For Traumatic Brain Injury, Slower Measurements May Be Better Measurements

This new-found knowledge that GFAP can be used to identify brain injury up to a week after the fact has enormous utility in sports medicine. Symptoms of concussion simply aren't always recognized on the field. Players want to get back into the game, and if the team trainer is not especially aware of the possibility of TBI, the player may finish out the game, hit the locker room, and go home before noticing symptoms. Players who are then tested for UCH-L1 may not show any markers of brain injury that appear in a blood test, and they may not be referred for an MRI. If this happens often enough, the player may develop chronic traumatic encephalopathy.

In some professional sports, the likelihood is that the player will develop chronic traumatic encephalopathy. According to the Concussion Legacy Foundation, and reported on the PBS news program Frontline, all but four out of 91 brains donated by National Football League players after their deaths were found to show signs of chronic traumatic encephalopathy. These football players did not suffer brain damage in a single incident. Almost certainly they suffered repeated brain injury. They had multiple concussions over a period of years. In some cases, this brain injury triggered the formation of tangled proteins (tau- proteins) associated with Alzheimer's disease. In other cases, repeated head injuries that weren't severe enough for the players to be taken out of the game resulted in chronic inflammation and chronic hypoxia. Both kinds of injuries were associated with Alzheimer's-like symptoms, confusion, forgetfulness, aggression, loss of coordination, and depression, but the brain injuries did not necessarily show up on scans.

What does all this mean for those of us who are not professional athletes? Should we avoid contact sports too?

Most experts agree that:

• Any sport that involves getting hit in the head or butting with the head like American football is probably not a good idea for children under 14. Their brains are still being formed and are especially susceptible to injury. At the very least, children should wear helmets. Some experts believe that soccer (European football) may be an exception. While repeated head trauma is a possibility in soccer, most children don't develop the skills with the ball that result in injury to the brain before adulthood. In soccer, traumatic brain injury is more of a concern with adult, professional players. The better you are, the more likely you are to injure your brain. If you're not a star player, you are not as likely to suffer chronic encephalopathy.
• Diet makes a difference in how your brain responds to injury. Some researchers believe that lithium may be protective against depression, dementia, and memory loss even years after one stops playing the sport. Even the small amounts of lithium (about 1 mg a day) in food may make a significant difference. Lithium is most concentrated in plants grown on desert soils, especially hot (chile) peppers and tomatoes. Shellfish, kelp, blue corn, pistachios, and coffee are good sources of lithium in non-toxic amounts.
• The armed services of the US and Israel are studying the acne medication minocycline as a long-term treatment for brain injury. Minocycline stops inflammation which may in turn stop progressive loss of brain tissue.