Football’s Brain Injury Crisis Lands in Family Court

March 6, 2018 by admin

Most of the disputes over football are occurring in states where football remains very popular, like Texas, Oklahoma and Ohio, places Mr. Cordell described as “heavy football states.” In states where football appears to be on the wane, including those in the Northeast, disputes are less common because both parents have already decided that the game is too dangerous for their child to play.

One of those football-heavy states is Pennsylvania, where Mr. Orsini, a musician and former lawyer, went to court last summer to prevent his youngest son from playing tackle football. The case will likely result in a trial.

Like many fathers of his generation, Mr. Orsini, 66, was for years an enthusiastic supporter of football. He played the game in grade school and rooted for the hometown Steelers. He enrolled his sons in youth tackle football leagues when they were as young as 5 years old, including his youngest son. Mr. Orsini said he attended their practices and games, including in the years after he and his ex-wife, Janice, divorced in 2004. Their oldest son, Giuseppe, who is now 21, plays football at Case Western University in Cleveland.

Mr. Orsini’s view of the game changed when his youngest son, 17, sustained three sports-related concussions. The first was in 2013, when he was hit in the head with a metal baseball bat while not wearing a helmet. He took a battery of tests at the University of Pittsburgh Medical Center and, after several weeks, was allowed to resume playing sports.

The second and third concussions were in 2015 and 2016 during football games. Orsini said that afterward, his son was sensitive to light and noise, experienced headaches and was lethargic. His son, he recalled, sat slumped at the table during meals. Again, within a few weeks, doctors cleared him to return to play. Orsini said that when he asked the doctor whether his son should stop playing football, he was told there was no medical evidence that he should cease playing.

“The moment for me started when he repeatedly got diagnosed with concussions and the doctors kept telling me there was no reason for him to not keep going,” Mr. Orsini said. Having worked as a plaintiff’s attorney, he was alarmed. “His mother didn’t question the doctors, but in my profession it is an impossibility.”

Mr. Orsini said he was surprised that his son’s doctors appeared to be sanguine about the dangers of the sport. So he began doing his own research and found, among other things, studies by researchers at Boston University that said that boys who began playing tackle football before the age of 12 had more behavioral and cognitive problems later in life than those who began playing the sport in their teenage years.

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Mr. Orsini said he tried unsuccessfully to discuss these findings with his ex-wife.

Mrs. Orsini declined to be interviewed. But her lawyer, John N. Demas, said she considered her son, now a junior in high school, mature enough to understand the risks of the game and to make up his own mind. She also felt reassured that her son’s coaches were well-trained at spotting and caring for concussed players, and that doctors had declared him free of symptoms from the concussions.

“The truth is, this young man loves to play football and understands the dangers, and based on the science now, his mom thinks the benefits are worth the risks,” Mr. Demas said on behalf of Mrs. Orsini.

Mr. Demas added: “Where we are with the science of it, I don’t know if there is enough evidence to say it’s inherently dangerous.”

Mr. Demas said that the Orsinis have joint legal custody of their son, and that Mr. Orsini’s attempts to block their son from playing football amounted to one parent acting unilaterally. In seeking to alter their custody agreement, Mr. Demas said, Mrs. Orsini was only trying maintain the status quo.

“We’re not asking for carte blanche,” Mr. Demas said, “we’re only asking for authority on this decision of whether he can play.”

In late July, just before his son was to start practicing for his junior season, Mr. Orsini told his school that he did not want his son playing. He had joint legal custody, so the school complied.

“I cannot speak to an individual student’s circumstance, but generally in custody disputes, the terms are spelled out and we follow them,” said Patrick O’Toole, the superintendent of the Upper St. Clair School District, about 10 miles south of Pittsburgh. “If there’s a dispute, the parents tell us what to do.”

The case then moved to family court. In early August, Mrs. Orsini filed an emergency request to let her son play, as he had for more than a decade. Mr. Orsini argued that while he had supported his son’s right to play for years, he was now aware of new, worrying research about the safety of the game.

“Playing football cannot be considered status quo when the Child has now suffered three concussions,” Mr. Orsini’s lawyer wrote in a…

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Neuroscientists Just Launched an Atlas of the Developing Human Brain

December 7, 2017 by admin

Your brain is one enigmatic hunk of meat—a wildly complex web of neurons numbering in the tens of billions. But years ago, when you were in the womb, it began as little more than a scattering of undifferentiated stem cells. A series of genetic signals transformed those blank slates into the wrinkly, three-pound mass between your ears. Scientists think the way your brain looks and functions can be traced back to those first molecular marching orders—but precisely when and where these genetic signals occur has been difficult to pin down.

