First Imaging Study Of Concussion-Related Abnormal Brain Proteins In Retired NFL Players

Sports-related concussions and mild traumatic brain injuries have grabbed headlines in recent months, as the long-term damage they can cause becomes increasingly evident among both current and former athletes. The Centers for Disease Control and Prevention estimates that millions of these injuries occur each year.

Despite the devastating consequences of traumatic brain injury and the large number of athletes playing contact sports who are at risk, no method has been developed for early detection or tracking of the brain pathology associated with these injuries.

Now, for the first time, UCLA researchers have used a brain-imaging tool to identify the abnormal tau proteins associated with this type of repetitive injury in five retired National Football League players who are still living. Previously, confirmation of the presence of this protein, which is also associated with Alzheimer's disease, could only be established by an autopsy.

The preliminary findings of the small study are reported in the online issue of the American Journal of Geriatric Psychiatry, the official journal of the American Association for Geriatric Psychiatry.

Previous reports and studies have shown that professional athletes in contact sports who are exposed to repetitive mild traumatic brain injuries may develop ongoing impairment such as chronic traumatic encephalopathy (CTE), a degenerative condition caused by a build up of tau protein. CTE has been associated with memory loss, confusion, progressive dementia, depression, suicidal behavior, personality changes, abnormal gait and tremors.

"Early detection of tau proteins may help us to understand what is happening sooner in the brains of these injured athletes," said lead study author Dr. Gary Small, UCLA's Parlow-Solomon Professor on Aging and a professor of psychiatry and biobehavioral sciences at the

Semel Institute for Neuroscience and Human Behavior at UCLA. "Our findings may also guide us in developing strategies and interventions to protect those with early symptoms, rather than try to repair damage once it becomes extensive."

Small notes that larger follow-up studies are needed to determine the impact and usefulness of detecting these tau proteins early, but given the large number of people at risk for mild traumatic brain injury - not only athletes but military personnel, auto accident victims and others - a means of testing what is happening in the brain during the early stages could potentially have a considerable impact on public health.

For the study, the researchers recruited five retired NFL players who were 45 years of age or older. Each had a history of one or more concussions and some were experiencing cognitive or mood symptoms. The players represented a range of positions, including linebacker, quarterback, guard, center and defensive lineman.

"I hope that my participation in these kinds of studies will lead to a better understanding of the consequences of repeated head injury and new standards to protect players from sports concussions," said Wayne Clark, a player in the study who had normal cognitive function.

For the study, the UCLA scientists used a brain-imaging tool they had developed previously for assessing neurological changes associated with Alzheimer's disease. They employed a chemical marker they created called FDDNP, which binds to deposits of amyloid beta "plaques" and neurofibrillary tau "tangles" - the hallmarks of Alzheimer's - which they then viewed using a positron emission tomography (PET) scan, providing a "window into the brain." With this method, researchers are able to pinpoint where in the brain these abnormal proteins accumulate.

After the players received intravenous injections of FDDNP, researchers performed PET brain scans on them and compared the scans to those of healthy men of comparable age, education, body mass index and family history of dementia.

The scientists found that compared to the healthy men, the NFL players had elevated levels of FDDNP in the amygdala and subcortical regions of the brain. These regions control learning, memory, behavior, emotions, and other mental and physical functions. Those players who had experienced a greater number of concussions were found to have higher FDDNP levels.

"The FDDNP binding patterns in the players' scans were consistent with the tau deposit patterns that have been observed at autopsy in CTE cases," said study author Dr. Jorge R. Barrio, a professor of molecular and medical pharmacology at the David Geffen School of Medicine at UCLA.

Each of the research volunteers also received a standard clinical assessment to gauge their degree of depression (Hamilton Rating Scale for Depression, or HAM-D) and cognitive ability (Mini-Mental State Examination, or MMSE). The players had more depressive symptoms than the healthy men and generally scored lower on the MMSE test, demonstrating evidence of cognitive loss. Three players had mild cognitive impairment, one had dementia and another had normal cognitive function.

Elevated levels of FDDNP have been shown in studies to be associated with cognitive symptoms in normal aging, mild cognitive impairment and dementia, according to Barrio. The FDDNP signals appear to reflect a range of mental symptoms that have been observed in CTE cases, he noted.

Although the FDDNP marker also binds to another abnormal brain protein called amyloid beta, previous autopsy studies have shown the amyloid plaques are observed in less than a third of CTE cases in retired football players, suggesting that the FDDNP signal in the players represents mostly tau deposits in the brain.

"Providing a non-invasive method for early detection is a critical first step in developing interventions to prevent symptom onset and progression in CTE," said Small, director of the UCLA Longevity Center. "FDDNP is the only imaging marker currently available that can provide a measure of tau in living humans."

According to Small, a recent study of more than 3,400 retired professional football players showed that they had a higher-than-average risk of dying from Alzheimer's disease. Small's team also is studying lifestyle interventions for delaying the onset of Alzheimer's symptoms. His new book "The Alzheimer's Prevention Program," released in paperback this month, features the latest research on this topic and offers the public practical strategies for protecting brain health.

