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Study: Just One Brain Injury May Cause Long-Term Damage

Remember the days when athletes (both student and professional) shook off concussions as no big deal? A new study finds that people who suffer traumatic brain injuries—such as concussions—could be permanently changing their brains for the worse.

The study, which appears online in Brain Pathology, examines the post-mortem brains of 39 longtime survivors of a single TBI (anywhere from 1 to 47 years survival after the TBI), and compared them with the brains of uninjured, age-matched controls.

Strap your medical-terminology reading hats on, folks.

The researchers found higher instances of neurofibrillary tau tangles (NFTs) and amyloid-beta plaques in survivors of TBIs, while the uninjured brains hardly ever contained tau tangles. NFTs occur when tau proteins work their way into the brain's neurons, and often signalRequires Adobe Acrobat Reader degenerative brain diseases, such as Alzheimer's disease.

NFTs are also the primary sign of chronic traumatic encephalopathy, a degenerative brain condition that has claimed the lives of multiple pro athletes in recent years, particularly football players and boxers. Just yesterday, a group of 75 former NFL players sued the league for reportedly hiding information about the damaging effects of concussions, as TMZ first reported.

Amyloid-beta plaques are extra deposits of amyloid within the gray matter of the brain, and like NFTs, signal degenerative brain diseases. For definite diagnosis of Alzheimer's with dementia patients, both the NFTs and amyloid-beta plaques must be present.

Roughly one-third of the single TBI sufferers in the study displayed signs of this widespread NFT accumulation.

The researchers discovered that in the brains of single TBI sufferers who died within four weeks of suffering the injury, the same tau accumulation cannot be found. This suggests that after suffering a TBI, the tau proteins progressively degenerate and eventually cause the accumulation of NFTs, instead of a spread of NFTs appearing immediately.

The amyloid-beta plaques in the brains of TBI sufferers, which had previously been thought to disappear within months of the injury, showed up years after the TBI in some of the brains studied. These amyloid-beta plaques also displayed the same characteristics of plaques found in the brains of Alzheimer's patients.

"A single traumatic brain injury is very serious, both initially, and as we're now learning, even later in life," said Dr. Douglas Smith, the study's co-author and the director of the Center for Brain Injury and Repair at Penn's Perelman School of Medicine, in a press release. "Plaques and tangles are appearing abnormally early in life, apparently initiated or accelerated by a single TBI."

Now, don't take this study to mean that any student-athlete who suffers a concussion is fated to a lifetime of Alzheimer's. A single TBI increases the likelihood of a neurodegenerative disease, but doesn't guarantee anything.

What this study does suggest is the importance of ensuring that student-athletes who suffer a concussion fully and completely heal from their injury before returning to competition. Roughly 30 states now have laws requiring coaches to remove student-athletes from play if they're suspected of a concussion and requiring those students to obtain medical clearance before returning. No state spells out specific return-to-play guidelines for student-athletes and coaches.

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