Alzheimer’s disease and Chronic Traumatic Encephalopathy (CTE) are both “neurodegenerative diseases.” That is, they are brain diseases that result in the progressive destruction of brain cells, eventually leading to cognitive, behavioral, and other impairments. Both diseases also lead to dementia. The distinction between Alzheimer’s and dementia is very often misunderstood, even by many doctors. “Dementia” is a clinical syndrome defined by memory and other cognitive impairments that are severe enough to cause difficulties in social and/or occupational functioning (i.e., reduced independence in functioning). Dementia is not an illness or a disease. Dementia is not a “mild” form of Alzheimer’s. Rather, it is analogous to “fever,” in that it tells you that you are sick, but doesn’t say what is causing the problem. Similarly, dementia means that there is something wrong with the brain’s functioning, but not what is causing it. Several illnesses and diseases can lead to dementia, including Alzheimer’s disease which accounts for approximately 75% of all cases of dementia. However, several other neurodegenerative diseases result in dementia, including CTE. Alzheimer’s and CTE are distinct diseases. Both Alzheimer’s and CTE can only be accurately diagnosed postmortem through a neuropathological examination of the brain. There have been several new scientific breakthroughs over the past few years that now allow doctors and scientists to be much more accurate in diagnosing Alzheimer’s during life. However, at this time, there is no method of diagnosing CTE during life, although our group at the Boston University Center for the Study of Traumatic Encephalopathy (CSTE) recently received a grant from the National Institutes of Health to begin developing these types of tests. One of the major differences between Alzheimer’s and CTE involves what causes each of the diseases. There is no known specific risk factor that leads to Alzheimer’s. For CTE, however, it is believed that repetitive brain trauma (including concussions and subconcussive blows to the head) is a necessary, but not sufficient risk factor. That is, everyone that has been found to have CTE in postmortem examination has had a history of repetitive brain trauma, including athletes (e.g., football and hockey players, boxers and wrestlers), as well as others, such as combat military personnel, developmentally disabled individuals who repeatedly bang their heads, and victims of domestic abuse. Boxers and football players (especially lineman) appear to be the most likely to get the disease because of the repetitive brain trauma exposure. But, it is important to note that not everyone with a history of repetitive brain trauma will develop CTE. Our center is currently conducting research into the other potential additive risk factors, such as genetics, age of initial brain trauma exposure, frequency and overall duration of exposure, etc. This research will hopefully lead us to understand why one person gets the disease and another person does not. This line of investigation, along with our new study to develop methods of diagnosing CTE during life, will eventually lead to effective treatments and prevention strategies. Robert A. Stern, Ph.D. is a Professor of Neurology and Neurosurgery; Co-Director, Center for the Study of Traumatic Encephalopathy; Director, Clinical Core, BU Alzheimer's Disease Center, Boston University School of Medicine.

Reducing the number of concussions suffered by student-athletes is on the minds of many, including those that lead some of the most prestigious universities in the nation. Soon, following in the footsteps of changes made last year to Ivy League football programs, athletes in other sports may see the adoption of more protective measures as well. Ivy League football players saw significant changes in their practices last season after the eight presidents, two of whom are medical doctors, acted to reduce the number of impacts to their student-athletes' brains in an effort to minimize concussions. In July 2011 the Ivy League Concussion Committee developed a new set of regulations limiting full-contact practices to two per week, three less than allowed by the NCAA. In addition, of the preseason "two-a-days" only one can be full contact. Similar sport-specific regulations may be applied to other activities such as lacrosse, hockey, and soccer in the near future. “We are leading other conferences,” said Ivy League Executive Director Robin Harris. “I don’t know of any conference looking at this in the same manner that we are. We really see this as an area that we can be a leader in terms of the medical care safety of our athletes as well as in terms of the research we contribute to our collective understanding of concussions and athletics,” according to the The Harvard Crimson. Ivy League Deputy Executive Director Carolyn Campbell- McGovern was apart of this game change, “A lot of the recommendations from the football report were naturally going to be applied to other sports as well, particularly the education components, sideline testing components, and any other of those types of enhancement,” Campbell-McGovern said. Recommendations for each sport, lacrosse, soccer, and hockey, will likely be different. On Wednesday, the Ivy League Concussion Committee met in New York to discuss what changes will be made. The committee will also review recommendations made by each sport's subcommittee. Athletic trainers, including Harvard Head Athletic Trainer Brant Berkstresser, physcians, and administrators make up the concussion committee. It is co-chaired by presidents David Skorton of Cornell, and Jim Kim of Dartmouth. Harvard Medical School instructor and doctor at Children's Hospital Boston's Division of Sports Medicine, Michael J. O'Brien has ideas for change. He says he sees 300-400 concussions every month, 98 percent of them sports-related. “The bigger risk is the athlete who gets injured, flies under the radar a little bit and gets a hit a few more times in that game or in the next two or three games. The injuries to that athlete tend to be exponential, their threshold to injury is much worse, and the damage is exponential. Using computer based testing to get objective information rather than just reporting symptoms would help," O'Brien said. Source: Ivy League Aims to Abate Concussions - The Harvard Crimson March 30, 2012 Questions/comments? contact Jean Rickerson at Jean@SportsConcussions.org

