What is the Disease in Concussion that Is Making People Nervous?

by The Motley Advocate

Last week, the trailer for Will Smith’s new movie Concussion caused a stir. The movie talks about the battle between Dr. Bennet Omalu, the NFL, and the real cost of constant brain damage. You can read about the attempts to actively  discredit Dr. Omalu’s research from several different sources. However, the story starts with Dr. Omalu, a forensic scientist who does what all scientists do:  he tries to understand how the world works. What I want to do is give you a brief look at the science the movie will be discussing. I hope that if you then see the movie, you can focus on the social issues without getting lost or weighed down in the science.

omalu

Dr. Omalu

The name of Dr. Omalu’s disease is chronic traumatic encephalopathy, a disease that starts with a concussion. A concussion is a type of traumatic brain injury, usually caused by violent shaking or a blow to the head. Most people can fully recover from having a single concussion. However, as a football player,  you could potentially experience numerous concussions over your lifetime. People who have experienced multiple concussions or brain damage can develop a degenerative disease where their brains deteriorate over an extended period of time, maybe even decades. This is chronic traumatic encephalopathy a disease that can affect football players, military members and others that experience repeated head trauma. Symptoms can include amnesia, altered behavioral control, and impaired decision making, among other symptoms, and can often be mistaken for other neurodegenerative diseases.  

“Getting hit in the head repeatedly for years will mess with your brain” seems to be an obvious statement. It’s the same as saying smoking cigarettes is bad for your health. However, it is important that these statements have physical evidence. Scientists often use the phrase “Correlation is not causation.” This simply means that just because two things seem to occur together, one does not necessarily cause the other. Scientists proved that cigarettes cause cancer by linking compounds found in cigarette tar to mutations in proteins that cause lung cancer (published in Science). In a court of law, could you prove that playing football is the direct cause of a neurodegenerative disease?

Dr. Omalu did exactly that. Prior to his work, people had already noticed that multiple head injuries could cause long term damage. Even in the 1920s a variant of chronic traumatic encephalopathy called dementia pugilistica, or punch-drunk syndrome, was identified in boxers. However, examination of the disease appears to have focused on studies of living people, and was primarily considered a disease for boxers. The phrase “chronic traumatic encephalopathy” was not yet used to classify a specific neurodegenerative disease, but just to describe certain patients having a form of long term brain trauma. By performing autopsies on the brains of multiple professional football players Dr. Omalu identified physical evidence of brain degeneration that linked to repetitive brain injury. This included the abnormal buildup of proteins that are involved in a variety of other neurodegenerative disorders including Alzheimer’s disease. Instead of just describing what he saw, he took this information and classified it as a specific disease, calling it chronic traumatic encephalopathy, and said he was seeing it in the brains of retired NFL players.

There are many more stories branching from this point. Diagnosis continues to improve, as a team at UCLA is currently investigating ways to identify chronic traumatic encephalopathy in living individuals, instead of through autopsy. The film Concussion follows the story of Dr. Omalu during his discovery and the consequences after.Before you see the film I’m here to tell you that  chronic traumatic encephalopathy is a real disease.  Real people suffer from it and real people are researching it. No matter how you feel about Dr. Omalu, the NFL, or even football, I invite you to research the facts in the hopes that you can understand the science behind the story.

Check out Concussion: Out Christmas 2015.

If you are interested in primary literature, you can find Dr. Omalu’s original paper here. Although you might need a journal subscription to access it.

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