Today, things are looking a little less mysterious. A team of researchers led by neuroscientists at UC San Francisco has spent the last five years compiling the first entries in what they hope will become an extensive atlas of gene expression in the developing human brain. The researchers describe the project in the latest issue of Science, and, with the help of researchers at UC Santa Cruz, they’ve made an interactive version of the atlas freely available online.

“The point of creating an atlas like this is to understand how we make a human brain,” says study coauthor Aparna Bhaduri. To do that, she and her colleagues analyzed not only how gene expression varies from cell to cell, but where and at what stages of brain development those genes come into play.

Crucially, the researchers performed that analysis at the level of individual brain cells—a degree of specificity neuroscientists have struggled to achieve in the past. That’s huge, in part because it gives researchers their clearest picture yet of where and in which cells certain genes are expressed in the fetal brain. But it also means scientists can begin to characterize early brain cells not according to things like their shape and location (two variables that neuroscientists have long used to classify cellular types and subtypes), but by the bits of DNA they turn on and off. As developmental neurobiologist Ed Lein, who was unaffiliated with the study, says: “This is not the first study in this area by any means, but the single cell technique is a game changer.”

Lein would know. An investigator at the Allen Institute for Brain Science (a key institutional player in the mission to map the human brain, and the home of several ambitious brain atlas projects from the past decade), he and his colleagues performed a similar survey of gene expression in developing human brains in 2014. To build it, they sliced fetal brain tissue into tiny pieces and scanned them for gene expression. But even after dissecting them as finely as possible, Lein says the cell populations of the resulting brain bits were still extremely diverse. Even a microscopic speck of gray matter contains a menagerie of functionally distinct cells, from astrocytes to neurons to microglia (though, to be perfectly frank, neuroscientists aren’t even sure how many cell types exist).

“When we measured the genes in our samples,” says Lein, “what we actually saw was the average output of all the cells in that sample.” When they were through, Lein and his colleagues had mapped the location and activity of some 20,000 genes in anatomical regions throughout the brain. But they still didn’t know which individual cells those genes came from.

UCSF’s new brain atlas doesn’t span as many regions as the Allen Institute’s (not yet, at least), but what anatomical areas it does covers it does with much greater specificity. “The difference between previous studies and ours is the difference between a smoothie and a fruit salad,” says study coauthor Alex Pollen. “They have the same ingredients, but one mixes them together and the other looks at them individually.”

The UCSF researchers focused on regions of the developing brain that eventually become the basal ganglia, which helps orchestrate things like voluntary motor control, and the cerebral cortex, the largest region of the mammalian brain and the seat of many human cognitive abilities. By examining the expression of individual cells from 48 brains at various stages of development, the researchers were able to trace a handful of genetic and developmental patterns to 11 broad categories of cell—and make a number of unexpected observations.

“One big surprise is that region-specific neurons seem to form very early in the developmental process,” says neurobiologist Tomasz Nowakowski, who led the study. That includes neurons in the prefrontal cortex, whose formation neuroscientists have long theorized to be influenced by sensory experience. But the new atlas suggests those areas begin to take shape before sensory experiences even have a chance to take place. That’s the kind of finding that could fundamentally alter neuroscientists’ understanding of the structure and function of adult brains.

The project’s other takeaways are too numerous to list here. But that’s the thing about brain atlases: They’re great at generating questions. “These things are foundational,” Lein says. “The reason these atlases are valuable is you can do a…

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Nick Buoniconti Will Donate Brain to Concussion Research

November 3, 2017 by admin

Several years ago, the league provided several million dollars to researchers at Boston University, but has since donated tens of millions of dollars to other institutions doing related research.

Buoniconti arrived at the news conference in a wheelchair, wearing his Super Bowl VII ring.

“I owe it to the thousands of others who will follow me on this trek,” Buoniconti said in the interview. “My life is not what it was, and I just want to be able to help with Ann’s research and hopefully the research will end up helping so many other players.”

The disease, which can only be diagnosed posthumously, has been found in more than 100 former N.F.L. players as well as dozens of others who played football in high school and college. Symptoms of the disease include irritability, memory loss and depression.

Buoniconti grew up in Massachusetts and played college football at Notre Dame and then 14 years in the N.F.L., where he led the famed “No Name Defense” that helped the Dolphins win two Super Bowl titles, including in the 1972 season, when they became the only team to go undefeated.

