The potential lasting brain damage suffered by NFL players due to the thousands of helmet-to-helmet blows over a career has been the subject of much recent controversy. For years, the NFL has said that it didn't know if playing professional football caused long-term brain damage, even though they started their concussion committee in 1994. Fifteen years later in 2009, Commissioner Goodell testified in Congress that they were still studying the issue. Congresswoman Maxine Waters sent shockwaves through professional sports when she told the Commissioner that having the NFL study brain damage was like the tobacco companies studying lung cancer. Perhaps there was a conflict of interest.
As a psychiatrist and brain-imaging physician, the answer seemed obvious to me. I wondered why the NFL had never performed a large-scale brain-imaging study. How would we ever really know unless we actually looked at their brains? After a number of players came to see me with dementia, depression, irritability and obesity, I decided to study their brains and answer the question, "Does playing professional football put players at risk for long-term damage to the brain?"
My colleagues and I performed two different types of brain-imaging studies on more than 100 active and retired players. We did brain SPECT scans, which look at blood flow and activity patterns in the brain, and QEEG studies, which measure electrical activity. In addition, we performed a group of tests to measure cognitive function. The answer, which did not surprise anyone except perhaps some in the NFL, was that playing professional football causes long-term brain damage.
You cannot get hit by guys like the Minnesota Vikings' offensive tackle Ron Yary (6'5" and 255 pounds, who is one of the players in our study) 30 to 50 times a game and not expect to have some trouble.
Our study found that the retired NFL brain seemed to have its own pattern. Damage typically affected the following areas:
- The prefrontal cortex (called the executive part of the brain that controls judgment, impulse control, attention span, organization and planning)
- The temporal lobes (mood stability and memory)
- The cerebellum (coordination and thought coordination)
The players tended to score poorly on the neuropsychological tests we gave them, except for reaction time and spatial processing. Forty-eight percent of our players had problems with obesity and nearly 30 percent suffered with or had been treated for depression. The incidence of memory problems and dementia were many times the rate in the general population.
As we were doing our study, a new study came out from the University of Pittsburgh that reported as a person's weight went up the actual physical size of their brain goes down. Holy smokes!
Once you admit that you have a problem you can then do something about it.
Our initial findings led us to a question that had much more implications outside of football. "Could we rehabilitate brains that have been damaged by chronic trauma?" I had spent the last 20 years of my career improving people's brains and subsequently their lives.
That became Part 2 of our study.
We put our players on a brain healthy program that included a weight-loss group, regular exercise (surprisingly many of these former elite athletes had become couch potatoes), mental exercises and nutritional supplements that support brain health, such as fish oil, and a proprietary formula including ginkgo biloba, huperzine A, phosphatidyl serine and vinpocetine, among others.
The follow-up results have been nothing short of amazing. We have found that recovery and improvement in cognitive function is indeed possible. This is the most exciting part of our study.
To date we have done follow-up scans and testing on 32 players. Twenty-five of them have shown significant improvement, both on their SPECT scans and on their neuropsychological testing, sometimes improving their test scores by over 400 percent.
Take Cam Cleeland, who played for the New Orleans Saints, New England Patriots and St. Louis Rams, for example. At 34, Cam is one of our younger retired NFL players. He volunteered for our study because he was struggling with problems of depression, irritability, frustration, high stress, obsessive thinking, memory problems and marital problems.
Cam had been diagnosed with a total of eight concussions--three in college and five in the pros. Cam's SPECT scan showed clear brain damage and his Microcog (a test of neuropsychological function) showed significant decreases in general cognitive functioning, information processing speed, attention, memory and spatial processing.
After eight months on our brain rehabilitation program, Cam reported feeling much better and noticed significant improvements in his attention, mental clarity, memory, mood, motivation and anxiety level. He felt his anger was under greater control and he was getting along better with his small children.
His SPECT scan showed dramatic improvement in the areas of his temporal lobes (memory and mood stability), prefrontal cortex (attention and judgment) and cerebellum (processing speed). His Microcog showed dramatic improvement as well.
A similar example is Big Ed White from the Minnesota Vikings, who played in four Pro Bowls and four Super Bowls. He weighed 365 pounds when he first came to see us, but lost 40 pounds in six months. All of his cognitive scores improved as well.
The interventions used in our study are simple. When players do not respond, we have added certain memory-enhancing medications, antidepressants, hyperbaric oxygen treatment and neurofeedback. Again, often the results are very encouraging.
Retired players need the NFL's help and advocacy. The NFL has recently made strides towards admitting that playing football in the NFL is a brain-damaging sport. Once you admit that you have a problem you can then do something about it!
The exciting news in my mind is that if we can demonstrate improvement in football players with chronic brain damage, it offers hope for the millions of people who have suffered a traumatic brain injury, including the 15 percent of soldiers who served in Iraq and Afghanistan who came home with brain injuries.
My nephew and Godson, Michael, is a Marine who serves in Afghanistan. Two weeks ago he fell and hit his head. I immediately sent him our protocol of supplements. This issue is much closer to home than I like.
If you have a comment, please write below.
To your brain health.
Daniel G. Amen, MD