Amen Clinics Position on Chronic Traumatic Encephalopathy (CTE)

Chronic Traumatic Encephalopathy

By Daniel G. Amen, MD

Chronic traumatic encephalopathy (CTE) was brought into the public’s awareness largely through the movie Concussion, starring Will Smith, based on the work of neuropathologist Bennet Omalu. When he did the autopsy on Pittsburgh Steeler Hall of Fame Center Mike Webster, he noticed something very different in his brain that had not been reported. There were excessive deposits of an abnormal protein in his brain, called tau. He subsequently noticed this pattern in other deceased NFL players who struggled with severe cognitive and emotional issues.

'I am interested in the living and doing everything I can to delay their journey to the autopsy table.' — Daniel G. Amen, MD Click To Tweet

INSIDE THE CTE BRAIN

Tau protein is essential as it provides the lattice-like structure of brain cells. However, when the brain is damaged from repeated concussions, common in football and soccer players, tau breaks down and pierces through cell membranes, causing an inflammatory response that damages the brain. I was blessed to be a consultant on the Concussion.

Since CTE can only be diagnosed with certainty on autopsied slices of brain tissue, it can only be diagnosed after death. I am friends with Dr. Omalu, and we have published scientific papers together. I tell him, his patients are the dead, but I am interested in the living and doing everything I can to delay their journey to his autopsy table.

WHY HEAD TRAUMA ISN’T HOPELESS

Yet, the lore in medical circles is that CTE is permanent, progressive, and untreatable. I think that is nonsense and there is virtually no scientific evidence to support the lack of hope. Yet, because many people believe it, former football players and other professional athletes avoid getting help because they do not believe there’s anything they can do to stem the inevitable destruction of their brains.

Some in the media have accused me of giving people with CTE false hope. Let me be clear, the scans we do at Amen Clinics do not diagnose CTE (you need a pathology slide for that). However, there is large body of peer-reviewed scientific research demonstrating that brain SPECT imaging can diagnose the current impact of past concussions, and whether or not with proper help, the brain can improve. The media tends to be purveyors of doom and despair, because that sells papers or gets more eyeballs for advertisers, but my 40-year career has shown that there is reason to be optimistic about the brain’s ability to heal.

Here’s an example. In July 2007, College Football Hall of Fame running back from USC and former professional football player Anthony Davis (AD), came to see me at Amen Clinics because of problems with memory, periods of confusion, and irritability. A professor at USC told him about our work, and he thought we could help him. He was also concerned about the cognitive problems he saw in other retired football players and was hoping to find a way to help them too.

At 54, Anthony’s brain looked like he was 85. It showed clear evidence of brain trauma to the prefrontal cortex and left temporal lobe. I put AD on a brain rehabilitation program described below, and within several months he told me that he felt better, was more focused, and had better energy and a sharper memory.

Through my relationship with AD, in 2009 I partnered with the Los Angeles Chapter of the Retired NFL Players Association, which co-sponsored the largest brain imaging and rehabilitation study on active and retired NFL players. At the time, the NFL was still saying they did not know if playing football caused long-term brain damage, but they had never done any brain-imaging studies on players to prove it or not. My colleagues and I decided to tackle the issue.

To date, we have scanned and treated more than 300 active and retired players using SPECT, a functional brain-imaging technique that measures blood flow and activity in the brain. The pre-treatment brain scans showed high levels of damage in almost all of the players. Damage was seen most commonly in the following regions:

  • Prefrontal cortex—involved with judgment, planning, forethought, and impulse control
  • Temporal lobes—involved with learning, memory, and mood stability
  • Cerebellum—involved with mental agility and processing speed

The treatment protocol for the players included overall brain health strategies, taking brain-supportive supplements—including a sophisticated multiple vitamin, high dose high-quality omega-3 fatty acids, and a brain-boosting supplement that works in 6 different ways—along with weight loss (for those who were overweight or obese).

The measures taken at the end of the study revealed that 80% of the football players made significant improvements, especially in the areas of mood, motivation, sleep, attention, memory, reasoning, and information processing speed and accuracy. In addition, their brain scans revealed increased blood flow in the prefrontal cortex and temporal lobes.

Ten years later AD’s brain was significantly better.

AD’s Brain Before and After 10 Years

In brain SPECT images, a healthy scan shows full, even, symmetrical blood flow. The “holes” in AD’s pre-treatment scan represent areas of low blood flow. His follow-up brain scan shows healthier overall blood flow.

HOPE FOR A BETTER BRAIN AND A BETTER LIFE AFTER HEAD TRAUMA

To not do anything to ameliorate the chronic effects of concussions, as some medical professionals and some in the media suggest, is unconscionable. Let’s not wait until people are dead to uncover that something is wrong. Let’s have a bias for action to make sure it takes longer to get on Dr. Omalu’s autopsy table.

