Mimicking ALS

concussion by Monica’s Dad

Study Says Brain Trauma Can Mimic A.L.S.
[Via NYT > Health]

A study suggests that head trauma can cause degenerative diseases similar to A.L.S. and that Lou Gehrig may not have had Lou Gehrig’s disease.

[More]

I have written about Dr.McKee’s work before. Concussions can have lifelong effects on some people. It appears that the brain reacts to the trauma by depositing some proteins in cells in the brain that eventually result in a degenerative brain disease, one that may mimic Lou Gehrig’s Disease according to her recent paper. The brain is affected throughout, even into the brain stem.

This paper, entitled TDP-43 Proteinopathy and Motor Neuron Disease in Chronic Traumatic Encephalopathy, is freely available – I love Open Access. She looked at 12 people that had developed a neural disease called chronic traumatic encephalopathy (CTE). The hallmark of this disease is a lot of a protein called tau deposited in the brain.

In 10 of the 12 people they also found a preponderance of another protein, called TDP-43. Three of the cases were former athletes who had been diagnosed with ALS. Examination showed that they probably did not suffer from ALS but from CTE, suggesting that many patients diagnosed with ALS might be suffering a different disease, one with a different disease course.

It may be that many cases of sporadic ALS, in contrast to familial, are due to traumatic brain injury. That is, it may be that CTE and sporadic ALS are the same thing. In fact, a lot of people diagnosed with ALS had a traumatic head injury within 10 years of onset. And onset happens later in these cases.

Reading about all the severe concussions Gehrig sustained – being knocked unconscious for over 5 minutes and then playing the next day, for example – really suggests that his disease may not have been ALS.

I expect that because of the severe head traumas seen with the current military actions in the world, that we will be seeing a lot more of this disease.

3 thoughts on “Mimicking ALS

  1. What if severe head trauma does NOT result in a concussion? And is this a large enough sample to be definitive? Inquiring minds are not disagreeing—they just want to know. And are some people more inclined to get concussions than other? All I have is anecdotal evidence in about as large a sample as she had.

    1. Remember, CTE is rally the new name for ‘punch drunk.’ But, one of the things they are finding out is that there can be a lot of damage without suffering an obvious concussion or losing consciousness. Her work is why so many sports teams are focussing new policies on concussions. Not everyone who has had concussions will develop CTE. But it appears that the brains of people with CTE have a history of concussions.There may be a genetic component. But, it does appear more and more likely that someone who suffered multiple severe concussions, leading to loss of consciousness, and then developing neurological problems, may very well be suffering from the deposition of these unusual proteins in the brain.

      That is why this new work regarding ALS is suggestive that Gehrig may have actually been suffering from CTE, which she shows can look like ALS, than ALS.

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