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Protecting the Player Protecting the Game

Boston University Center for the Study of Traumatic Encephalopathy


I love this game, and I think I

owe a lot to it. I want to do anything I can to make it better, make it safer for generations to come. Athletics can be a powerful influence in a young person’s life, so we need to make sure that sports are safer so kids can enjoy

the experience.

–Matt Birk

PHOTO COURTESY OF THE BALTIMORE RAVENS

Matt, an All-Pro center with the Baltimore Ravens, has agreed to donate his brain to the BU CSTE (Boston University’s Center for the Study of Traumatic Encephalopathy), located at the Bedford VA Medical Center, after he has passed away. This gift will help scientists study the long term effects of concussions sustained by football players. A Harvard graduate, Matt played nine seasons for the Vikings, including six Pro Bowl appearances. He joined the Baltimore Ravens prior to the 2009 season. Matt’s generosity is also evident in the work done by his charitable organization, Matt Birk’s HIKE Foundation, a group dedicated to providing educational opportunities for Baltimore-area at-risk children.

PHOTO COURTESY OF THE BALTIMORE RAVENS

MattBirk


Chronic Traumatic Encephalopathy slowly destroys your brain, advancing even after you retire from playing football, and causes problems with memory, depression, and emotional control.

It’s Time to Tackle CTE Football, a game loved by millions, is facing a threat that can impact any player, at any age, on and off the field. We’re here to protect the game by protecting the players. We all know football is a tough game. It’s a physical game that produces injuries. Most injuries we can see and feel. Until recently, however, we’ve never given much thought to how those violent collisions might injure your brain and result in significant problems later in life. Groundbreaking new research at the Center for the Study of Traumatic Encephalopathy at Boston University School of Medicine (BU CSTE) has revealed that repeated hits to the head can lead to a disease called Chronic Traumatic Encephalopathy, or CTE, in some people. If you develop CTE, and if you live long enough, you will likely develop dementia.

He l p us make t h e g ame safe r. For more infor mation, call 617-638-6143


It would be great if every

player in the League, in college, and in high school would participate in research so we can protect the players and protect the game.

–Mike Haynes

Pro Football Hall of Famer Mike Haynes has agreed to donate his brain to the BU CSTE, located at the Bedford VA Medical Center.

MikeHaynes

Widely recognized as one of the NFL’s greatest defensive backs, Mike’s illustrious career began in 1976 with the Patriots. He appeared in nine Pro Bowls and was named All-Pro five times. He was named to the NFL’s 75th Anniversary All-Time Team in 1995, and inducted into the Pro Football Hall of Fame in 1997. The president and founder of the Mike Haynes & Associates consulting company, Mike is also a cancer survivor and works to raise awareness of prostate cancer as a spokesperson for the American Urological Association.


The Boston University Center for the Study of Traumatic Encephalopathy has studied the brains of more than 25 deceased NFL players as part of the largest CTE “brain bank” in the world, located at the Bedford VA Medical Center.

CTE Isn’t New In the past, CTE was mostly diagnosed in boxers; you’ve probably heard of it as being “punch drunk” or “dementia pugilistica.” In fact, this disease has been identified in boxers since the 1920s. As of today, CTE can only be diagnosed after death by the examination of brain tissue. It has now been diagnosed in a wide range of people, including hockey players, professional wrestlers, a soccer player, a battered spouse, and even a circus clown shot out of a cannon. “I’m learning more about CTE and recognizing that a lot of my friends older than I and even my age are having some kind of difficulty with their memory, thinking, and behavior. And I wonder if it’s related to brain trauma.” Mike Haynes

No one ever thought to study football players’ brains for CTE until 2002. Since then, many former NFL players, like Andre Waters, Wally Hilgenberg, Hall of Famer Lou Creekmur, Tom McHale, John Grimsley, Shane Dronett, and Eric Scoggins have been positively diagnosed with CTE after they passed away. Sadly, the list is longer and continues to grow. In fact, most of the NFL players studied so far have had CTE, and they, along with their families, suffered horribly. Because it cannot yet be diagnosed in living people, none of these men ever knew they had CTE. As of today, even if we could diagnose CTE during life, there is still no treatment that will stop, slow, or reverse progression of the disease.

