{"id":5882,"date":"2015-02-12T13:53:07","date_gmt":"2015-02-12T18:53:07","guid":{"rendered":"http:\/\/www.bumc.bu.edu\/busm\/?p=5882"},"modified":"2015-02-12T13:53:07","modified_gmt":"2015-02-12T18:53:07","slug":"head-examiner","status":"publish","type":"post","link":"https:\/\/www.bumc.bu.edu\/camed\/2015\/02\/12\/head-examiner\/","title":{"rendered":"Head Examiner"},"content":{"rendered":"
\n

MED neurologist on battered brains, tangled tau, and the future of sports<\/h4>\n<\/div>\n
\"Ann<\/p>\n

Ann McKee, a MED professor of neurology and pathology, studies the long-term effects of repetitive brain injury. \u201cIt\u2019s shocking to see neurodegenerative disease in a 25-year-old,\u201d she says. Photo by Vernon Doucette<\/p>\n<\/div>\n

For Ann McKee<\/a>, every brain tells a story. And sometimes it\u2019s a tragic one. McKee, a School of Medicine professor of neurology and pathology, is the director of neuropathology for the Veterans Affairs <\/a>New England Health Care System<\/a> and also directs BU\u2019s Chronic Traumatic Encephalopathy Center<\/a>. Chronic traumatic encephalopathy (CTE) is a degenerative brain disease found in athletes with a history of repetitive brain trauma. McKee first identified its telltale mark\u2014tiny tangles of a protein called tau, clustered around blood vessels\u2014in the dissected brain of a boxer who had been diagnosed with Alzheimer\u2019s disease.<\/p>\n

Although most people associate CTE with professional football players, McKee has found it in the brains of soccer, hockey, rugby, and baseball players as well. Her research has alerted the public to the long-term dangers of repetitive hits in sports and raised tough questions about safety. McKee was invited to speak about this growing public health concern at the annual meeting of the American Association for the Advancement of Science<\/a>, the world\u2019s largest general scientific society, held February 2015 in San Jose, Calif. She told BU Today<\/em> the story behind her discovery of CTE, and what it might mean for the future of sports.<\/p>\n

BU Today:<\/i> You\u2019re a world expert on tau protein, which has been implicated in Alzheimer\u2019s, CTE, and other brain diseases. Have you studied tau your whole career?<\/b><\/h5>\n

McKee: <\/b>Yes. I love tau.<\/p>\n

Why?<\/b><\/h5>\n

It\u2019s beautiful, the way it collects throughout the nervous system and just sort of fills up the nerve cell. It\u2019s always been quite lovely to look at, visually captivating. I mean, how crazy is that? But it\u2019s true.<\/p>\n

When you started studying tau, you were studying Alzheimer\u2019s disease? <\/b><\/h5>\n

I was interested in Alzheimer\u2019s, but I also worked on PSP (progressive supernuclear palsy), and something called corticobasal degeneration.<\/p>\n

Those are not so famous.<\/b><\/h5>\n

No, they\u2019re not so famous. But I got very involved in defining what these individual diseases looked like. It\u2019s like being at the Smithsonian and being really interested in one collection of pottery or something. And once you start understanding it, you start seeing all these differences, and it\u2019s like, Whoa!<\/p>\n

\"Brain<\/p>\n

Do you remember the first time you saw a brain with CTE?<\/b><\/h5>\n

Yes. It was phenomenally interesting. The first case was Paul Pender, a professional boxer here in the Boston area. He had twice been world champion. That was my first time seeing it under the microscope. I looked at the slide and it was like, Oh, my God. This is so amazing. I\u2019ve never seen anything like this. It just blew my mind. That was 2003.<\/p>\n

How did it look different than, say, a brain with Alzheimer\u2019s?<\/b><\/h5>\n

Alzheimer\u2019s disease has these beta amyloid plaques that look like small puffs of smoke throughout the brain. You have to have these plaques in fairly high numbers to make the diagnosis of Alzheimer\u2019s disease. In most cases, and certainly below the age of 50, CTE doesn\u2019t have any plaques. The other difference is the tau pattern. Tau clusters in little tangles, and in CTE they\u2019re always around blood vessels. So the blood vessels are a clue to the origins of CTE\u2014we think it might be damage to the vessels and leakiness of the vessels that\u2019s causing it.<\/p>\n