He left the league after the 1976 season and worked as an agent for professional athletes; became president of U.S. Tobacco; and was a host of the HBO program “Inside the N.F.L.”

But in recent years, Buoniconti has become more forgetful, has had trouble speaking and has had more difficulty completing basic tasks, he said in an interview with Sports Illustrated in May. Buoniconti said that he was also falling more frequently, and had to call 911 five times in the past two years.

These problems, coupled with a growing body of research that connects concussions and head hits to C.T.E., led Buoniconti to donate his brain. In July, doctors at Boston University said that 110 of the 111 brains of former N.F.L. players that they examined showed signs of C.T.E.

The list includes the Hall of Fame quarterback Ken Stabler of the Oakland Raiders and the former Chicago Bears defensive back Dave Duerson. Since that study was published, the former Patriots tight end Aaron Hernandez, who committed suicide in prison, has also been found to have had C.T.E.

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In addition to Buoniconti, other former N.F.L. players including Warren Sapp, Matt Hasselbeck and Leonard Marshall have pledged to donate their brains to the C.T.E. Center.

The doctors acknowledge that the research on the 111 brains has limitations because, rather than a random sample, most of the families who donated the brains of players did so because those players had symptoms of cognitive problems.

But they assert the findings are still significant and point to other research that has suggested risks in playing tackle football before the age of 12.

Buoniconti began playing at a young age as well, as did his son, Marc. When Marc suffered a spinal cord injury in 1985 while playing college football at The Citadel that left him a quadriplegic, Nick founded the Miami Project to Cure Paralysis. The Project has since been expanded to research head trauma as well.

In an interview last month with The Associated Press, Marc said that his father’s recent decline has convinced him that youth football should be banned. Marc said that Nick’s opinion has “changed 180 degrees.”

Buoniconti and his wife, Lynn, spoke often about what to do to alert other former players and their families, and to help researchers.

“We kind of both felt that we wanted to come here to get more clarity on what Nick has,” she said.

He agreed, adding that too often, players try to hide their problems rather than talking about them. He hopes that will change now that he has spoken out about his own condition.

“It’s not hard for me to go public like this because so many others depend on getting out there and not to be ashamed,” he said, speaking slowly. “I never, never, never dreamed it would happen to me. We just hope this will pave the way for thousands of others who are out there and in denial and can come out now.”

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After Las Vegas, Searching for Meaning in a Killer’s Brain

October 31, 2017 by admin

On October 1, Stephen Paddock killed 58 people and wounded 546 more, firing multiple rifles from a hotel room in Las Vegas overlooking an outdoor concert. Then he killed himself. No one knows why he did it.

As part of the attempt to figure that out, The New York Times and others report, the Clark County Coroner’s office is sending Paddock’s brain to the Stanford University lab of Hannes Vogel, a neuropathologist. Vogel (who, at the request of Stanford’s communications office, is not speaking to the press) will perform both visual and microscopic examinations of Paddock’s brain, looking for abnormalities, tumors, degenerative illnesses, or anything else that might suggest why an otherwise unassuming video poker player would turn his extensive gun collection on innocent people.

Nobody thinks it’s going to work.

Sure, this is due diligence, part of a complete investigation. Vogel is a pathologist, so maybe he’ll find something pathological—maybe a tumor in the ventral medial or dorsolateral prefrontal cortex, parts of the brain that have to do with impulse control and willpower. Damage there, or maybe to the inferior posterior ventral cortex can also make people more violent.

Under a microscope, stained with various dyes, a brain can reveal degenerative disorders that can contribute to depression or poor emotional control.

But people get tumors and degenerative diseases all the time. Most of them don’t become vicious killers. “If you have a mass murderer and you looked at his brain, it would completely amaze me if you could see anything relevant or useful,” says Christof Koch, chief scientist and president of the Allen Institute for Brain Science. “The brain probably looks relatively normal.”

That, in short, is the “mind-body problem” that scientists and philosophers have struggled with for as long as there have been scientists and philosophers. You have the meat (billions of neurons and other gunk performing electrochemically networked computation) and you have the ghost—the perception of sensory inputs, their reconstruction inside the brain, the processing of those reconstructions into something comprehensible, and maybe even an awareness of some of that processing. In other words: consciousness.