Concussions and other head injuries can’t wait. At Amen Clinics, we’re here for you. We offer in-clinic brain scanning and appointments, as well as mental telehealth, remote clinical evaluations, and video therapy for adults, children, and couples. Find out more by speaking to a specialist today at 888-288-9834 or visit our contact page here.

11 Comments »

  1. Dr. Amen, Thank you for your work and your contribution to humanity. I am also a veteran of the United States Army 1964, Thank you for your Vietnam service and the work you do for veterans, for athletes, and first responders. And humanity. I am a 77-year-old man, physically fit always have suffered two concussions and TBI since 2017. Basic medicine is clueless careless about TBI education. Most do not even know what SPECT stands for. I have spoken with your California office Over the past 18 months and hope to visit your Atlanta clinic for treatment. Dr. thank you for your Continuing work and treatment for humanity. God bless you lovely wife your loved ones and all those of us who reach out and help daily. Steve Banis

    Comment by Steve Banis Charlston SC — April 6, 2022 @ 4:56 AM

  2. I was curious what the baseline looked like before the career started. Have you done anything maybe before college career football players start. I’m just curious. I love your work. Hopefully I’ll get to see you one day.

    Comment by Lisa Overstreet-capuano — April 6, 2022 @ 5:08 AM

  3. Thank you

    Comment by Camille Esposito — April 6, 2022 @ 5:36 AM

  4. All material relating to brain injury, CTE, depression, Adhd, bipolar

    Comment by Viliame Mudu — April 6, 2022 @ 6:42 AM

  5. Thank you!! Thank you!! Thank you!!, I am on my 6th concussion in my lifetime, I am 66 yrs old. Three years ago I fell on a icy sidewalk, concussion number 6. I am currently still on workman comp, and getting better, due to rest and taking Dr. Amen Focus & Energy I am thinking and accomplishing more. Noise and lights are getting better for me. Focus and Energy supplements have made a big difference in my life.

    Comment by Jamie Mae Roberts — April 6, 2022 @ 7:20 AM

  6. Why doesn’t the medical community talk about people who have epilepsy and it’s toll on concussions? A person who falls to the ground uncontrollably and hits their head repeatedly due to misfiring in the brain. Aren’t they at risk for CTE also? We only seems to hear about Combat Veterans and Athletes.

    Comment by Ann Marie Oliver — April 6, 2022 @ 9:04 AM

  7. Doc, I have been following you for the full 40 years. I have the first 8×11 pages typed you sent in beige envelopments way back in the beginning of your practice. I wish, oh how I wish, when I had visited Beauview WA, I had known you have an office there. I could have made an appointment and ventured in. Now forty-some years later an many assaults to my precious brain–diving board accident at age 12 and incomplete and ramming my head into the corner of a window ceil and let’s not forget the drug Naturethryoid going belly and me experiencing horrific brain trauma. If only I had done the scans years ago. If only, i f o n l y …………………Karen

    Comment by Karen Kadoura — April 6, 2022 @ 10:30 AM

  8. I HAD AN MRI OF MY BRAIN, NECK, HEAD, AND IT SHOWS ON THE LEFT HEMISPHERE OF MY HEAD I HAVE A HEMATOMA 0.7 CM, I AM 80 YRS OLD, AND
    I EXPERIENCE PAIN ON MY LEFT EYE AND HEADACHE ON MY LEFT SIDE. COULD YOU TREAT A PATIENT LIKE ME.

    I DO NOT REMEMBER FALLING, PERHAPS WHEN I WAS ABOUT 14 YRS OLD AND TWO YEARS AGO DURING SWIMMING DOING THE BACK STROKE I HIT
    MY HEAD SLIGHTLY.
    THANK YOU,
    A. BAHR

    Comment by AURA BAHR — April 6, 2022 @ 2:37 PM

  9. You are the best. We will contact you when we are able. My husband needs your help. Thank you.

    Comment by Diane Conroy — April 6, 2022 @ 3:28 PM

  10. Is there any treatment for stroke victims?

    Comment by Valda — April 6, 2022 @ 10:55 PM

  11. I was about 2 1/2 years old when a lawn dart penetrated my skull. My parents, being drunk an having no insurance decided not to seek treatment as they expected nothing could be done. I was cross eyed for a couple years, got in a lot of trouble, always getting spanked, bullied, not knowing why. Thought I was hated. At 54 years old thanks to Dr. Amens descriptions of what ADHD is, I finally got my Doctor to give me meds. Although my family still hates me, at least I can think more clearly and understand the abuse.

    Comment by Seanna L. (Popps) Mendez — April 12, 2022 @ 6:08 AM

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