How did you end up with this boxer\u2019s brain?<\/b><\/h5>\n

He was a veteran and died at the Bedford VA<\/a>\u00a0with a diagnosis of Alzheimer\u2019s disease. And there was no amyloid, so it was like, well, it\u2019s not Alzheimer\u2019s disease. And the tau pattern was so unusual that I asked my technician to do this very old technique that people used to use in neuroanatomy before everything was automated. It\u2019s difficult\u2014you cut the brain very slowly in these big sections that contain the whole hemisphere, then you have to stain it while it\u2019s floating in water, and then you have to very painstakingly lay it all out on the slide. It was amazing, because it allowed you to see the landscape of the brain. So it\u2019s phenomenally informative. It allows you to see nuances that you can\u2019t really appreciate with tinier, thinner specimens. The technique contributed to our recognition that this was really something quite extraordinary. This was something really different.<\/p>\n

That was 2003. Was CTE a known disease?<\/b><\/h5>\n

Not really. It was primarily called dementia pugilistica and most people thought it affected only boxers. Then, in 2008, I had the opportunity to look at a football player who had had some cognitive issues, and it was like, Oh, my God, another one. And what I couldn\u2019t believe was that the football player was 45. If you\u2019re used to studying neurodegenerative diseases, 45 is incredibly young. So after that case, we started the center and started collecting more brains. The next brain we got was from a football player who died at the age of 45, too. And it was the same disease. It was like, What? Holy Christmas.<\/p>\n

And you now have 240 brains in the CTE bank. Are most of them football players? <\/b><\/h5>\n

Yes. We have more football players in the bank than any other sport. But we have boxers, we have hockey players, we have a few soccer players, a couple of rugby players. We have military.<\/p>\n

When CTE started coming into the public perception, it was just about the NFL. Now it\u2019s getting bigger and bigger.<\/b><\/h5>\n

That\u2019s exactly right. We\u2019ve seen it in all these professional players, but we\u2019re finding it in nonprofessional players, college players. And I think, from the public health perspective, that\u2019s what\u2019s really important.<\/p>\n

Are there implications for kids\u2019 sports?<\/b><\/h5>\n

There\u2019s a lot of interest now in heading in soccer, because that would be something easy to take out. It wouldn\u2019t destroy the game, especially at the lower levels. But also in football, which is such a hugely popular sport, we need to understand the risks for young athletes and reevaluate whether or not young kids should even be playing this game. Their bodies are immature, their necks aren\u2019t very well developed, they\u2019re not very coordinated. Plus, they\u2019re literally walking bobbleheads with big heads, thin necks, and small bodies. Your brain is adult-size by age four, and it\u2019s relatively heavy for those little bodies. The only good thing is, they\u2019re low to the ground.<\/p>\n

What surprises you most about CTE?<\/b><\/h5>\n

The thing that is shocking to me, and continues to be shocking, are the 25-year-olds who have died with this disease. Not because of it\u2014it\u2019s usually a suicide or an accidental death. I can\u2019t say that CTE caused their suicide. But for me, it\u2019s shocking to see neurodegenerative disease in a 25-year-old. It\u2019s horrible. And it\u2019s undeniable. We\u2019ve seen it in enough 20-somethings now that you can\u2019t escape this. It\u2019s a shock to think, that guy looks so young, and he\u2019s dead. And he\u2019s dead with this.<\/p>\n

A version of this story appears on the <\/em>BU Research<\/a> website.<\/em><\/p>\n

This BU Today<\/em> story was written by Barbara Moran. She can be reached at bmoran@bu.edu<\/a>.<\/p>\n","protected":false},"excerpt":{"rendered":"

MED neurologist on battered brains, tangled tau, and the future of sports Ann McKee, a MED professor of neurology and pathology, studies the long-term effects of repetitive brain injury. \u201cIt\u2019s shocking to see neurodegenerative disease in a 25-year-old,\u201d she says. Photo by Vernon Doucette For Ann McKee, every brain tells a story. And sometimes it\u2019s […]<\/p>\n","protected":false},"author":903,"featured_media":0,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":[],"categories":[90,1],"tags":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/5882"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/users\/903"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/comments?post=5882"}],"version-history":[{"count":0,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/5882\/revisions"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/media?parent=5882"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/categories?post=5882"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/tags?post=5882"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}