Mike Webster (Patient zero): It’s just a concussion right? A report exposing the future consequences of repetitively sustained head injuries in sports By: Akhil Ramaswamy Figure 5: NFL Logo (Source: http://www.sportslogos.net/teams/list_by_league/7)  Controversies: Correlation does not prove causation statement issued by many Several other factors effect CTE development Demographics (Age, gender) A Protein E gene mutatoin present in all cases What is a TBI? Traumatic Brain Injuries are basically concussions and can range in severity Concussions can cause two different types of damage to the brain Occur when a biomechanical force is applied to the head Structural (skeletal) Damage Affects physical brain regions Functional damage Caused by hook like and rotational forces Causes axonal damage thus disrupting communication of neurons within the brain The axon is the part of the neuron that is responsible for relaying signals across the brain, after a direct hit on the head the axons may swell causing functional damage to the brain Can cause neural cell death Most cases of structural and functional damages arise from lower CBF to the brain (Cerebral Blood Flow) and increase in glucose usage causes a energy crises that puts a lot of stress on the brain Can lead to a variety of disorders and problems Mike Webster (Patient zero): Former Center for the Pittsburgh Steelers First football player to be diagnosed with CTE Suffered from serious Dementia and loss of cognitive function throughout his life Had trouble sleeping as a result of injuries sustained to the brain in his playing career Body and brain was in a deteriorated state Suffered from severe memory loss Could not remember family members More info on CTE: Chronic Traumatic Encephalopathy A neurodegenerative disorder that can lead to death caused by TBI’s Known as “Punch-Drunk Syndrome” in boxing Very common in athletes Pathology synonymous with that of ALS and Alzheimer's Diagnosed after death Accumulation of Tau protein in brain What’s being done!: New Concussion protocol by the NFL Concussion education and awareness training Better helmets that provide impact force protection New sensor technology that players can wear that monitors and quantifies impact force data when a collision occurs (Triax sensor) Figure 4: Mike Webster (Source: http://articles.latimes.com/2014/mar/21/sports/la-sp-sn-mike-webster-nfl-concussions-lawsuit-20140321) Figure 6: Triax Sensor (Source: http://urbanwearables.technology/triax-smart-impact-monitor-for-team-sports-and-individuals/ Work Cited: Webster, P., Omalu, B., M.D., Otto, J., & Young, S. (2014, September 29). Mike Websters Legacy [Interview]. Retrieved February 27, 2017, from http://www.pbs.org/wgbh/pages/frontline/oral-history/league-of-denial/mike-webster-s-legacy/   Ling, H., Morris, H. R., Neal, J. W., Lees, A. J., Hardy, J., Holton, J. L., . . . Williams, D. D. (2017). Mixed pathologies including chronic traumatic encephalopathy account for dementia in retired association football (soccer) players. Acta Neuropathologica,133(3), 337-352. doi:10.1007/s00401-017-1680-3 Garber, G. (2005, January 24). A tormented soul. Retrieved February 18, 2017, from http://www.espn.com/nfl/news/story?id=1972285 Ling, H., Hardy, J., & Zetterberg, H. (2015). Neurological consequences of traumatic brain injuries in sports. Molecular and Cellular Neuroscience, 66, 114-122. DOI: 10.1016/j.mcn.2015.03.012 Mckee, A. C., MD, Cantu, R. C., MD, Nowinski, C. J., AB, Hedley-Whyte, E., MD, Gavett, B. E., PHD, Budson, A. E., MD, . . . Stern, R. A., PHD. (2009). Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy After Repetitive Head Injury . Journal of neuropathology and experimental neurology,68(7), 709-735. doi:10.1097/NEN.0b013e3181a9d503 Giza, C. C., MD, & Hovda, D. A., PhD. (2014). The New Neurometabolic Cascade of Concussion. Neurosurgery,75(4), 24-33. doi:10.1227/NEU.0000000000000505 Castillo, %. (2014, March 20). Basketball and the brain: Concussions aren't just a risk in football. CBS News. Retrieved February 27, 2017, from http://www.cbsnews.com/news/basketball-concussions-a-risk-in-contact-sports-not-just-football/ Figure 2: Neuropathology of CTE (Source: http://www.sciencedirect.com/science/article/pii/S104474311500041X ) Where’s the proof?: TBI has negative consequences in all sports from football and boxing to soccer Majority of brain autopsies of athletes with repetitive forms of brain trauma show damage to specific brain regions Dementia and memory loss are common symptoms in all case studies Majority of the athletes who have dementia also have CTE Figure 1: Graphic of neuron of cell (Source: http://www.wikiwand.com/en/Neuron) What does it cause?: Dementia Steady decline of motor and cognition functions CTE Secondary impact syndrome occurs when a player has not recovered from a concussion and gets hurt again where he/she might go into a coma Juvenile Head Trauma Syndrome: TBI in children and youth athletes Subdural Hematoma Most common case of TBI related death Usually found in boxers Figure 3.2: Tau Protein stained images (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945234/) Figure 3.2: Frontal Cortex of damaged vs normal (Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945234/) Figure 3.2: Damaged Hippocampus of athletes(Source: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2945234/)