BALTIMORE – Jonathan Martin believes he is doing a lot of things right.
A former offensive fight with the Miami Dolphins and San Francisco 49ers, he retired at the age of 26 before failing to do more damage to the bottom-shaking head shots that were a sign of his position. She lost 50 pounds, practiced yoga and meditation, and entered the MBA program at the University of Pennsylvania after moving from job to job.
But now 32-year-old Martin says he has had dozens of concussions while playing football and has anxiety and depression, all the symptoms associated with chronic traumatic encephalopathy, degenerative brain disease that worries players and the death of his former teammate. He died at the age of 26.
Martin’s concerns prompted him to join a study at Johns Hopkins University in 2019 that could help scientists develop treatment for the symptoms and diseases associated with brain trauma and CTE.
“I wanted to be at the forefront of a solution,” said Martin, who was targeted by his teammate’s violence in the headlines in 2013. “There needs to be more awareness about head injuries. I want to know how I can lubricate my brain.”
The study, which has already completed its second phase, examines why former players’ brains continue to work hard to correct themselves years after they stopped playing. Using PET scans, the researchers tracked brain cells known as microglia, which remove and repair damaged neurons. These cells usually become active after trauma, including concussions, and decrease as the brain heals.
Jonathan Lifshitz, director of the Translational Neurotrauma Research Program at Phoenix Children’s Hospital, which did not participate in the Johns Hopkins study, said, “Microglia and the molecules they work with are mostly sanitary workers in the brain.” “They are like FEMA: They are on high alert and will come in and take action when needed.”
Head injuries and CTE in sports
Permanent damage to athletes from brain injuries can have devastating effects.
Active microglia are normally encountered because they help the brain recover, but the fact that they remain active for a long time after the trauma is over can mean other problems.
Although the activity of these microglia can be found in other people who have suffered a brain injury, such as in a car accident, it can be difficult to find these groups and follow them up in a time-consuming study. However, NFL players are a discrete group that can be easily identified and eager to participate like Martin.
Dr. Jennifer Coughlin, an associate professor at Johns Hopkins University School of Medicine and lead researcher, first observed the work of reparative brain cells in the pilot of the study, which began in 2015. Testing four active NFL players and 10 former professionals The Coughlin team, whose careers ended 12 years ago, found higher levels of biomarker as microglia activity increased.
According to him, this chronic activity may indicate that players are at risk of developing other problems related to memory trauma, mood disorders or brain trauma, such as Alzheimer’s disease.
“We want to know whose brain is healing and why,” Coughlin said. “It could provide information about new treatments.”
To get more clarity, Coughlin and the researchers directed the second phase of the study to young former players who are less likely to have vascular disease or other symptoms that could confuse the interpretation independently.
Martin, who has been battling depression since leaving the NFL after a violent scandal, wondered if football played a role. To learn more about the potential relationship, he approached the Concussion Legacy Foundation, and the group referred him to the Johns Hopkins study.
“Based on some of my behaviors, the question came to my mind: Is there anything wrong with me other than normal depression?” Martin said. “Everyone who plays football knows that it’s not good for you to break your head.”
He was first examined in late 2019 and returned to Baltimore in March for a two-day follow-up test after being delayed in research due to a coronavirus pandemic.
On the first day, after his first visit, Martin answered questions about changes in cognitive abilities and mental health. The next morning, he returned for a PET scan, a visualization test that would monitor his brain activity by tracking the chemical injected into his arm.
During the 90-minute scan, Martin meditated to get rid of the claustrophobia associated with keeping his head in a fixed metal cylinder for a long time. Karen Edmonds, a nuclear medicine technician, put a wet mold on him to keep Martin’s head still after it hardened.
“Once molded, it sits like a glove,” he said.
The anesthesiologist then placed a catheter in Martin’s left arm for about 35 blood samples to be collected during the scan.
Once in the PET scan room, Martin lay on his back on a table covered with a blanket and slid back until his head fell into the scanner tube. The search agent then shot him in the right arm, and Edmonds watched him on the monitor.
“The goal is to see how much the radio viewer’s brain is burning,” Edmonds said. “Initially, there is only one dose, and then we observe how quickly it deteriorates.”
When the test was over, Edmonds took Martin’s table out of the pipe. “I have claustrophobia, but I just breathed,” Martin said. “Of course you’re bored, but it’s over.”
Coughlin came to remove the arterial catheter and took about 15 minutes.
He has so far tested 22 former NFL players and 25 other athletes, and he hopes to test a total of 70 participants to better isolate potential factors that cause brain activity. Coughlin said genetics, other medical conditions, the player’s position on the field, and when he starts playing football can all help.
“This will allow analysis to determine what factors are present for people with chronic brain injury,” he said.
Even with the participation of Martin and other players, the Johns Hopkins study is still relatively small and is just beginning to understand how traumatized brains behave. However, it has the potential to help detect the early onset of diseases and symptoms associated with traumatic brain injury, not only in footballers, but also in people who have previously been involved in bicycle accidents, car accidents and other collisions.
“Currently, there is no really good way to diagnose Alzheimer’s or Parkinson’s disease early,” said Jay Alberts, a neurologist at the Center for Neurological Rehabilitation at the Cleveland Clinic. “It’s very important to be able to raise a yellow or red flag.”
The study is blind, meaning that Martin and other participants are not informed of the results of individual tests. But Martin said participation is about helping others as much as he is.
“All of this is part of the research I’m eager to make the game better,” he said.