Research into CTE and the long-term effects of mild traumatic brain injuries such as sports-related concussions has been picking up momentum.

"It is the holy grail of CTE research to be able to identify those who are suffering from the syndrome early, while they're still alive. Discovering the effects of prior brain trauma earlier opens up possibilities for symptom treatment and prevention," said study author Dr. Julian Bailes, director of the Brain Injury Research Institute and the Bennett Tarkington Chairman of the department of neurosurgery at NorthShore University HealthSystem based in Evanston, IL.


The study was funded by the Brain Injury Research Institute; the Fran and Ray Stark Foundation Fund for Alzheimer's Disease Research; the Ahmanson Foundation and the Parlow-Solomon Professorship.

UCLA owns three U.S. patents on the FDDNP chemical marker. Small and Barrio are among the inventors. Disclosures are listed in the full study.

Additional study authors included Vladimir Kepe, Ph.D.; Prabha Siddarth, Ph.D.; Linda M. Ercoli, Ph.D.; Dr. David A. Merrill; Natacha Donghue, B.A.; Susan Y. Bookheimer, Ph.D.; Jacqueline Martinez, M.S.; and Dr. Bennet Omalu.


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Stimulating The Brain's Natural Defense Mechanisms Offers Potential For Alzheimer's Disease Vacccine

A team of researchers from Universite Laval, CHU de Quebec, and pharmaceutical firm GlaxoSmithKline (GSK) has discovered a way to stimulate the brain's natural defense mechanisms in people with Alzheimer's disease. This major breakthrough, details of which are presented in an early online edition of the Proceedings of the National Academy of Sciences (PNAS), opens the door to the development of a treatment for Alzheimer's disease and a vaccine to prevent the illness.

One of the main characteristics of Alzheimer's disease is the production in the brain of a toxic molecule known as amyloid beta. Microglial cells, the nervous system's defenders, are unable to eliminate this substance, which forms deposits called senile plaques.

The team led by Dr. Serge Rivest, professor at Université Laval's Faculty of Medicine and researcher at the CHU de Québec research center, identified a molecule that stimulates the activity of the brain's immune cells. The molecule, known as MPL (monophosphoryl lipid A), has been used extensively as a vaccine adjuvant by GSK for many years, and its safety is well established.

In mice with Alzheimer's symptoms, weekly injections of MPL over a twelve-week period eliminated up to 80% of senile plaques. In addition, tests measuring the mice's ability to learn new tasks showed significant improvement in cognitive function over the same period.

The researchers see two potential uses for MPL. It could be administered by intramuscular injection to people with Alzheimer's disease to slow the progression of the illness. It could also be incorporated into a vaccine designed to stimulate the production of antibodies against amyloid beta. "The vaccine could be given to people who already have the disease to stimulate their natural immunity," said Serge Rivest. "It could also be administered as a preventive measure to people with risk factors for Alzheimer's disease."

"When our team started working on Alzheimer's disease a decade ago, our goal was to develop better treatment for Alzheimer's patients," explained Professor Rivest. "With the discovery announced today, I think we're close to our objective."

n.p. "Stimulating The Brain's Natural Defense Mechanisms Offers Potential For Alzheimer's Disease Vacccine." Medical News Today. MediLexicon, Intl., 17 Jan. 2013. Web.

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Link Between Passive Smoking And Dementia

An international study by scientists in China, the UK and USA has found a link between passive smoking and syndromes of dementia.

The study of nearly 6,000 people in five provinces in China reveals that people exposed to passive smoking have a significantly increased risk of severe dementia syndromes.

Passive smoking, also known as 'second-hand' smoke or environmental tobacco smoke (ETS), is known to cause serious cardiovascular and respiratory diseases, including coronary heart disease and lung cancer. However, until now it has been uncertain whether ETS increases the risk of dementia, mainly due to lack of research. Previous studies have shown an association between ETS and cognitive impairment, but this is the first to find a significant link with dementia syndromes.

The study, published in Occupational and Environmental Medicine, is a collaboration between scientists at King's College London and Anhui Medical University, China, along with colleagues in the UK and USA.

According to the World Health Organization (WHO), nearly 80 percent of the more than one billion smokers worldwide live in low- and middle-income countries, where the burden of tobacco-related illness and death is heaviest; but only 11 percent of the world's population are protected by comprehensive smoke-free laws.

China is the largest consumer of tobacco in the world, with 350 million smokers. Since 2006, the Chinese government has actively promoted the introduction of smoke-free environments in hospitals, schools, on public transport and in other public places, but implementation has not been widespread.

Recent data show that the prevalence of passive smoking is still high, with over 50 percent of people exposed to environmental tobacco smoke on a daily basis. China also has the highest number of dementia sufferers in the world, with increasing rates of new cases as the population ages.

Dr Ruoling Chen, senior lecturer in public health from King's College London, and colleagues interviewed 5,921 people aged over 60 in the rural and urban communities of Anhui, Guangdong, Heilongjiang, Shanghai and Shanxi to characterise their levels of ETS exposure, smoking habits and assess levels of dementia syndromes.

