HJNO Jul/Aug 2023

CTE 10 JUL / AUG 2023 I  HEALTHCARE JOURNAL OF NEW ORLEANS Chris, thank you for taking the time to discuss a topic close to your heart and one I have become pas- sionate about lately. Let’s start with the basics. What is chronic traumat- ic encephalopathy (CTE), and how did you get involved in studying it? CTE is a degenerative brain disease caused by repeated head impacts. It’s pri- marily found in contact sport athletes, but it’s also been seen in military veterans, vic- tims of abuse, and others exposed to hun- dreds or thousands of head impacts. I got involved in studying it after repeated con- cussions ended my professional wrestling career withWWE in 2003. I began research- ing concussions and realized the narrative of the time — that concussions were not a big deal — was false and was promoted by the sports industry for their benefit. I wrote a book in 2006 called “Head Games: Foot- ball’s Concussion Crisis,”and in the process also learned about CTE. When former NFL playerAndreWaters died by suicide in 2006, I contacted the medical examiner and then his family to coordinate brain donation, and he was found to have CTE. I realized that a CTE brain bank was the key to getting peo- ple to realize the dangers of concussions and the key to figuring out how to prevent and cure CTE. What is unique about the tauopathy of CTE? Since 2019, researchers using cryo-elec- tron microscopes have found that tau mis- folds differently in various tauopathies. It was a big deal when CTE was found to mis- fold differently than Alzheimer’s disease. But in the past year, it’s been discovered that subacute sclerosing panencephalitis, which is caused by measles, and ALS/PDC (Parkinson’s Dementia Complex), with an unknown cause, all result in the same mis- folding, which suggests an environmental cause for all three. CTE is unique because of the location of the misfolded tau. In CTE, the tau lesion considered pathognomonic is an abnormal perivascular accumulation of tau in neu- rons, astrocytes, and cell processes in an Chris Nowinski, PhD, is co-founder and CEO of the Concussion Legacy Foundation, a non-profit organization leading the fight against concussions and CTE. A former All-Ivy Harvard football player turned professional wrestler, Nowinski discovered the concussion crisis after a kick to the chin in a WWE match ended his career. He developed post-concussion syndrome and met his eventual CLF co-founder Robert Cantu, MD. Through Cantu, Chris learned that concussions and brain trauma were misunderstood in the sports world. Nowinski wrote the investigative book Head Games: Football’s Concussion Crisis in 2006, co-founded CLF in 2007, and co-founded the VA-BU-CLF Brain Bank in 2008. Today, he serves as an outreach, recruitment, education, and public policy leader for the Boston University CTE Center. Nowinski earned a doctorate in behavioral neuroscience from Boston University School of Medicine and has authored more than 30 scientific publications. Nowinski serves on the NFL Players Association Mackey-White Health & Safety Committee, the Ivy League Concussion Committee, the Positive Coaching Alliance National Advisory Board, and as an advisor to All-Elite Wrestling. CTE Q&A Chris Nowinski, PhD Co-founder & CEO Concussion Legacy Foundation