Early onset dementia and potential CTE in professional football and hockey players are key focus of UB study

BUFFALO, N.Y. – Early onset of dementia and the potential for chronic traumatic encephalopathy (CTE) in former professional athletes, including former members of the Buffalo Bills and the Buffalo Sabres, is the focus of a new University at Buffalo research and treatment study called the Healthy Aging Mind Project.

Funded in large part by the Ralph C. Wilson Foundation Team Physician Fund, the study is based in UB’s Concussion Management Clinic, which is a joint effort between the Department of Orthopaedics and the Department of Psychiatry in the UB School of Medicine and Biomedical Sciences.

The UB study involves comprehensive physical and mental health assessments of participants. The assessments include brain imaging analysis through advanced magnetic resonance imaging, as well as lifestyle issues, including nutrition, exercise and sleep patterns; behavior, including mental health and addictive behaviors; cognition, including memory and executive function; and physical health.

An important impetus for the study was the seminal finding by Boston University (BU) researchers of CTE in autopsies of former players, according to Barry S. Willer, PhD, UB professor of psychiatry, who is the study’s co-investigator with John Leddy, MD, UB associate professor of orthopaedics.

Boston University faculty have agreed to share with the UB investigators their research protocols, including those that will be used in the UB brain imaging studies.

“The Boston researchers are sharing their imaging protocol with us because they want to be able to compare findings over the long run,” Willer explains. “No one expects the diagnosis of CTE to be simple and 100 percent conclusive. We all know it will involve degrees of difference between normal and abnormal.

“We are now proceeding down the same path as the BU researchers,” Willer continues, “namely, to identify CTE through imaging, with the goal of identifying early onset dementia while former players are still alive.” 

In addition to conducting research on brain function in aging athletes, the UB project has a strong service component designed to provide education, assistance and, where possible, treatment for these athletes.

Willer notes that the National Institutes of Health-funded study at BU has precise restrictions on the former NFL players who can enroll, since those who played certain positions are believed to be at higher risk for CTE.

The UB study, however, is open to any former professional athlete from any team who played a contact sport, such as football, hockey or even rugby.

“The larger and more diverse the sample is, the better,” says Willer. “Our study may be unique in the U.S. in that it is including not just former football players but former National Hockey League players as well, who also were subjected to repeated concussions and therefore are at risk for CTE.”

A key factor in the design of the UB study is the active participation of former players themselves.

“The athletes wanted a more positive approach in the study,” says Willer. “They don’t just want to be guinea pigs. They want us to help them understand what could happen to them as a result of their participation in professional sports and what kind of help we could provide.”

As a result, the UB researchers have expanded on the BU protocol by adding more extensive investigation into lifestyle choices that may impinge on healthy aging. The UB researchers also have developed educational resources and referrals for interventions to assist participants and their families in maintaining healthy choices and dealing with any diagnoses that are established as a result of the extensive physical and mental health exams.

To accomplish this, Willer and Leddy took a year to plan their study, creating intensive and highly productive collaborations with faculty throughout UB.

So far, the researchers have completed assessments on about a dozen former players. They hope to recruit more athletes as well as an equal number of healthy controls for a total of 60 participants.

They will begin analyzing the brain scans only after all imaging has been completed.

Co-investigators with Willer and Leddy include Gary Giovino, PhD, professor and chair. UB Department of Community Health and Health Behaviors in the School of Public Health and Health Professions; Carla Jungquist, PhD, assistant professor in the School of Nursing; Daniel Antonius, PhD, assistant professor of psychiatry; John Baker, PhD, research associate professor and David Wack, PhD, research assistant professor, both in the Department of Nuclear Medicine and Robert Zivadinov, MD, PhD, professor of neurology and director of the Buffalo Neuroimaging Analysis Center.

Additional funding for the study comes from the NFL Charities, the Robert Rich Family Foundation, the Buffalo Sabres Foundation and the Program for Understanding Childhood Concussions and Stroke (PUCCS), which was founded by Elad Levy, MD, chair of the UB Department of Neurosurgery.