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Daniel Amen, M.D.

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Can Brain Trauma in NFL Players Be Rehabilitated?

Posted: 07/21/10 08:00 AM ET

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

 
 
 

Follow Daniel Amen, M.D. on Twitter: www.twitter.com/docamen

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 tha...
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 tha...
 
 
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HUFFPOST SUPER USER
Barbara Graham
Comin at u from Area 5150
01:00 PM on 08/09/2010
Dear Doctor Amen,

While your work is quite fascinating, according to the experts over at the Scientology compound it is completely unnecessary because, you see, the brain is merely a shock absorber. It does nothing but keep your skull inflated, apparently. See for yourself:

http://www.youtube.com/watch?v=QDOf-9HH1-U
04:59 PM on 07/28/2010
I had a very severe brain injury in a hit and run on my motorcycle only to be discovered 12 hours later the next day. I had hematoma's, hemmorhages, and shearing globally. My next memories begin again 2 months later when I still could not move, see, or my memories were still fragmented and not congruent. Six weeks later I walked out of the hospital, but still had very severe deficits. Because of my life's choices up to that point I had no ability to obtain any further medical help for my condition. Working on my own, I completed my own rehabilitation. I now am a very successful Certified Occupational Therapy Assistant, President of the Head Injury Association of Northern NV, on the state of NV boards for Independent Living and Head Injury, work for the local school district, and also for multiple rehab settings/community reentry programs/home health/ a hand clinic/and to much more to list. I know first hand that rehabilitation of a severe brain injury is not only possible, but should be expected. As many are aware though, the degree to which a person can be rehab'ed depends on them, their families, their diets, and their willingness not to mention many other components to numerous to list.
04:48 PM on 07/27/2010
While Dr Amen's post is certainly informative and important, Dr Benjamin is correct to discuss the necessary steps needed for safety and efficacy of the claims. Just so you all know, because Dr Amen uses supplements, they do not have to go through the rigorous FDA process. However, and importantly, making the right diagnosis in the first place will help direct treatment plans. Dr Amen provides that, but there are a few other companies that also provide diagnostic help. If you are in serious need, I know of one that is in Denver that could help. It doesn't cost anything to read about it, or to talk to someone on the phone. Don't you think that might be worth it?
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05:54 PM on 07/22/2010
There are plenty of us college football players who endured concussions and played right through them. I can't tell you the number of times us defensive players collided head first with 1000s of lbs of running backs and their blockers, or how we suffered concussions in practice and played on to avoid getting benched and replaced by 2nd team players.

The mythical image of a high school or college football star who later in life becomes a janitor, or is mentally deficient in several ways, could be based on the very real possibility that this football star literally endured long term brain damage for love of the sport, the team, and the idea. And he likely did so without being fully aware of the health consequences.
02:31 PM on 07/22/2010
Evidently a couple of readers object to Dr. Amen's use of supplements to treat his patients. It should be noted the U.S. miltary is actively researching nutrition for the treatment of TBI:

http://www.nutraingredients-usa.com/Research/US-Army-funds-study-on-nutrition-for-neurotrauma

If these methods are providing Dr. Amen with clinical success, why shouldn't he keep us informed? There are no ethical dilemmas here.
01:53 PM on 07/22/2010
I hope the supplements are applicable and available to previously abused children/wives, current epileptics, whose brain trauma can compare NFL players...or at least it feels like it. :|
10:49 AM on 07/22/2010
Hello!
I was so very excited to read your article, it gives hope to those that are not in professional sports yet suffer from the same issues from the very same reasons, concussions!

I want to ask you and really hope that I receive an answer for we had almost given up hope for a "normal" life...How does the average person get the proper help in the medical field when the majority of physicians do not believe that such a condition like this exists? No matter how hard we try to explain the symptoms and give proof of research that supports it, physicians don't seem to think it is anything more than ADD or Depression and give medicines for that diagnosis...of course the meds may help mask some of the symptoms and give just enough to keep you moving, but none ever make you feel "normal".
Please give some advice to us "little people" out here who may not have made it to Professional Sports but did suffer the same blows throughout High School and College.
thank you
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HUFFPOST BLOGGER
Dr. Johnny Benjamin
08:08 AM on 07/22/2010
Dr. Amen,

I struggled with writing this comment but I must...to do otherwise would lack integrity.

I was excited to read this article after glancing at the title. This is a topic that is very important to me. I was surprised that I was reading your work here on Huffpost before the usual medical literature.

Sir, with all do respect as a colleague, to disseminate information that has not been independently verified via standard professional methods nor has been vetted in peer reviewed publications has very questionable ethical footing. For an investigator to devise and conduct the study then interpret their own data is unacceptable...to then publish it for public consumption and promote a specific treatment regimen without proper verification is a breach of our ethical code as physicians.

But you already know this.

