Shedding Light on Elusive Brain Injuries

Robin Green
Robin Green

When former professional hockey player Todd Ewen committed suicide last year, he believed he was suffering from a degenerative brain disease caused by the concussions he’d repeatedly received on the rink.

Chronic traumatic encephalopathy (CTE), which can be detected only by an autopsy, has been found in the brains of 90 of 94 former National Football League players examined by Boston University researchers. Other studies have confirmed its existence in former National Hockey League players. Such research, along with extensive media coverage, has triggered widespread concern, prompting pro athletes to retire early and parents to insist their children avoid playing contact sports.

But Ewen did not have CTE. And, according to alumna Robin Green, who studied Ewen’s brain as a lead neuropsychologist with the Canadian Concussion Centre, his case calls into question prevailing assumptions about CTE.

“This is a very important finding, because it affirms that a person with a history of multiple concussions does not necessarily develop CTE,” says Green, head of the Toronto Rehabilitation Institute’s Cognitive Neurorehabilitation Sciences Lab. “Even a retired professional hockey player who has a history of concussions and shows symptoms does not necessarily develop the disease.”

Green’s breakthrough generated media coverage in The New York Times, The Washington Post, and The Globe and Mail.

Current CTE research relies on the brains of former athletes who exhibited symptoms. Conversely, individuals who do not show symptoms after sustaining concussions are less likely to donate their brain. Green suggests a wider sample of brains — particularly those of patients without symptoms — must be studied to better understand the disease’s incidence.

Green’s research, which has won her a Canada Research Chair and significant national funding, focuses on people who have sustained a single, serious traumatic brain injury. Her team has made important discoveries about the declines these patients endure post-injury, which have led to new treatments currently in testing. She plans to launch a research center, the first of its kind in the world, that treats people living with the chronic effects of severe brain injuries. The center would enable her to dramatically increase the scale and capacity of her lab’s research.

“Every time I talk to a patient, I ask them their story,” says Green, whose interest in the brain began at Brandeis, where she played volleyball and majored in neuropsychology. “Getting to understand each patient in a personal way enables me to help more effectively.

“It can be hard to know in a clinical setting if you’re having an impact on someone’s life, but sometimes there are signs. That’s what’s encouraging.”

— Emily Evans