BRAIN SCIENCE THE COLLISION SYNDROME Football players diagnosed with Lou Gehrig s disease may suffer from the effect of repeated blows to the head controversial new research says By Jeffrey Bartholet Kevin Turner a former professional football player su ered at least two concussions during his career and has been diagnosed with ALS or Lou Gehrig s disease Some scientists believe that he has a distinct type of ALS caused by repeated concussions and that other players have su ered a similar fate The ndings which stem from research connecting concussions to another brain disease are controversial Proponents compare their e orts to show a link between brain trauma and an ALS like disease to the battle to prove a connection between smoking and lung cancer others say that the science does not justify that analogy There is widespread agreement however that repeated blows to the head such as those sustained during a football player s career can result in brain damage SCOTT CUNNINGHAM Getty Images IN BRIEF 66 Scientific American February 2012 sad0212Bar74p indd 66 12 14 11 5 35 PM sad0212Bar74p indd 67 12 14 11 5 36 PM K evin turner was a premier athlete in the national Football League a fullback who could run catch and block At 6 1 and roughly 230 pounds he was slightly undersized for his position but he had tremendous thrust in his legs and used all of it to launch himself into players who were bigger than he was He played for the New England Patriots from 1992 to 1994 then joined the Philadelphia Eagles with whom he stayed until his abrupt retirement in 1999 Some called him the Collision Expert a nickname he got because of the gouges he collected on his helmet Now Turner can t button his shirt When we met recently at a California Pizza Kitchen in Birmingham Ala the first sign of physical impairment came when he put his small backpack into the booth where he would be sitting His arm was Frankensteinstraight and his shoulder was stiff as he swung the pack away from his body Other issues soon became apparent His fingers were curled up and his thumbs almost useless so he drank from a glass by holding it in his palms After he had trouble removing the little paper ring from his napkin he took a furtive glance at the nearby tables before ducking his head down to rip it off with his teeth I can t tell you how frustrating it is to open a box of cereal the 42 year old father of three told me as we left the restaurant Opening a box of cereal is an event Turner needs someone to help him pull his pants on in the morning His then 11 year old daughter performed that duty the day I met him She also helped him shave In 2010 Turner was diagnosed with amyotrophic lateral sclerosis ALS commonly known as Lou Gehrig s disease Nobody knows what causes ALS In 5 to 10 percent of cases the disease is inherited otherwise it is a random death sentence Its arrival is a mystery and there is no cure Now a group of scientists in Boston believes that Turner despite suffering symptoms of ALS may not really have the disease Around the same time he was diagnosed these researchers discovered what they say could be a separate disorder with exactly the same clinical syndrome as ALS It is also incurable The only real difference is that this disease seems to have a clear cause repeated blows to the head like those that often occur on the football field The finding is hugely controversial Many specialists in ALS have been critical of the science behind the new study and worry that it has confused their patients They maintain that decades of research trying to find a link between head trauma and ALS have been inconclusive at best They have been particularly incensed by the suggestion made in press interviews that Lou Gehrig might not have had Lou Gehrig s disease In a letter to the editor of the Journal of Neuropathology Experimental Neurology more than a dozen doctors and researchers questioned the science in the findings and complained that many patients have understandably been frightened and confused by these statements and are now wondering if their diagnoses are correct Ann McKee a neuropathologist at Boston University and the Bedford VA Medical Center in Massachusetts is the primary sci entist behind the study She says she regrets the controversy stirred up by the speculation regarding Gehrig but stands firmly behind the science Her original study was based on three cases and she now has five more as well as three other suspected cases awaiting confirmation McKee and her colleagues liken their battle to the one waged by scientists trying to show that smoking causes cancer There has been a lot of resistance but ultimately they believe they will prevail in showing that repetitive concussions cause a motor neuron disease with ALS like symptoms Already findings about the potential for repetitive concussions to cause other forms of mental impairment have spurred the NFL to change some of its rules on flagrant hits to the head and many states have passed legislation to ensure that young athletes do not return to the field too quickly after a concussion Even some scientists critical of certain details in McKee s research or the way in which it was presented to the press believe her findings are significant The core observations of her work are very important says Robert Brown chair of neurology at the University of Massachusetts Medical School and the public policy implications are staggering HAVOC IN THE BRAIN to grasp the controversy it helps to first understand what happens inside the brain when someone suffers a concussion Our current knowledge is based largely on animal models experiments on rodents and cats as well as the monitoring of human patients in intensive care with severe brain injuries and magnetic resonance imaging of people with mild concussions Part of this picture is uncertain but the science is improving Previously there was no way to get some of the necessary data without drilling a hole in somebody s head says Christopher Giza an associate professor of pediatric neurology and neurosurgery at the University of California Los Angeles who has done a review of the scientific literature We now have advanced imaging that has provided us with some of this information What is clear is that when the head moving at significant speed comes to an abrupt stop the brain cells inside get stretched squeezed and twisted In their normal state these cells function by transmitting electric current A part of the cell called
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