Concussion-related trauma masquerades as ALS

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The New York TimesAlan Schwarz reports on what he says is “the first firm pathological indications that brain trauma results in motor-neuron degeneration.” The headline behind that conclusion, of course, is that researchers say some  athletes with concussion and impact-induced brain injuries may have been misdiagnosed as ALS victims.

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Photo by peterjr1961 via Flickr

In interviews, the study’s authors even speculate that Lou Gherig, who gave the disease its popular name, may have instead suffered from a similar disease caused in part by brain injuries.

The finding was not unexpected, given that ALS seemed to occur at much higher rates in concussion-heavy populations like athletes and soldiers.

Schwarz’s summary of the study:

Doctors at the Veterans Affairs Medical Center in Bedford, Mass., and the Boston University School of Medicine, the primary researchers of brain damage among deceased National Football League players, said that markings in the spinal cords of two players and one boxer who also received a diagnosis of A.L.S. indicate that those men did not have A.L.S. at all. They had a different fatal disease, doctors said, caused by concussionlike trauma, that erodes the central nervous system in similar ways.

It’s in the emergence of that second disease that really seems to have attracted Schwarz’ attention. It behaves similarly to ALS, but shows a distinct protein pattern that only seemed to emerge in patients with a history of head injury. There is not, however, a 1:1 relationship. Other factors seem to also be at play, Schwarz writes.

Gary Schwitzer of HealthNewsReview.org examines the story more closely and concludes that, while this is an “important and fascinating area of research,” the story “did not exhibit the best of health/medical/science journalism.” He lists seven points of criticism and includes comments from one of the site’s medical editors.

John Gever of MedPage Today offers more scientific coverage of the study and points out that there was no mention of Gehrig in the study but that “a New York Times reporter coaxed McKee into suggesting that Gehrig may have been among those misdiagnosed – even though, as a first baseman, he did not routinely experience violent collisions. (He was, however, beaned at least twice during his 14-year career with the New York Yankees.)”