Israeli Creates First-of-its-Kind Test to Detect Football Players’ Brain Injuries

Israeli university researchers study players in the Israel Football League to develop new MRI test that can detect brain damage related to concussions.

By Yakir Benzion, United With Israel

Determining if an athlete who has suffered repeated concussions has any brain injury is a serious problem in contact sports like football.

To address this issue, Israeli researchers are giving sports medicine experts a new tool to help prevent chronic brain damage.

Scientists at Ben Gurion University in Beersheba developed a new method for MRI scans,combining that approach with analytical methods to see how blood vessels have been affected in football players who have Chronic Traumatic Encephalopathy (CTE), a neuro-degenerative disease caused by repeated head injuries that has been cited as a major issue in football.

The discovery is important because to date, CTE could only be diagnosed by studying brain tissue after an athlete had died. However, in the new study published in the neurology journal Brain, BGU researchers show how to measure leakage of the blood-brain barrier to test living athletes for brain injuries.

This new brain-imaging technique and analytical method shows whether football players have CTE.

The method known as the “modified dynamic contrast-enhanced-MRI (DCE-MRI) protocol” reveals information on the illness called blood-brain barrier disorder (BBBD).

In short,DCE-MRI is a new method to find out which athletes have had localized specific CTE-related damage resulting from concussions.

The technique generates 3D maps of the brain that “revealed an increase in slow blood-to-brain transport in a subset of amateur American football players,” said Prof. Alon Friedman, a neurosurgeon and researcher at BGU. Friedman said some of the players had damage that persisted for months, with players scanned both on- and off-season.

“Not less important is the observation that few players who did not complain of severe symptoms also showed a leaky BBB. This suggests that DCE-MRI should be used in conjunction with symptom questionnaires before return to play is approved,” Friedman said.

Researchers used the NFL sideline concussion assessment tool to document any history of previous head injuries, including concussions, as well as symptoms assessment and Standardized Assessment of Concussion (SAC) tests.

The BGU study checked 42 players from the Israeli Football League (IFL) and a control group comprising 27 playing non-contact sports and 26 non-athletes. The MRI scans were also performed on 51 patients with malignant brain tumors, ischemic stroke or traumatic brain injury (TBI).

The findings showed that the Israeli DCE-MRI method can be used to diagnose specific damage after traumatic brain injury associated with concussions, Friedman said, and coupled with other methods would help assess if and when a player is ready to return to action.

“Since a leaky BBB is also found in CTE and causes brain dysfunction and degeneration, it now seems that this test could provide the first  – and so far the only – evidence for brain injury in the players we studied on the Israel football team,” Friedman said. Because they studied otherwise-healthy amateur players, Friedman recommended more work to compare the results in professional players as well as retired players with and without CTE clinical signs and symptoms.

“Importantly, we believe that those with persistent leak encompassing months or years are more likely to develop CTE. Many players seem to repair their BBB quickly, and if they do not suffer from repeated traumatic brain injuries, or are not sensitive to brain injury, they are not likely to develop CTE.”

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