‘Leaky blood-brain barriers’ beset football players

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Images from the Ben-Gurion University of the Negev JAMA Neurology study show the intact blood-brain barrier group, top, and the pathological blood-brain barrier group with focal blood-brain barrier lesions in different cortical regions. Photo courtesy of Ben-Gurion University
Images from the Ben-Gurion University of the Negev JAMA Neurology study show the intact blood-brain barrier group, top, and the pathological blood-brain barrier group with focal blood-brain barrier lesions in different cortical regions.
Photo courtesy of Ben-Gurion University

The research is starting to catch up with football’s concussion problem as fears increase about the long-term consequences of skull-rattling hits — a 2013 poll found that 40 percent of Americans believe tackle football should be banned from high school, and President Obama famously said if he had a son he wouldn’t let him play professional football.

Now, a new study from the Brain Imaging Research Center at Israel’s Ben-Gurion University of the Negev (BGU) is amplifying concerns. Football players for the first time were found to have brain damage from mild “unreported” concussions.


As explained in the current issue of the American Medical Association’s JAMA Neurology peer-reviewed journal, researchers at BGU and its affiliated Soroka University Medical Center in Beersheva used dynamic contrast-enhanced magnetic resonance imaging (DCE-MRI) to study a cohort of 16 football players from the Israel Football League’s Beersheva Black Swarm and 13 track-and-field athletes from BGU.

According to Dr. Alon Friedman, lead author of the study and head of the Laboratory of Experimental Neurosurgery at Ben-Gurion University of the Negev, the results were “astonishing” — 40 percent of examined football players with mild traumatic brain injury showed abnormal vasculature, or a “leaky blood-brain barrier” versus 8.3 percent of the control athletes.

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The blood-brain barrier protects the brain from dangerous substances by separating circulating blood from extracellular fluid so a post-concussion pathology that is subtle early on could lead to degenerative neuropsychiatric disorders later in life, such as Alzheimer’s, dementia, Parkinson’s, depression and chronic traumatic encephalopathy (CTE), which was recently found in 76 of 79 deceased NFL players examined by the nation’s largest brain bank, The Department of Veterans Affairs Biorepository Brain Bank based in Boston.

“We were thinking that the blood-brain barrier pathology is exactly the pathology you would think of because there is a leakage of proteins from the blood to the brain. It doesn’t produce immediate damage but other kinds of delayed changes, accumulating changes in the brain leading to dysfunction, abnormal function of nervous tissue,” Friedman said in a phone interview.


Friedman said that the current NFL concussion protocol is not based on scientific evidence but that the new diagnostic could help determine if there is a pathology and then give the player time to heal before returning to game action so as to prevent the possibility of brain damage later in life.

“The NFL should recognize that there might be a problem and invest to scan now,” said Dr. Friedman. “Just look at the players and look for this pathology and, once we can see this pathology, we can follow up and make decisions. If we are aware of potential problems there are ways to make football a safer game and that is what is important. And with new diagnostic tests, we can just know if you are at risk, stay at home for another week.”

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