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COSTLY COLLISIONS

Ann McKee, MD (MED '79), is a brain expert and diehard Green Bay Packers fan who dared to challenge the NFL over concussions—and is helping to change how the nation thinks about the impact of collisions on both the playing field and the battlefield.

McKee first publicly presented her groundbreaking research at a Tampa, Fla., news conference during 2009 Super Bowl festivities. But she began raising awareness about the risks of brain trauma—specifically, the long-term consequences of repetitive head injury—even earlier.

"No detailed evidence like that existed before her contribution," said P. Hunter Peckham, PhD (GRS '68, '72, biomedical engineering), Distinguished University Professor and Donnell Institute Professor of Biomedical Engineering at Case Western Reserve. "She's probably identified as one of the—if not the—world's leaders in brain pathology and sports injury in brain concussion."

Over the summer, Peckham chaired Concussion: A National Challenge, a regional conference of the National Academy of Engineering and Institute of Medicine hosted and co-sponsored by the university, featuring national experts including McKee, professor of neurology and pathology at Boston University (BU) School of Medicine, associate director of BU's Alzheimer's Disease Center and director of neuropathology services for the VA New England Healthcare System, among other appointments.

McKee and her colleagues study the effects of what is known as chronic traumatic encephalopathy (CTE), a progressive degenerative disease that results in the presence of lesions of an abnormal protein, called "tau," in the brain. Described simply, areas of the brain begin deteriorating over time—a process that can start while an athlete in any high-contact sport is playing, or months, years or even decades later.

The symptoms can be severe. Some athletes still in their 20s have experienced personality changes and violent mood swings, often combined with depression and hopelessness. Older patients typically suffer cognitive impairments, including memory loss, short attention spans and dementia. McKee's center has discovered signs of CTE in 87 of 91 brain tissues tested from deceased former NFL players. "It's a very debilitating disease," McKee told convention attendees.

The Wisconsin native was a self-described "tomboy" who wanted to follow her football-playing older brother turned sports doctor to Case Western Reserve School of Medicine. After a stint in internal medicine, McKee became fascinated by the brain because it "not only explains our physical functions, but our mind, how we think and our memories," she said. "It explains who we are."

The VA, U.S. Department of Defense and even the NFL and World Wrestling Entertainment have sponsored her center's research. But the NFL was initially dismissive when she presented her findings to the league and, later, on Capitol Hill.

"They were like, 'Get a doctor in the room. Who is this girl? We need somebody who knows what they're talking about.' I was stunned," she said.

But now the NFL, which declined to respond to McKee's description, has adjusted elements of the game to reduce concussions. Among other things, it requires stricter return-to-play guidelines for players who exhibit concussion-related symptoms—including the addition of a neurological consultant to work with team physicians for in-game assessments. And, in 2010, the NFL donated $30 million to the National Institutes of Health for brain trauma research, some of which BU receives. A grateful McKee said the dollars have made a dramatic difference in the breadth, depth and speed of research.

While greater awareness and proper management will make a huge difference for future brain health, McKee said, issues associated with routine, less severe head injuries will remain without significant changes in game rules or practices.

For McKee—who grew up steeped in a football culture—a love of the game is an intrinsic part of her. "But gradually," she said, "it's becoming increasingly difficult to enjoy it because of what I know is happening to some of the players. At the end of the day, I care more about football players than I do about football."

—BILL LUBINGER