Johnny Benjamin MD
Orthopedic Spinal Surgeon
12:56 PM on 07/22/2010
Dr. Benjamin/Dr. Amen,
I understand the position of those functioning in the realm of science needing the tangible scientific evidence, according the "rules" of the game, to fully participate in or even acknowledge such treatment protocols. My MD basically says the same as Dr. B. Dr. A., my hope is you will be able to work with others to validate your work is that way.
In the mean time, I am extremely disappointed in the medical realm (and do NOT TRUST the majority). I APPRECIATE your sharing what you are finding. My daughter & I have suffered from 3 major car accidents w/in 10 yrs. (not my fault). Not only has my life been repeatedly & continually turned upside down, but finding docs to properly diagnose and treat has been a nightmare. The first thing they automatically do is reach for the RX pad for antidepressants. When the different varieties did not work, dosages were increased and stacked.
Dr. B, now that I can do more searching on my own, I have learned to have my Vit D & iron checked... both were significantly LOW. No one ever checked (both contribute to symptoms of depression). With as deplete as our food supply is, combined with the physiological, neurological and biological effects of trauma, I am a strong advocate for using the chemistry of healthy foods and supplements to FIRST support our bodies healing.
Dr. A, your work & sharing is greatly appreciated. Thank you, and please, keep it coming!
02:53 AM on 07/22/2010
Hi, Dr. Amen: I feel extremely heartened by your post! I suffered a brain injury in a car accident, seven years ago with extreme cognitive lacunae as a result. The studies regarding Tau tangles in professional athletes have really scared me. I tend to wonder -- if they are suffering from dementia and amyloid plaques without ever having realised that they suffered a brain injury -- what hope is there for those of us who had concrete, measurable damage to our brains? It can be quite overwhelming.

I would be curious to know if your supplements are available for the use of the general public?

Thank you,

Callique
05:50 PM on 08/03/2010
I hope people check with their medical professionals before taking nutritional supplements of any kind, especially after an injury. For example, there are over-the-counter supplements that "thin" the blood and could be detrimental to healing and even prolong bleeding, and others can cause a variety of side effects. Heck, even grapefruit juice can interract with prescription and over-the-counter medications. I recently had a colonoscopy and was told ahead of time to skip my normal Vitamin E and my daily aspirin for several days just as a preventative, so what's good for me most of the time might be problematic if some part of me gets inadvertantly punctured during a procedure.
Make a call, you might save your life.
06:57 PM on 08/03/2010
Thank you, Jan. Yes, we are enjoined to do our own research. Perhaps the unintended benefit of the unresponsive medical system: we must become our own guardians, and take nothing for granted nor remain in ignorance as to possible unforeseen effects.
02:00 AM on 07/22/2010
Anyone with TBI might wish to learn about the emerging science for Progesterone as an effective treatment.

Progesterone May Improve Outcomes from Brain Injury:

http://www.lef.org/magazine/mag2009/nov2009_Progesterone-May-Improve-Outcomes-From-Brain-Injury_01.htm
11:54 PM on 07/21/2010
Nice article. Very glad studies are being done of these warriors.

However, I have one problem: Who is validating these studies independently?

Doctor, you correctly point out that the NFL is perhaps not the best judge of the results of its own study; by the same token, shouldn't someone besides your own people be trying to replicate and validate your findings?

Also, how "proprietary" can your mystical formulation be, since it consists of commonly available, over-the-counter diet supplements? Crowing about those results, again absent independent verification, feels more like a crummy commercial for Amen-brand supplements than a scientific break-through.
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10:38 PM on 07/21/2010
Thank you Dr. Amen for telling this story. This is so encouraging for everyone who has
ever experienced a brain injury.
09:22 PM on 07/21/2010
That's funny -- my comment asking why Dr. Amen's findings are never published in peer review journals is missing! I wonder why that is...
06:05 PM on 07/21/2010
Dr. Amen,

I am impressed with the work that youhave done with the NFL players. However, I have a nephew who has a seizure disorder that the doctors are unable to figure out. He went from a normal 3 yo child to a now 7yo boy who is unable to walk, talk, sit alone, or use his hands or hold his head up for longer than 3 seconds. He fell off of a truck because no matter how often you tell a 3yo don't do it they do especially boys. Since then he has had seizures. He has been on a plethera of medications which have diminished his abilities to walk, talk, stand, etc. as mentioned prior. I am hoping that you read my comment and would be able to help my nephew. If you do read this please contact me at ladyluc7@yahoo.com

Thank you.
11:54 AM on 07/22/2010
You should contact Dr. Amen directly i would think. He is listed with phone numbers for his clinics if you search online for the Amen clinics. I would not wait and leave it to chance that he contact you via this venue. This little boy needs you to be aggresive in searching for help for him. Waiting is clearly costing him vital days of life. Don't wait; Go call Dr. amen. And we will be praying for you.
05:47 PM on 07/21/2010
Dr. Amen's post is certainly an important one, especially relevant for returning soldiers with TBI. Dr. Amen doesn't mention Acetyl-L-Carnitine as part of his supplement protocol. According to Byron Richards, ALC is very useful for those recovering from head injuries:

http://www.wellnessresources.com/studies/entry/acetyl-l-carnitine_and_nerve_regeneration