HAYS, Kan. - Lately, there has been a spate of media coverage on the connection of brain damage to the sport of football. The New York Times, NPR, and PBS have all weighed in. Congress held hearings about it, too. Probably the most influential piece of late is Malcolm Gladwell's "Offensive Play" (The New Yorker, Oct. 19, 2009.)
Mr. Gladwell focuses on the research associated with the football-brain damage connection. This brings up a big question: if repetitive hits to the head are causing brain damage in NFL players, could something similar be happening to younger players?
In his article, Mr. Gladwell gives an example of an eighteen-year-old male who had died. An examination of his brain was performed. The startling discovery was that the young man's brain exhibited damage similar to that showing up in the NFL players' brains. The young man had played only two years of high school football.
Football has long been connected with broken bones and, worse yet, spinal cord injuries, but the recent attention to brain damage--which manifests itself in Alzheimer-like symptoms: forgetfulness, explosive anger, and loss of mobility--should cause even more concern.
The Way of the Tau. The pathological changes noted in the brain studies of former NFL players were caused by an over abundance of a protein called "tau." In order to better understand how tau operates in the brain, I spoke with Dr. Kent Rohleder, a biologist currently teaching physical science at Fort Hays State University and a person whose particular expertise is in human genetics and molecular biology. His degree comes from Johns Hopkins University in Baltimore, Maryland .
"Tau protein is found in the neurons of the brain. Tau attaches to other proteins called microtubules located on the axon, the longest portion of the brain cell," explained Dr. Rohleder. "The microtubule's chief job is to the stretch the axon to make a smooth track for signals to move from one neuron to the next to the next. This communication between the brain cells tells your body what to do and where to go. The signals provide the information to tell you where you parked your car in Dillon's parking lot."
The tau arranges the microtubules on the axon in a specific pattern to produce the needed stretch. "Tau does this by having one small conformational change; it has a phosphate added to it," he continued. "Phosphates are used to move energy around in the body. The tau becomes phosphorylated so that it can attach to the microtubules."
When Tau Obstructs the Way. The problem with tau arises when it becomes hyperphosphorylated, when too much phosphate attaches to it. When this happens, the tau starts to attach to each other instead of the microtubules. Without the tau to organize the microtubules on the axon, the inside of the cell folds on to itself, causing the axon to twist rather than stretch out.
This twisting results in tau neurofibrillary tangles in the brain. You might think of the way plastic wrap works. When stretched without folds, it seals well and prevents food from spoiling. But just a minor fold can start a downward spiral. Attempts to smooth the fold can result in more folding in on itself, and that in turn results in a wad of ineffective plastic. You eventually throw it out and try again.
Unfortunately, the brain cell once damaged is like the wad of plastic wrap and cannot fully recover. "The tangles move the axon off of where it is supposed to be," Dr. Rohleder explained. "It interferes with the signal, which goes from one neuron to the next to the next to tell the body what to do and where to go and to remember things. Neurofibrillary tangles are associated with a number of neurological diseases, with the most famous being Alzheimer's Disease."
What is the connection between too much tau in the brain and repeated hits to the head? Dr. Rohleder expressed uncertainty over just what biochemical process responds to repetitive strikes to the head by the hyperphosphorylation of tau that produces the tangles in the brain. But he is convinced that it does exist, as exhibited by the post mortem examinations of the brains of former football players such as the eighteen year old.
"While you need to be cautious about drawing a scientific conclusion from such a small study sample," Dr. Rohleder noted, "when someone who looks at brains a lot is struck by something, then it is something to be followed up on, which is what they are doing."
Bread and Circuses. Dr. Rohleder returned to the example of the eighteen year old in the brain study featured in "Offensive Play." "The example of the eighteen year old's brain was telling. Upon examination of his brain, they found tau deposits that a normal fifty year old would not have."
Dr. Rohleder went on to say, "I think that any reasonable person would think that football is a horribly violent sport. And I think that it is bad for us in a number of ways: biologically, definitely. It is gladiatorial in nature. It uses kids up."
He then cited the Roman poet Juvenal, who described Roman society as it was facing its end as the problem of "bread and circuses." As long as the masses had enough to eat and distractions like the gladiatorial games, the senators could do what they wanted to do to satisfy their own selfish ends. "The circuses were the gladiatorial sports. We, today, are interested in our own gladiatorial sports and not in the things that really matter."