You can make a difference in the BU CSTE research. F or more infor mation, call 617-638-6143


John was a wonderful husband

and father. In the last years of his life he became a different person. He was quick to anger and noticeably forgetful. When he forgot about the engagement party for our son and future daughter-in-law, I knew some-

thing was gravely wrong. – Virginia Grimsley, wife of John Grimsley

Virginia Grimsley was the first spouse to agree to donate brain tissue from her deceased husband to the BU CSTE to help future generations.

VirginiaGrimsley

John Grimsley, a Pro Bowl linebacker who played nine seasons with the Houston Oilers and Miami Dolphins, died of an accidental gunshot wound at his home in Missouri City, Texas on February 6, 2008. After his death, he was found to have Chronic Traumatic Encephalopathy as a result of his football career.


It is not yet known why some people get CTE and others do not. What CTE Looks Like Normal Age 65

Grimsley Age 45

Boxer with dementia Age 75

Here’s What We Know About CTE UÊÊÊÊIt is a progressive, degenerative disease of the brain caused in part by repetitive trauma. UÊÊÊÊThis brain disease appears to begin while an athlete is actively playing, and continues to progress even after retirement. UÊÊÊÊSymptoms usually start years or decades after the brain trauma. They include memory difficulties, depression, irritability, emotional instability, and problems with impulse control. UÊÊÊÊEventually, CTE may lead to full-blown dementia.

UÊÊ Tests for CTE turn toxic tau protein brown. UÊÊ Toxic tau protein is not found in a healthy brain. UÊÊ The presence of this toxic tau protein indicates that brain cells are

no longer able to function normally and will eventually die. UÊÊÊÊAt age 45, John Grimsley had an advanced case of CTE,

similar to the 75-year-old boxer.

UÊÊÊCTE is not directly correlated with the number of concussions experienced by an athlete. CTE is likely caused by a combination of concussions and repeated subconcussive brain trauma that doesn’t produce symptoms. Former football players have been diagnosed with CTE who haven’t been diagnosed with a concussion. UÊÊÊAlthough the later-life symptoms of CTE can look similar to Alzheimer’s disease, it is a distinct brain disease. UÊÊÊÊThere is no known treatment or cure for CTE, though some of the symptoms may be able to be temporarily treated. UÊÊÊÊCTE is the only known preventable cause of dementia.

There’s no cure, but CTE can likely be prevented. For more infor mation, call 617-638-6143


I walked away from the NFL in July,

2010 after nine seasons because I was no longer healthy enough to do my job. Several experts told me to retire, and I made the right call for my team, my family, and my own personal health. I am concerned about what lies ahead, but I pour that energy into positive efforts like this. I believe this research will impact the lives and careers of active, former, and future NFL players, as well as help make sports safer for our kids. I owe it to the

kids, and I owe it to the game.

–Sean Morey

Sean Morey, former Pro Bowl Special Teamer, retired from the NFL in 2010. He currently serves as Co-Chair of the NFLPA Mackey-White Traumatic Brain Injury Committee, a group of leading neurological and medical experts formed to interpret the science of brain trauma, educate players, and support independent research efforts to advocate for the health, safety and welfare of NFL players. Sean’s nine-year NFL career included a Super Bowl XL championship with the Pittsburgh Steelers, a 2008 Pro Bowl selection with the Arizona Cardinals, and a Special Teams MVP with the Eagles in 2003. An NFLPA Executive Committee Member, Sean was also the first player to have his jersey number retired by Brown University.

SeanMorey


Owen Thomas, a 21-year-old co-captain of the University of Pennsylvania football team, was diagnosed with CTE by the BU CSTE. He committed suicide in April of 2010, before his senior season. He was never diagnosed with a concussion, but he experienced thousands of subconcussive blows to the brain through his many years of football, starting at the age of nine. It is not known if CTE played a role in Owen’s suicide, but what is clear is

PHOTO COURTESY OF PENN ATHLETICS

that at the young age of 21, the initial stages of the brain disease were already apparent.

