Treating chronic traumatic encephalopathy, or CTE, is a struggle for medical professionals and athletic trainers by its very nature. Although CTE stems from traumatic brain injury and concussions, it is difficult to confirm CTE’s presence until patients are deceased — a debilitating and heartbreaking journey for patients and their families.
Now, new research by an Indianola nonprofit aims to transform the way concussions are diagnosed — ultimately impacting how likely an athlete is to develop CTE.
CTE Hope researchers Mike Hadden, chief science and research officer, and Sue Wilson, chief research and resource development officer, have launched a pilot study aimed at matching levels of inflammation in the body with the severity of concussions experienced by athletes. The foundation was established by the family of Zac Easter, a former football player who was diagnosed with CTE after his death in 2015.
“We are using saliva from college athletes, football and soccer, and then spring high school athletes from around the area. … We’re looking for inflammatory markers we call biomarkers, that occur inside the brain following a concussion,” Hadden said. “We hope to match those markers with the severity of the symptoms, and hopefully then we can actually hold (athletes) out for the proper period of time.”
“Inflammation is the accelerator to CTE. So if we can control that, then we shut off any route to CTE,” he added.
For the pilot study, Wilson and Hadden are testing all participating athletes’ baseline biomarker levels before the season begins. The two will also test all athletes’ levels after the season ends — and in the event that an athlete is injured, the researchers will test at particular time points after the injury — typically at 24 hours, 72 hours, one week and three months — to see how biomarker levels are affected. Samples collected are sent to Harvard’s laboratory and will hopefully be sent to another laboratory in New York, which is well known for micro-RNA studies, Hadden said.
“Those results will be really telling, too, whether there’s even a concussion involved,” Wilson said.
Preliminary evidence in one case has shown a player recovering from a concussion had seen inflammation levels fall during recovery, only to rise again once activity resumed, even though the athlete was reporting no symptoms, Hadden said.
So far, the study has recruited eight high schools, two football teams and a rugby team for this season, but the study still needs more athletes involved. The researchers had originally contacted more than 30 schools for the spring sports season; they’ll return to the participating schools in the fall to track football athletes.
Parents have already shown a willingness to sign up student athletes, Wilson and Hadden said. It has been difficult to convince athletic departments at larger schools and universities to join, even though the testing is completely free for athletic departments – at this stage, CTE Hope’s research is funded through grants and laboratory partnerships.
“We could have 2,000 baselines and only end up with 50 concussions. In the realm of science, that’s still a small sample size,” Wilson said. “Every school board that we’ve been to is on. It’s getting to the school board. … We’ve had some big schools say, ‘We’re not interested.’”
“I think athletes are scared that this test could show, if you get a concussion, you’re done for the season now,” Hadden said.
“And it could,” Wilson added. “It could change sports.”
Both researchers are hoping the study’s results will lead to a point-of-care medical device for athletic trainers and medical professionals — a handheld device that would indicate when an athlete’s biomarkers are in the inflammatory range, and protocol developed by researchers for medical professionals to follow depending on what the device detects.
“It’s like making the invisible visible,” Wilson said. “I think that would really be a huge turning point in how we can start keeping these athletes safe.”
That device would still be best used by medical professionals who compare results to current tests — like the athlete’s balance — rather than relying on athletes or their families to monitor results.
“This is just a tool in the toolbox,” Hadden said.
Reaching a larger scale would mean CTE Hope will have decisions to make — whether to patent the process and sell it all to a drug company, to start reaching out to investors, or finding another path. For now, that conclusion is a ways off as CTE Hope continues recruiting teams for the study – departments or teams interested in taking part can contact CTE Hope at www.cte-hope.org/contact.
“Right now, our big thing is data and getting it done,” Wilson said.