MUNCIE, Ind. -- Student-athletes will receive financial assistance to help defray the costs of baseline testing from a fund named for the late Chicago Bears' Dave Duerson who committed suicide a year ago. An autopsy revealed Duerson suffered from chronic traumatic encephalopathy (CTE), a degenerative brain disease. CTE is associated with repetitive head trauma and can affect judgement, mood, impulse control and memory. Computerized neuropsychological concussion tests, known as "baseline" tests, are typically taken by student-athletes prior to the beginning of their sports season on a computer at home, in a school computer lab or in a doctor's office. Structured similar to a computer game, a student-athlete will complete various online exercises that measure memory, reaction times and cognitive processing speeds. If an injury occurs the test is retaken and baseline scores are compared to post-injury values. The difference between the two can give trained medical professionals a look at potential issues that need further evaluation prior to clearing a student-athlete to return to activity. "The baseline testing gives everyone a free opportunity to pre-test," Central High School football coach John Hochstetler said. "The post-test comes with a fee, and that's where some of our youngsters run into challenges," according to The Star Press. The Dave Duerson Muncie Community Schools Athletic Safety Fund will assist injured athletes who can't afford the post-injury test at two middle schools and two high schools beginning with the 2012-2013 season. Duerson played football, basketball and baseball at Northside High School in Muncie, Ind. He went on to play for Notre Dame where he received All-American recognition in 1981 and 1982 before entering the NFL. Duerson played for the Chicago Bears, New York Giants, and the Arizona Cardinals. He earned two Super Bowl championship rings and was selected to four consecutive Pro Bowls from 1986-1989 during his eleven-year career in the NFL. Duerson was the NFL 'Man of the Year' in 1987. Source: Duerson fund will assist Muncie athletes -- The Star Press April 1, 2012 Questions/comments? contact Jean Rickerson at Jean@SportsConcussions.org

Collisions. Headers. Goalpost run-ins. Soccer athletes and fans can't help but wonder which elements contribute most to the frequency of concussions in the sport, particularly among young girls. Researchers have been collecting data in helmeted sports for many years using accelerometers embedded in head gear, but non-helmeted sports have presented obvious challenges. Impact data has provided some of the most critical science in the concussion field. As a result, the forces that players sustain in various contact sports are well-documented and found, in some cases, to be alarming. The latest addition to the data bank was the inclusion of an impact study on 7-and 8-year-old football players and the adult-sized forces they incurred during practices. Now the focus is turning to other sports, including soccer. A new study by researchers at Wayne State University, published in the Journal of the American College of Sports Medicine offers insight into head acceleration in girls' youth soccer (U14) during game play. HITS The Head Impact Telemetry System (HITS) used to measure the force impacts, was utilized in this study. Small accelerometers typically mounted inside helmets, transmit data wirelessly to researchers on the sideline. In this case, soccer headbands with the padding removed were outfitted with the instrumentation. Impacts over 10g, or 10x the force of gravity, were recorded and analyzed at a later time alongside corresponding video footage to determine the nature of the hit. For reference, a sneeze might be 3g, a fighter pilot might "pull" 9g during maneuvers, and high school football players regularly sustain hits ranging from 60-100g and higher, many without reporting concussion symptoms. A total of 24 girls participated in the study, conducted during scrimmages on grass fields. Scrimmages lasted 30 to 65 minutes each. None of the players suffered a concussion during the research. Results There were 47 header impacts and 20 non-header impacts observed during the study. Non-header impacts included collisions with another player, player falls, collisions with goalposts, and unintended collisions with the ball. Researchers found: - majority of non-header impacts (40%) were player-to-player collisions - most headers impacted the front of the head; the peak linear acceleration (force) recorded was 4.5g- greatest header force occurred on the right side of the head and was measured at 62.9g - most head impacts players sustained in one scrimmage was four - side headers resulted in greater forces than back headers - player collisions resulted in the highest number of nonheader impacts and had a maximum force of 56.7g - impacts from player falls measured a