, the most pressing issue for the retired players who will be treated as part of the program is a condition known as Chronic Traumatic Encephalopathy (CTE), a condition sustained after many concussions over an extended period of time. This condition has also appeared in boxers and soldiers who have suffered blast injuries, sparking interest from the Department of Defense for the treatment of traumatic brain injuries. The NFL and Department of Defense will host a joint meeting for the five treatment centers in Washington, D.C.
“We’re going to see as many of these players with CTE as we can, try to figure out what we can do to help them and try to learn more about the disease in the process,” Brody said. “Even though there’s nothing we can do right now that reverses the pathology, there’s a lot we can do symptomatically to help the patients.”
Often, complications from CTE appear in a delayed fashion and may include headaches, attention deficit, depression, sleep disorders and seizures. In addition, many patients are drinking alcohol in excess.
“One of the things that’s really exciting about having this study at Washington University is the tremendous power of the neuroimaging research that goes on here,” Brody said. “We’re hoping that with some of the modern neuroimaging approaches that we’ll be able to understand at relatively early stages what is happening in CTE and be able to watch the evolution over time and be able to correlate that evolution with symptoms that are emerging.”
A more severe concussive condition known as Second Impact Syndrome occurs when a patient sustains multiple concussions in quick succession; for example, two in one game. This condition can be deadly, but according to Brody, it is relatively rare.
“Essentially what happens in Second Impact Syndrome is there’s massive swelling in the brain, much more than you would expect in a single concussion,” Brody said. “This is massive swelling which leads to greatly elevated inter-cranial pressure and often death from that disability.”
Although concussions may lead to serious disorders like Second Impact Syndrome and CTE, Brody noted that at least 90 percent of otherwise healthy patients make full recoveries from single concussions.
At the same time, a traumatic brain injury is the most common cause of permanent disability for those under 45; as such, student athletes at Washington University are educated on how to prevent and recognize them.
“If you look at some of the sports where you see larger incidents [of concussions], contact and collision sports, you try to do more of an education program with them in terms of being able to safely play without putting themselves at risk,” Wash. U. athletics head trainer Rick Larsen said. “In football, you can do that by not leading with the head…try to tackle more with the shoulders.”
Athletes involved in football, men’s and women’s soccer, men’s and women’s basketball and diving undergo cognitive testing to establish baseline cognitive levels. In the event of a concussion, these tests provide guidelines for trainers and medical staff.
“We follow that person on a daily basis, waiting for them to recover…once their symptoms diminish we begin a light exercise program and see if their baseline cognitive functions come back,” Larsen said.
With the program still in its earliest phases, much is yet to be determined about how it will operate. Representatives from the five sites will soon be meeting for the first time as a group in Atlanta, Georgia at Morehouse.
“The five groups, plus possibly some of the Department of Defense people will try to get together to find some common ground,” Brody said.
“We are independent groups, but, this will be most useful scientifically and clinically if we can pool our data and have some homogeneity such that data can be directly compared from across centers.”