They found that 10 percent of the group had severe dementia syndromes. This was significantly related to exposure level and duration of passive smoking. The associations with severe syndromes were found in people who had never smoked and in former and current smokers.

The data from the Anhui cohort, which were collected at baseline in 2001-03 for dementia syndromes and in the follow up in 2007-08 for ETS exposure and dementia, further excluded the possibility that dementia syndromes caused people to be more exposed to environmental tobacco smoke.

Dr Ruoling Chen, also a visiting professor at Anhui Medical University said: 'Passive smoking should be considered an important risk factor for severe dementia syndromes, as this study in China shows. Avoiding exposure to ETS may reduce the risk of severe dementia syndromes.

'China, along with many other countries, now has a significantly ageing population, so dementia has a significant impact not only on the patients but on their families and carers. It's a huge burden on society.'

The findings from this study, together with a second recent study by Chen and colleagues published in Alzheimer's & Dementia on the links between passive smoking and Alzheimer's disease, strengthen the case for public health measures to protect people from exposure to environmental tobacco smoke.

'At present, we know that about 90 percent of the world's population live in countries without smoke-free public areas. More campaigns against tobacco exposure in the general population will help decrease the risk of severe dementia syndromes and reduce the dementia epidemic worldwide.'

He added: 'The increased risk of severe dementia syndromes in those exposed to passive smoking is similar to increased risk of coronary heart disease - suggesting that urgent preventive measures should be taken, not just in China but many other countries.'


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n.p. (2013, January 11). "Link Between Passive Smoking And Dementia." Medical News Today.
 

What is an Assisted Living Facility?

Assisted Living Facilities (ALF's) are housing facilities for the elderly with any sort of disability that would prevent them from being able to live independently. ALF's provide supervision or assistance with activities of daily living or better known as ADL's. These tasks can be simple as brushing ones teeth to more complicated tasks like eating, bathing or using the restroom. ALF's also supervise the residents to help ensure their health, safety and over-all well being. They also have a trained staff licensed to regulate and hand out medications.

There are 4 major benefits to staying in an Assisted Living Facility.

1. Safety. Assisted living centers are set up to provide a safe, comfortable environment for elders. Many, though not all, have secure entrances. Nearly all are monitored enough so that elders aren't vulnerable to attack or burglary as they may be if they stay alone in their home. Just the fact that there are other people around makes communal living safer than being alone in a house. Also, most assisted living centers have alerting systems so if residents have emergencies in their own apartments or rooms, they can summon help.

 

2. Meals. Appetites can diminish as we age, plus many people don't enjoy eating alone. Elders home alone often warm up something in the microwave or on the stove rather than preparing a nourishing meal. They then may eat in front of the TV for company. In assisted living, meals are provided and they often offer many choices of food. But the biggest plus may be that people have company for their meals.

 

Many centers offer kitchenettes, so people have the option of preparing some meals in their apartments if they choose, which some do, especially breakfast. However, the pull of communal dining is pretty strong once they get used to company. When people have company for a meal, they generally eat better, so these communal meals can help keep a senior healthy. Also, many assisted living centers keep an eye on how well the elders eat to see if supplements seem to be necessary.

 

3. Transportation. Most assisted living centers provide group transportation for shopping and to community events. Also, they can generally arrange transportation for seniors who need to get to clinic appointments. Each center is different, but the ability to go where they want is important to elders, and many seniors can no longer drive, or choose not to drive in heavy traffic. Assisted living centers can be a big help getting people where they want to go.

 

4. Socialization. Socialization is perhaps the most important reason why many people who insist that they will hate assisted living end up thriving. Many elders have slowly gotten so they don't want to go out of their home because it's too difficult to get where they want to go. Significant lifelong friends have health problems or have died.

When not actively used, social skills can decline, causing anxiety when elders do go out among people. Depression can set in, furthering their reluctance to be socially active. Elders without social exposure can become virtual hermits, except for those who have family visits. While family visits are fun, seniors needs peers, as well. In assisted living, even those who swore they'd hate it often find, once they adjust, that they again enjoy the company of peers. They play cards, listen to music, exercise, have snacks, go to community events and have people come in to entertain them.

 

 

 

A good facility provides choices. They don't force involvement, but they encourage residents to try different activities. The facility staff should find out what activities the senior has enjoyed in the past and try to find something similar that they can do at the center. The vital ingredient, however, is that the elders are around peers. The chance to form new friendships grows with each day they live in a good center. Socialization has been shown to keep many people active and healthier than they would be if they remained alone at home.

While assisted living isn't the answer to every elder's living problems, it does help many have a healthier, happier life. This, in turn, often increases life expectancy. However, quality of life may be the key factor in the growing success of good assisted living facilities, as it should be with every service we provide for our elders.

 

Always Best Care Senior Services provides Free Assisted Living Placement, at no cost to you. Give us a call and find out what's in your area and what's right for you! We'll take you to the placed you like and tour you around at no cost! Please let us help find you a wonderful place! Give us a call 619-757-1114 and press ext. 3!

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