NFL awards Boston Children’s Hospital $14.7m to study brain injury

The Children’s Hospital researchers will propose clinical trials to test the most promising of the treatments, which could potentially help those with chronic traumatic encephalopathy, or CTE, which has afflicted football players and other athletes. Gene J. Puskar/Associated Press/File 2012

Boston Children’s Hospital has won a $14.7 million grant from the National Football League to study how hits to the head affect neurological health over time — and to identify potential treatments for brain injuries.

The money enables Children’s and four collaborating institutions to study thousands of former NFL players and to investigate ways of mitigating the damage from jolts to the head during contact sports. Such impacts have been linked to chronic traumatic encephalopathy, or CTE, the brain condition that has afflicted football stars such as the late Aaron Hernandez.

The grant to Children’s is the largest of five awards to support medical research, totaling $35 million, that the NFL announced Thursday. They included $1.5 million for a project by Spaulding Rehabilitation Hospital and Harvard Medical School to study the short- and long-term effects of concussions on high school athletes.

The money is part of $100 million that the league pledged for research, amid accusations of failing to adequately protect players from head injury.

Boston has become a center for CTE research. Separate from Thursday’s grants, Boston University has been studying the brains of deceased athletes, documenting a connection between visible damage in brain tissue and symptoms experienced during life.

But unlike the BU research, the Children’s project will focus on the living — retired football players who have volunteered to answer questions and undergo tests. At the end of five years, researchers will propose clinical trials to test the most promising treatments.

“What makes us unique is that we’re studying specific treatments and specific preventive strategies,” said Dr. William Meehan of Boston Children’s Orthopedics and Sports Medicine Center, the project’s leader.

Children’s researchers have been studying sports-related concussions for a decade, in collaboration with Beth Israel Deaconess Medical Center; Beth Israel Deaconess will also be part of the NFL-funded research. Children’s was selected in a competitive process to lead the project, Meehan said.

Dr. Julian E. Bailes, a former NFL doctor whose brain-injury research was featured in the 2015 movie “Concussion,” praised the breadth of the five NFL-funded projects.

“I’m impressed that they’re trying to look at the prevalence of brain health issues,” said Bailes, chairman of the department of neurosurgery at the NorthShore University HealthSystem in Evanston, Ill. “They’re trying to get a handle on the long-term effects [of head impacts] across the spectrum of age groups and across the life span.”

Chris Nowinski , cofounder and CEO of the Concussion Legacy Foundation, a nonprofit advocacy group concerned with sports concussions, said he was surprised but pleased that the NFL funded the research projects.

“I didn’t think they would fund CTE research because their last move in this space was to de-fund CTE research,” he said, referring to the NFL’s decision last year to back away from a funding arrangement with the National Institutes of Health. “But I’m glad to see it, and I’m also glad to see that clinical trials are being discussed. And that the goal is to lead to treatment.”

Research suggests that CTE occurs when multiple hits to the head, even those that don’t cause a concussion or produce symptoms, trigger a degenerative process in the brain that years or decades later can cause disabling mental problems, including agitation, impulsivity, explosive tempers, depression, anxiety, and memory loss.

CTE has been diagnosed in former amateur and professional athletes as well as military veterans, but it is not known how common it is or why some are afflicted and not others. Still, the drumbeat of CTE news and the involvement of high-profile athletes have led parents to worry about enrolling children in contact sports.

Studying CTE is tricky because it cannot be diagnosed until after death, and early symptoms resemble those of other conditions. The best-known research into CTE has involved examining donated brains.

In contrast, the Children’s project aims to provide new insights about the living, by assessing the neurological health of retired NFL players. Some 2,500 players were first interviewed in 2001 by University of North Carolina researchers; since then, the study group has grown to more than 3,000 and Children’s hopes to recruit more, Meehan said. The players’ names and data will be kept confidential, he said.

The researchers will survey them annually, and also conduct more intense testing on a few hundred of the players, performing brain scans, blood tests, and other physical and neurological measurements.

The team wants to see whether the players’ neurologic health correlates with the number of concussions they experienced or with the number of blows to the head that did not produce concussion symptoms.

They will try to measure tau — a brain protein that becomes misshapen after injury and may trigger CTE — through brain scans and blood tests. The goal will be to see whether abnormal levels of tau can be detected in the living, signaling the presence of CTE.

The researchers will also examine four potential treatments for CTE: an antibody that in mouse studies has been shown to destroy the toxic tau; memantine, a drug used to treat Alzheimer’s disease; carbon monoxide, a poisonous gas that in low doses may protect the brain after injury; and “environmental enrichment” — using physical and mental exercises to keep the brain healthy.

In addition to Children’s and Beth Israel Deaconess, the project consortium will include the University of North Carolina at Chapel Hill, the Medical College of Wisconsin, and the University Orthopedic Center at Penn State.

The NFL assembled an advisory board of leading scientific experts to help select the grant winners from among 129 applicants. In addition to the awards to the Children’s and Spaulding groups, the grants include $6 million to the University of Pittsburgh, $9.4 million to the University of Calgary, and $3.4 million the University of California San Francisco.

Thursday’s awards expend all but $5 million from the $40 million pool the NFL allocated for medical research. The league said the remaining money would be distributed later to medical research on player health and safety.

In addition, the league has set aside $60 million for engineering and biomechanical studies, such as developing safer helmets.