maximum force of 23.7g - a goalpost collision measured a maximum of 27.1g Researchers hypothesized that non-header impacts would exceed those from heading the ball, but that was not what the case. Many of the players experienced multiple impacts in a single scrimmage, the cumulative effects of such impacts within a short time frame are unknown. Conclusions Concussions can occur in any sport and amending equipment and making rule changes to decrease the frequency and severity of the injury depends on science. Soccer has emerged as the leading cause of sport-related concussions for young girls and researchers are working to unravel the reasons why. Hypotheses range from less neck strength, to hormonal differences to better reporting by females. Source: Medicine & Science in Sports & Exercise: June 2012 - Volume 44 - Issue 6 - p 1102–1108 doi: 10.1249/MSS.0b013e3182444d7d Applied Sciences Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

Wisconsin governor Scott Walker signed youth concussion legislation into law today at Lambeau Field in Green Bay. Support for the bill came from physicians, student-athletes, the NFL's Green Bay Packers and other organizations. NFL Commissioner Roger Goodell has exhibited an unwavering committment to the adoption of concussion legislation nationwide, starting with the Washington state concussion law named after middle school football player Zackery Lystedt, who was injured during a game in 2006. Like the Lystedt Law, Wisconsin's concussion law calls for the removal of any athlete suspected of having suffered a concussion and requires a player to obtain written medical authorization before resuming activity. The new law also requires the state Department of Public Instruction to work in conjunction with the Wisconsin Interscholastic Athletic Association to develop guidelines and education standards for parents, coaches, and athletes. Source: Walker signing bills legalizing wolf hunt, cracking down on youth concussions -- Star Tribune --April 2, 2012 Questions/comments? Contact Jean Rickerson at Jean@SportsConcussions.org

President Obama's recent remarks regarding concussions in football reopened the discussion of the safety of the game just days before Super Bowl Sunday. In an interview appearing in the New Republic Obama says, "If I had a son, I'd think long and hard before I let him play football. And I think that those of us who love sports are going to have to wrestle with the fact that it will probably change gradually to try to reduce some of the violence." Leaders from sports-related organizations including pee-wee, high school, college and professional have worked for several years now to understand the injury, provide guidance to athletes and coaches, and fund research related to the effects of brain trauma. Changes have been broad and deep. NFL Commissioner Roger Goodell has surrounded himself with the most well-respected medical professionals in the concussion field, seeking their council. As co-chairmen of the NFL Head, Neck and Spine Committee, Drs. Richard Ellenbogen (chief of neurosurgery, Univ. of Washington) and Hunt Batjer (President of the Neurological Society of America) have assembled an impressive team, including senior adviser Dr. Robert Cantu, co-director Center for the Study of Traumatic Encephalopathy. Chronic traumatic encephalopathy, or CTE, is a degenerative brain disorder suspected to be associated with repetitive hits to the head. Previously only diagnosed post-mortem, evidence of the disease was recently found in five former NFL players who took part in a groundbreaking diagnostic study at UCLA. The committee is also actively involved in improving on-field recognition and assessment policies, helmet technology, and brain impact research. In 2011, the NFL dedicated over $100 million over the next decade to medical research, with the vast majority of those dollars committed to the science of concussions, their prevention and care. Concussions have always been a part of sports, and have never been limited to football. Soccer, volleyball, wrestling, lacrosse, bicycling, and yes, playground activities can all cause concussive injuries. Girls are at risk as much as boys. Seniors and soldiers suffer too. Change of this magnitude takes time. Those athletes who have paid the price through their individual suffering are heroes, having opened the door for the rest of us, exposing an issue whose time is due. Former NFL linebacker Junior Seau, who tragically took his own life in 2012 at age 43, was later diagnosed with CTE, which many believe contributed to his death. He and the other NFL, NHL and professional boxers who died at a young age and were later diagnosed with CTE, have commanded our attention. In 2006, Zachery Lystedt suffered a debilitating brain injury during a middle school football game at age 14, and now fights daily to escape his wheelchair. Zachery, with the help of Commissioner Goodell and the NFL, led us to develop legislation in almost every state helping to safeguard youth athletes from the effects of concussions. Zach's hero, Baltimore Ravens Ray Lewis will play in Sunday's Super Bowl. Zach and the estimated 111 million viewers will watch a safer game, one that is still evolving, striving to maintain the integrity of the contest while preserving the health of its players for the future. Thankfully, visionaries like Commissioner Goodell appear in the right place at the right time. Under his leadership the NFL has, and is, providing a road map and the necessary funding to investigate the questions and find solutions that will improve our understanding of risk as it applies to protecting our youth, preserving the competitive spirit, and honoring the bonds that bind us as teammates and fans. Photo courtesy: Creative Commons; copyright dcJohn 2004