Top row: Brain sections showing dense toxic tau protein deposition in multiple areas of the frontal cortex (boxes). Bottom row: Microscopic images showing toxic tau protein as brown spots in the areas of damage.

Here’s What We Need to Discover About CTE UÊÊÊNot everyone who gets hit in the head gets CTE; so then, why do some people get the disease while others do not? UÊÊÊHow common is CTE? UÊÊÊDo some people have a genetic predisposition to the disease? UÊÊÊAre there other factors, in addition to repeated hits to the head, that result in CTE—for example, the type of hits, the number of years played, the position? UÊÊÊHow does CTE start? UÊÊÊHow can we diagnose CTE during life? UÊÊÊHow does CTE progress? UÊÊÊHow can we treat CTE? UÊÊÊHow can we cure CTE? We simply don’t know the answers... yet.

Help us find the answers. F or more infor mation, call 617-638-6143


In December 2001, my husband was

diagnosed with dementia. He was 60 years old. When I look back over the years, I can see a general decline. He grew apathetic, said inappropriate things, lost interest in personal hygiene and dressed strangely. Today, he lives in a memory care facility. His speech is gone. His motor skills are declining. When John passes, I will donate his brain to the BU CSTE. He would want that, I know, and I believe doing this is so important. I know it’s not an easy decision, but I encourage you to participate in this important research because it will ultimately benefit so many people.

– Sylvia Mackey, wife of #88, John Mackey

Sylvia Mackey, wife of Pro Football Hall of Famer John Mackey, has been instrumental in bringing attention to football players who suffer with dementia and who face catastrophic medical costs. She was also influential in the development of the NFL’s 88 Plan, named after John’s jersey number. John was the second tight end in NFL history enshrined in the Pro Football Hall of Fame when he entered in 1992. During his 10-year NFL career, John caught 331 passes for 5,236 yards and 38 touchdowns. John also served as NFLPA President from 1970 – 1973. John now suffers from dementia and, at age 69, lives in an assisted living facility requiring around-the-clock care.

John & Sylvia Mackey


Not only are NFL players at risk, but so are millions of boys who play football, as well as all kids who play sports like hockey and soccer.

Spre a d i ng t h e Wo rd Ab o u t CTE Until a few years ago, most people had never heard of CTE. Word is finally getting out about this disease. You have probably seen the BU CSTE research featured on HBO Real Sports, 60 Minutes, and ESPN, or read about it in Sports Illustrated, The New York Times, The New Yorker, and Time Magazine. The new awareness of CTE has helped drive policy and rule changes in youth sports across the nation, making the games safer for children. Our goal is not to end the games, but to make them safer. Your participation in research at the BU CSTE will help inform education and advocacy programs for safer sports, through our partner, the non-profit Sports Legacy Institute (SLI). We’re asking you to get involved.

H e l p us r ai se aw ar e n e ss. For more infor mation, call 617-638-6143


The BU CSTE was initiated by a four-person multidisciplinary team whose members now serve as Co-Directors of the Center. The team includes:

ROBERT CANTU, MD

ANN MCKEE, MD

CHRISTOPHER NOWINSKI

ROBERT STERN, PhD

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Clinical Professor of Neurosurgery, Boston University School of Medicine

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Professor of Neurology and Pathology at Boston University School of Medicine

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Former Harvard football player and former WWE professional wrestler

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Associate Professor of Neurology at Boston University School of Medicine

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Chief of Neurosurgery Service; Chairman, Department of Surgery; Director of Sports Medicine; Emerson Hospital, Concord, MA

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Director of the Neuropathology Core, NIH-Funded BU Alzheimer’s Disease Center

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Author of Head Games: Football’s Concussion Crisis

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Director of the Clinical Core, NIH-Funded BU Alzheimer’s Disease Center

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Director of the BU Alzheimer’s Disease Clinical and Research Program

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Member of the Mackey-White Traumatic Brain Injury Committee of the NFL Players Association

Neuropathologist for the Framingham Heart Study, the New England Centarian Study, and National VA ALS Biorepository Brain Bank