Neuroscientists actually know quite a lot about the human brain and the mind it generates. At the Allen Institute and elsewhere, they’re building maps of all those neural connections. They can build interfaces into it, wires that go through the skull and into the cortex so that people can control wheelchairs or play piano. By applying machine learning algorithms to brain activity as volunteers watch images for hours inside an fMRI tube, computers can learn to infer from changes in that activity what the person is seeing—to, in essence, read people’s minds. And it works on more than visual input; you could put the same algorithms to work figuring out how someone felt. Is that flower pretty? Is that car cool? Which dress looks better? “I see no a priori reason that couldn’t be done today,” Koch says. “Maybe someone is doing it.”

It’s not phrenological poppycock to say that brains change physically with new experiences. It’s called plasticity. London cab drivers, for example, famously have to acquire a detailed spatial map of the city as part of their training, and they also acquire an enlarged hippocampus. Stimuli and experiences perceived by the mind change the connections in the meat.

As a presumably skilled user of guns (and player of poker and frequent guest in Las Vegas hotels), maybe Stephen Paddock’s brain has some physiological variance from someone who wasn’t any of those things. But none of that is likely to explain why he kept pulling that trigger. “Sure, you can point to locations in a brain and say, yeah, this general part of it is processing this kind of information,” says Michael Graziano, a neuroscientist at Princeton University. “You can point to structures deep in the brain and say, ‘these have a crucial role to play in emotion, and when this spot revs up it’s associated with anger and rage.’ But in terms of understanding—at the detail level, the circuitry level—how it works and why one person is different from another? Wow, that’s really unknown.”

Investigators and others looking for answers about Las Vegas would like to find that one mechanistic synapse, the one electrical moment that went zing instead of zap and led to the deaths of 58 people, to trauma and injury felt by so many more, rippling outward from that concert. It would give it all some kind of meaning. But it isn’t there. Even if it was, it wouldn’t change what happened.

It might, perhaps, keep it from happening again. Maybe you could imagine a bigger research project. Take the brains of 100 mass murderers, or 1,000, and put them through an analytical gauntlet. Do the same for brains of non-murderers—with the researchers blinded to which brains are which. Maybe you’d find a…

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Controversial Brain Imaging Uses AI to Take Aim at Suicide Prevention

October 30, 2017 by admin

When someone takes their own life, they leave behind an inheritance of unanswered questions. “Why did they do it?” “Why didn’t we see this coming?” “Why didn’t I help them sooner?” If suicide were easy to diagnose from the outside, it wouldn’t be the public health curse it is today. In 2014 suicide rates surged to a 30-year high in the US, making it now the second leading cause of death among young adults. But what if you could get inside someone’s head, to see when dark thoughts might turn to action?

That’s what scientists are now attempting to do with the help of brain scans and artificial intelligence. In a study published today in Nature Human Behavior, researchers at Carnegie Mellon and the University of Pittsburgh analyzed how suicidal individuals think and feel differently about life and death, by looking at patterns of how their brains light up in an fMRI machine. Then they trained a machine learning algorithm to isolate those signals—a frontal lobe flare at the mention of the word “death,” for example. The computational classifier was able to pick out the suicidal ideators with more than 90 percent accuracy. Furthermore, it was able to distinguish people who had actually attempted self-harm from those who had only thought about it.

Thing is, fMRI studies like this suffer from some well-known shortcomings. The study had a small sample size—34 subjects—so while the algorithm might excel at spotting particular blobs in this set of brains, it’s not obvious it would work as well in a broader population. Another dilemma that bedevils fMRI studies: Just because two things occur at the same time doesn’t prove one causes the other. And then there’s the whole taint of tautology to worry about; scientists decide certain parts of the brain do certain things, then when they observe a hand-picked set of triggers lighting them up, boom, confirmation.

In today’s study, the researchers started with 17 young adults between the ages of 18 and 30 who had recently reported suicidal ideation to their therapists. Then they recruited 17 neurotypical control participants and put them each inside an fMRI scanner. While inside the tube, subjects saw a random series of 30 words. Ten were generally positive, 10 were generally negative, and 10 were specifically associated with death and suicide. Then researchers asked the subjects to think about each word for three seconds as it showed up on a screen in front of them. “What does ‘trouble’ mean for you?” “What about ‘carefree,’ what’s the key concept there?” For each word, the researchers recorded the subjects’ cerebral blood flow to find out which parts of their brains seemed to be at work.

fMRI scans of two groups of people thinking about the word “death.” On the left are those who have previously attempted suicide. On the right is a neurotypical control group.