PITTSBURGH – The unpredictable nature of concussions is one of the most frustrating factors to the millions of sufferers each year, but early neurological indicators and symptoms can predict a protracted healing time in certain cases, according to specialists at UPMC and the University of Pittsburgh School of Medicine. “It’s a highly variable injury with a variety of outcomes,” said Michael “Micky” Collins, Ph.D., director of the UPMC Sports Medicine Concussion Program and co-investigator of the Pitt/UPMC study published in the February issue of Neurosurgery. “We see some patients who take a day or two to recover, and some who take a year or longer to recover. If clinicians had a way of determining within two days of injury who’s going to take a month or longer to recover, that’s a very important piece of information to have. It’s a game-changer.” The study, one of the first to examine concussion prognoses, showed that specific neurocognitive “cut-off” scores derived from ImPACT™ (Immediate Post-concussion Assessment and Cognitive Testing) improved clinicians’ ability to predict which sports-related concussions could take longer –- as much as five times longer -- to rehabilitate than others. They found, in as many as 85 percent of the cases, the scores could warn athletes, parents, coaches, schools, teams and health professionals when a concussion is likely to take on average a month to heal. Such an objective prognosis could help clinicians to better prepare a treatment plan, arrange academic accommodations for students and set tangible expectations for return to play and school, Dr. Collins said. The study reviewed 108 high-school football players who were given ImPACT tests within a median of two days after their concussions. Fifty boys experienced a recovery lasting, on average, 33 days before returning to play, and those longer rehabilitations could be forecast by specific “cut-off” scores in ImPACT Visual and Processing Speed testing. Migraine and cognitive symptoms also appeared to have predictive power. Study participants who scored above the threshold levels recovered within a median of seven days. “We’ve established statistical ‘cut-offs’ that indicate people who take a month or longer to recover,” Dr. Collins said. “Eighty percent of concussed people recover inside of three weeks. This prognostic information allows us to develop a risk profile of athletes who don’t recover well from this injury. Other study authors include Brian Lau, B.S., from the Pitt School of Medicine, and Mark Lovell, Ph.D., the Concussion Program’s founding director who retired from UPMC last summer. About UPMC Sports Medicine Cohttps://n Program The first-of-its-kind UPMC Sports Medicine Concussion Program, established in 2000, is the largest multi-disciplinary clinical and research program that focuses on the diagnosis, evaluation and management of sports-related concussion in athletes of all levels. The UPMC clinicians and researchers treat more than 13,000 patients a year, and published more than 75 clinical research studies in peer-reviewed scientific journals. About ImPACT ImPACT™ (Immediate Post-Concussion Assessment and Cognitive Testing) is an independently validated and researched concussion-evaluation system that has become the most widely used in the United States. Co-founded in the early 1990s by Drs. Mark Lovell, Joseph Maroon and Michael “Micky” Collins, who have a proprietary interest in ImPACT Applications, Inc., ImPACT is a 20-minute test that is a standard tool used as part of comprehensive clinical concussion management adopted across the NFL, NHL, NBA, Major League Baseball, college and high-school athletics -- with roughly 3 million people tested. Source: UPMC press release- https://www.upmc.com/mediarelations Photo courtesy UPMC

Common sense has led many to believe that youth football players can't possibly sustain high-impacts like their adult counterparts. But veteran correspondent Stone Phillips' report "Hard Hits, Hard Numbers," features researchers at Virginia Tech (VT) who recently turned that theory upside down when they analyzed impact data from the helmets of 7- and 8-year old players in Montgomery County, Virginia. Accelerometers placed inside seven helmets wirelessly transmitted data to scientists on the sideline for a season's worth of practices and games, with surprising results. The bottom line? Maybe it's time to take another look at practices, drills, and helmet design to minimize the forces absorbed during an average season. Regardless of the significance of the impact, none of the players sustained concussions during the season. Therein lies an enduring mystery, why small impacts can cause concussions in some players while others walk away from big hits. The force of acceleration is often measured in g. Fighter pilots may "pull" 9g in an F-16, a sneeze may register 3g. They're part of everyday life. But because of the heightened interest in sports-related concussions, researchers are looking at a multitude of ways to reduce brain impacts for everyone from adults to youth. But first, they had to identify if there was even an issue at all. Worth a look The VT study was the first of its kind to measure the impacts sustained during youth football. Having worked for nine years recording over 150,000 hits with the helmet impact system at the university, researchers turned their attention to an area youth league. The forces averaged about 15g, meaning half of the hits measured below that level, the other half above. In one case, well above. One