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J.A.N. Corsellis and his colleagues are one of the many contemporary heroes in the field of neuroscience. Amongst their many contributions there’s one that stands out the most. They have helped to promote our understanding of trauma-related neurodegeneration and made us appreciate the thin line between a robust and healthy brain, and a fragile and injured brain. Today, the legacy of Dr. Corsellis, his Corsellis Collection of Brains, which is one of the largest in the world and the largest in Europe, is used to assist epilepsy research in the UK. Surely, despite its main objective, this project will have its connections and contributions to other diseases of the brain and nervous system. Praise the interdisciplinary nature of science!   

In 1973, Corsellis and colleagues investigated the brains of 15 retired boxers, identifying cerebral changes that have been shown to underlie the increased risk of developing dementia. Today, it is known as chronic traumatic encephalopathy (CTE) or popularly referred to as dementia pugilistica. In the early 20th century a more derisive and biased term has been initially used to describe boxers whose heads had gone through a bit of trouble – the so-called punch-drunk syndrome.  The name really speaks for itself, but today it comprises a wide variety of victims, ranging from professional athletes to war veterans to cyclists who couldn’t care less about wearing a helmet. One of the prevailing theories that explains the pathophysiological manifestation of trauma-related neurodegeneration is the progressive neurodegenerative tauopathy, which is the aggregation of destructive tau protein seen in many other forms of neurodegenerative disease such as Alzheimer’s. However, the evidence is not certain and more research is required. On the other hand, what is certain is that traumatic brain injuries are long-term, dormant threats to life and many people are unaware that their concussion might be a silent killer in the making. In the US alone, there are approximately 5.3 million people with TBI-associated disabilities (traumatic brain injury) and this number will continue to grow if we don’t start to appreciate the severity of this condition.

Fortunately, CTE and its consequent detrimental effect on the brain, namely the possibility of dementia, are increasingly becoming a worldwide concern because of its growing public attention. Its rising awareness is especially evident from the real experiences told by athletes and shared by ordinary people on social networks. The late boxing legend Muhammad Ali is one notable example, though he never allegedly admitted it to be true. Nevertheless, the likelihood that he contracted Parkinson’s disease after repetitive TBI is very high. A 2015 dramatization “Concussion” based on Dr. Bennet Omalu’s investigation of CTE in American football players is yet another piece of evidence that communicates the gravity of CTE research and the need for its awareness. Certainly there are other cases, which deserve to be mentioned, but there’s one case that I would like to go over because it relates to me on a personal level.

Not so long ago I came across a YouTube clip of a former ice hockey player (which in fact served as my inspiration to blog about this topic), with which I have connected emotionally through my long-standing relationship with ice hockey. The link to the video is down below if you’re interested. Daniel Carcillo is a former NHL player who suffers from CTE. He has put his life story out, sharing his path to rehabilitation and revealing what it means to live with this condition. His story is highly personal to me because I am an ice hockey player myself and I have a close friend who has had several on-ice accidents involving his head. I am lucky that when I played junior hockey the only injury I’ve suffered was a broken thumb. It’s a completely different story with my friend whose concussions might lead to bigger problems. He’s only 21 years old and understandably it’s not something that he worries about. In fact, if I have stayed in Latvia to continue my ice hockey career instead of joining university I would have been most likely oblivious as well and wouldn’t know any better about the bigger picture of getting hit in the head. I showed the video to my friend and he instantly became unsettled when he heard Carcillo say: “Old-timers with dementia, Parkinson’s disease, you’re 80% more likely to contract these diseases if you have three or more concussions.”  

But there’s hope and now my friend knows it. The neat thing about Carcillo and other athletes who decided to tell the truth about CTE is that thanks to them sports organizations are now aiming to educate and make people more aware about the consequences of repetitive TBI. It’s not that before it was different, but now this information has become more accessible to a layperson and change is finally taking place. New regulations are being introduced in contact sports and more emphasis is being directed towards human health and safety. Hopefully, with greater recognition of CTE as an underlying cause of dementia, clinical research will in turn receive more endorsement to try and fight this disease in its earliest stages. Even if the unpredictability and inevitability of Rota Fortunae exists, the closer we get to the truth, the greater our odds are, and raising awareness might just be one of the first things we can do to get there.

CTE Awareness Foundation: http://stopcte.org/

The link to the video: https://www.youtube.com/watch?v=K4BySsH6FgQ

References:

Castellani RJ and Perry G, Dementia Pugilistica Revisited, J Alzheimer’s Dis. 2017; 60(4): 1209–1221. Doi: 10.3233/JAD-170669.

Smith DH, Johnson VE and Stewart W, Chronic neuropathologies of single and repetitive TBI: substrates of dementia? Nat Rev Neurol. 2013 April; 9(4): 211–221. Doi: 10.1038/nrneurol.2013.29.
https://www.researchgate.net/publication/18439689_The_aftermath_of_boxing
https://www.epilepsyresearch.org.uk/research_portfolio/new-purpose-for-historic-epilepsy-brain-collection/