A cure for CTE? How Baltimore scientists are working to reverse the damage of head traumas in NFL players

Editor’s note: The following article appeared on Medium on February 3, 2018.

After a crushing tackle and helmet hit during a January 7 playoff game, Carolina Panthers quarterback Cam Newton slowly raised himself up from the field, and jogged toward the sidelines as fans cheered. Then the 28-year-old stumbled and sank to his knees as medical staff rushed to his side.

It was one of at least three serious helmet hits during the first weekend of NFL playoff games. These were followed by a dramatic televised helmet hit that sidelined star New England Patriots tight end Rob Gronkowski in a January 21 playoff match.

The helmet hits — and questions that were raised about Newton’s injury and the NFL’s failure to invoke its concussion protocol and send Newton to the locker room for a full evaluation — have raised public awareness again of the long-term effects head injuries can have on football plyers and others.

In recent years, researchers have brought to light the devastating effects of repeated head traumas, which can trigger a degenerative brain disorder known as Chronic Traumatic Encephalopathy, or CTE.

For example, a 2017 study in the Journal of the American Medical Association found that of 111 deceased NFL players, 110 suffered from CTE, and recently Boston University School of Medicine neurologist Dr. Lee E. Goldstein published a ground-breaking study which found that even mild head trauma can lead to CTE.

Since the disorder can only be definitively diagnosed by autopsy, there is no way to determine how many living current and former NFL players suffer from CTE. Researchers believe that along with football players, members of the military, boxers and others who receive repeated head injuries are at high risk for CTE.

The disorder causes memory loss, poor impulse control, depression, anxiety and suicidal tendencies. Perhaps the most notable casualty of CTE is former New England Patriots star Aaron Hernandez. He was convicted of murder and hanged himself in his jail cell. An autopsy of his brain found it riddled with damage from CTE.

With all the scientific evidence piling up, one might think there would be a push to develop treatments.

As it turns out, in Baltimore — a national hub for ground-breaking medical research — there is just such a push. Researchers in a technology park just down the street from Johns Hopkins Hospital are on the cutting edge of the science and are trying to answer an alluring question.

What if there were a way to mitigate the long-term and often debilitating CTE?

Scientists at the Lieber Institute for Brain Development in Baltimore are developing a new drug that appears to address some of the behavioral and cognitive symptoms of repeated head injuries.

“We want to help former [football] players who are having real problems in their current lives,” said Kari Stoever, the Lieber Institute’s Chief External Relations Officer. “We hope that within a year or two, we’ll be able to offer this novel treatment in [drug trials for] humans.”

When people suffer repeated concussions, portions of the brain begin to atrophy. The Lieber Institute’s team is developing a drug that appears to remediate these changes in animals. The Institute is now in the final stage of selecting their lead molecule with plans to submit an investigational new drug application to the FDA in the coming year, which would precede testing the drug in humans.

In addition to helping athletes, Lieber Institute researchers hope the drug can be used to improve brain function in members of the military. In December, Congress passed legislation that cleared the way for the Department of Defense to increase funding for treatments associated with the long-term effects of traumatic brain injuries, an initiative that the Institute has actively supported through their education efforts with members of Congress.

During the past seven years Lieber has quietly built the world’s largest repository of postmortem human brain tissue for the study of neuropsychiatric conditions, including schizophrenia, post-traumatic stress disorder, mood disorders, suicide and substance abuse disorder. Tissue from more than 2,300 donors is stored at the Institute.

The institute may be a household name, but it has big backing. It was founded in 2011 through a $120 million gift from Stephen and Connie Lieber and Milton and Tamar Maltz.

Despite competition from Harvard, Yale and Columbia universities, the institute’s leadership team chose to open the brain repository and research facilities in Baltimore, at the Johns Hopkins Science + Technology Park. Stoever said the leadership team was drawn to the city for the opportunity to become an independent affiliate of Hopkins with state of the art facilities on the medical campus.

It was the right decision, said Dr. Daniel Weinberger, the institute’s CEO and director.

“I’m thrilled with the development occurring around the [Johns Hopkins University] medical campus and enthusiastic about its potential to become a major biotech hub on the East Coast,” he said.

On a recent morning, Lieber researcher Dr. Rahul Bharadwaj inspected a brain that had been donated to the institute. Wearing a protective suit and mask, he pointed out sections of the pink tissue responsible for memory, learning and judgement.

“All aspects of someone’s personality are contained in the brain,” he said.

Heavy drinking, smoking, and Parkinson’s disease — and head injuries — all lead to changes in the brain that are visible to the naked eye, he said.

Researchers here are also developing a treatment for a severe form of autism, known as Pitt-Hopkins Syndrome. They’re also working on an ambitious project with the Veteran’s Administration that seeks to understand brain changes that stem from PTSD and head trauma in an effort to reduce the high rate of suicides among returning service members.

If all goes well with the ongoing animal trials, researchers will expand to human subjects within the two years, Stoever said. It could be some years yet before any CTE drug makes it to market.

But Lieber researchers are hopeful that if the drug in development is as effective as early results indicate, it could change the lives of thousands of athletes and others — while adding to Baltimore’s global reputation as a hotbed of cutting-edge medical research.

Photo credit: Lieber Institute for Brain Development

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