Co-Founder and President of Sports Legacy Institute (SLI), a non-profit organization dedicated to solving the sports concussion crisis

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Co-Founder of Sports Legacy Institute (SLI), a non-profit organization dedicated to solving the sports concussion crisis

Director of Neuropathology, New England Veterans Healthcare System

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Author of over 200 journal articles, chapters, and abstracts, as well as many widely used neuropsychological tests

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Member of the Mackey-White Traumatic Brain Injury Committee of the NFL Players Association

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Member of the Mackey-White Traumatic Brain Injury Committee of the NFL Players Association

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Special Advisor to the NFL Head, Neck, and Spine Committee

Member of the Mackey-White Traumatic Brain Injury Committee of the NFL Players Association

Boston University Center for the Study of Traumatic Encephalopathy


The BU Center for the Study of Traumatic Encephalopathy is the leading center in the world dedicated to the study of CTE.

W h o We A re

The two scans on the left show a former athlete with symptoms of CTE, while the two scans on the right show a healthy, age-matched control. The findings from the athlete show a loss of brain tissue and a loss of connections between brain cells. The BU CSTE is driving cutting-edge research using advanced MRI brain scans like these, aimed at developing a diagnostic test for CTE.

The BU CSTE: U Has leading experts in the study of concussion, brain trauma, degenerative diseases, dementia, genetics, and new drug development. U Has the full support of the National Football League Players Association, which encourages athletes to participate in the BU CSTE research. U Has the full support of the National Football League, which gave a one million dollar unrestricted gift to the center. U Has the largest CTE brain bank in the world, located at the Bedford VA Medical Center, and was the first to diagnose CTE in college and high school football players. U Discovered that CTE can cause a disease that looks like ALS or Lou Gehrig’s disease. U Collaborates with researchers from leading academic institutions like Harvard, Penn, Columbia, and the University of North Carolina. U Uses clinical evaluation programs, biomarkers, and neuroimaging involving players as a first step to develop treatments. U Is reaching out across the country to help athletes, young and old, amateur and pro, active and retired. The BU CSTE’s research programs are growing for one reason—they provide enormous hope for the future.

Contact us to get involved. F or more infor mation, call 617-638-6143


When Tom died, I had never heard of CTE. I was

quite certain they would find nothing because Tom never reported any concussions. I simply felt that if this research would somehow make sports safer for future athletes, Tom would have wanted to be a part of that. I could not have been more wrong. Tom’s brain demonstrated significant disease. Now I do have questions, beginning with ‘If Tom, how many others?’ and, ‘What is the risk to our boys?’ I’m hopeful enough people are willing to step forward and participate in research to make a difference.

– Lisa McHale, wife of Tom McHale

Lisa McHale donated Tom’s brain to the BU CSTE. She now works as the family coordinator for SLI and has helped over 50 families throughout the donation process. Tom McHale, a 9-year veteran of the NFL, was an offensive lineman for the Buccaneers, the Eagles, and the Dolphins before retiring and running several Tampa-area restaurants. Tom died of a fatal overdose at 45.

Lisa McHale


W h at You Can Do: ĖŤ13(!(/3#Ť(-Ť1#2#1!'Ď ĖŤ #1-Ť'.6Ť3.Ť24//.13Ť1#2#1!'Ť(-Ť.3'#1Ť682Ď ĖŤ.-3!3Ť'1(23(-#Ť$.1Ť,.1#Ť(-$.1,3(.-ď Call: 617-638-6143 or Email: cbaugh@bu.edu ĖŤ(2(3Ť.41Ť6# 2(3# www.bu.edu/cste

Find out how your participation in research at BU CSTE, can help make a difference in the fight against CTE. For more information on CTE, BU research, or how you can get involved, please contact our research coordinator: Christine Baugh at 617-638-6143 or cbaugh@bu.edu


Boston University Center for the Study of Traumatic Encephalopathy Boston University School of Medicine Center for the Study of Traumatic Encephalopathy 72 East Concord Street, B7380 Boston, MA 02118 (617) 638-6143 www.bu.edu/cste


Protecting the Players/Protecting the Game