8 February 2013. The National Football League Players Association (NFLPA) recently announced that it chose Harvard University to lead a $100 million research effort to study chronic traumatic encephalopathy and a host of other devastating health problems in professional footballers (see Boston Globe and Harvard news stories).
The grant will fund two key projects. One is a 10-year cohort study of 1,000 retired NFL athletes with diverse playing histories and various ethnic, geographic, and sociodemographic backgrounds. During the first phase, participants will receive extensive tests ranging from blood work to brain imaging. "We want to gain insight into what makes some players develop problems while others remain healthy,” said Alvaro Pascual-Leone of Beth Israel Deaconess Medical Center, Boston. Pascual-Leone is one of four co-directors of the Harvard initiative. The others are Lee Nadler of Dana-Farber Cancer Institute, Ross Zafonte of Spaulding Rehabilitation Hospital, and William Meehan of the Sports Concussion Clinic at Boston Children’s Hospital.
From this initial analysis, scientists will identify 100 of the healthiest and 100 of the least healthy participants for further testing. “Ultimately, we want to develop markers of disease that we can test in players in a second phase, to see if we can identify problems early enough to treat or prevent them,” Pascual-Leone told Alzforum. He estimates it will take two and a half years to recruit the full 1,000 participants.
In parallel with the cohort study, the Harvard team plans to launch clinical trials testing therapeutic approaches in three areas—repair of anterior cruciate ligament (ACL) injuries, treatment of heart muscle disease (cardiomyopathy), and prevention of cognitive deficits caused by concussions. “The clinical trials will focus on interventions that can benefit players,” Pascual-Leone said. “We want to address their needs now without having to wait for results from the cohort study.” The scientists will choose some participants of the cohort study to take part in the intervention trials. They hope to launch the first trials in the next few months, Pascual-Leone said, noting that Harvard will also seek applications for therapeutic trials from other institutions.
The connection between sports-related injury and CTE has intensified in recent years. Several conferences in 2012 were dedicated to this topic (see Lou Ruvo series; ARF Keystone story), and the development of brain imaging ligands for tau—the culprit protein of CTE neuropathological aggregates—was high on the agenda at the Human Amyloid Imaging (HAI) conference last month in Miami, Florida (ARF related conference story and McKee et al., 2013).
In a separate effort, the NFL itself—which got hit with thousands of lawsuits filed by ex-players—announced it would partner with General Electric (GE) in a four-year initiative that would devote $50 million to develop tools including imaging technology to detect concussion-related brain problems (see New York Times story). The league also has a new website focusing on health and safety.—Esther Landhuis.