hit measured 100g, a big hit by college standards. Most of the more forceful impacts came during practice. Highlights from PBS NewsHour include: - reseachers believe 98g or above is a red flag for a possible concussion - a total 753 impacts were recorded - average player sustained 107 impacts in one season; high school players average about 500; college players sustain about 1,000/season - there were 38 impacts of 40g or greater; almost every one occurred during practice - six impacts measured over 80g the lower range VT researchers consider to be the risk of concussion - youth football players lack strong neck and chest muscles of older players to maintain head stability - 50, 60, 70g loads were surprising - location of impact is important as are individual differences and tolerances - there is more helmet-to-helmet contact in youth football than occurs in older players; most impacts occurred to the front of the helmet - more head-to-ground impacts found at college level Changes afoot Researchers concluded that addressing changes in practice would likely reduce the number of impacts per season, an important factor in any youth sport. Less contact drills, fewer contact practices and other modifications would be beneficial, particularly as the effects of sub-concussive hits, impacts that may cause changes in the brain without causing symptoms, continue to be studied. Source: Stone Phillips Reports Pint-Size Footbal Players Take Big-League Hits -- PBS NewsHour -- April 3, 2012 Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org

KANSAS CITY, Mo. -- The National Operating Committee on Standards for Athletic Equipment (NOCSAE) issued a warning to athletes and parents of athletes to thoroughly understand the extent of protection provided by – or not provided by – athletic equipment worn while playing sports. This warning follows claims made by several companies that products such as head bands, supplements or mouth guards reduce the incident of concussion. NOCSAE issued the warning at the onset of its summer meeting held this year in Kansas City. NOCSAE is an independent organization with the dual purpose of setting standards for the performance of athletic equipment and funding research necessary to advance the science of sports. Through NOCSAE's independent process, physicians, academic researchers, coaches, trainers and manufacturers come together to establish standards based on accepted science and reliable data. "Parents, athletes and coaches are becoming more informed about concussions, and this increased awareness is vitally important to advancing athlete safety. But it also creates a demand for quick solutions. Unfortunately there are quick solutions offered for sale which have neither scientific nor medical support that validate their claims to prevent or reduce concussions," said Mike Oliver, NOCSAE executive director. "Any device or supplement promoted as being able to prevent, diagnose or cure a concussion must be supported by scientific data and peer-reviewed research. Currently there is no definitive scientific research linking mouth guards, head bands, supplements or other specialty products to a reduction in concussion risk or severity. For companies to suggest otherwise misleads athletes, parents and coaches into a dangerous false sense of protection against concussion. NOCSAE warns athletes and parents of athletes to get the facts about sports equipment and concussion protection and not rely solely on marketing and promotional materials when making equipment decisions." NOCSAE does not maintain any standards for such products, and, therefore, no such products can be claimed as meeting the NOCSAE standards. While protective equipment certified to the NOCSAE standard play an incredibly important role in protecting athletes on the field of play, they should be not the primary approach to protecting against concussion. Learning to avoid unnecessary head impacts, reporting concussion symptoms to a coach or parent and following trained medical management decisions about when a concussed athlete can return to play are far more likely to prevent a concussion or reduce the chance of chronic problems that may be related to untreated concussions. For more information, please visit www.nocsae.org. About NOCSAE NOCSAE, the Nhttps:// Operating Committee on Standards for Athletic Equipment, is an independent and nonprofit standard-setting body with the sole mission to enhance athletic safety through scientific research and the creation of performance standards for protective equipment. Formed in 1969, NOCSAE is a leading force in the effort to improve athletic equipment and, as a result, reduce injuries. NOCSAE efforts include the development of performance and test standards for football helmets and facemasks, baseball and softball batters and catchers helmets, baseballs and softballs, ice hockey helmets, soccer shin guards, lacrosse helmets and facemasks and polo helmets. NOCSAE is comprised of representatives from a number of groups which have an interest in athletic equipment – including manufacturers, reconditioners, athletic trainers, coaches, equipment managers, sports medicine and consumer organizations. These diverse interests have joined forces in an attempt to arrive at a common goal of reducing sports-related injuries. NOCSAE is a nonprofit, charitable organization supported by individuals and organizations with an interest in athletics. SOURCE: National Operhttps://ommittee on Standards for Athletic Equipment (NOCSAE) Questions/comments? contact Jean Rickerson at jean@SportsConcussions.org Back to top RELATED LINKShttps://www.nocsae.org Source: PR Newswire (https://s.tt/1ezQW)