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Dr. Carmela Tartaglia wants to know what causes our brains to change, and how can we stop it?
"You are a reflection of your brain," says the neurologist at the Krembil Neuroscience Centre's Memory Clinic and a concussion researcher. "When your brain changes, you change."
The human brain can change in many ways and for many reasons, and some of Dr. Tartaglia's research looks at the role multiple concussions might have in that process. Although there is enough research to indicate that concussions likely affect the brain and, in some cases might cause a neurodegenerative disease known as Chronic Traumatic Encephalopathy (CTE), experts still can't diagnose CTE until they examine a patient's brain after death.
Currently, when patients do not recover from a concussion and develop a post-concussion syndrome (PCS), only the symptoms – such as headaches, pain, depression and a whole list of others – can be treated. Although a physician can suspect a patient might have PCS or even a more serious condition such as CTE, there is no test to diagnose these conditions with certainty.
Furthermore, symptoms of PCS and CTE overlap with those of neurodegenerative disorders such as Alzheimer's, Parkinson's disease or other causes of dementia.
"Changes in someone's cognition, personality, motor function, behaviour – all these changes are the result of something happening to the brain," she says. "But we don't know what is happening to the brain to cause it."
First professorship focused on concussion research
However, Dr. Tartaglia is getting the support she needs to move that research forward. In July 2016, she was awarded the Marion and Gerald Soloway Professorship in Brain Injury and Concussion Research; the first professorship in the world focused on concussion research.
Marion and Gerald Soloway, whose generous donation established the professorship, are longtime supporters of the research efforts of Dr. Charles Tator, neurosurgeon and director of the Canadian Concussion Centre, which he founded in 2010 – originally called the Canadian Sports Concussion Project.
The professorship awarded to Dr. Tartaglia is a joint appointment between the University Health Network (UHN) and the University of Toronto.
"Marion and I have known Dr. Tator for over 50 years and have watched him help so many people, ourselves included," says Gerald Soloway. "The professorship is a way for us to ensure the continuity of his life passion: brain injury research.
"We look forward to seeing the contribution Dr. Tartaglia will make under this appointment, and how she will further the field that Dr. Tator has so passionately worked for."
On the way to finding some answers
"We are so fortunate to have a star like Carmela on our team," says Dr. Tator. "I look forward to seeing what she is able to achieve with this professorship and how that will improve our understanding of concussions so we can help patients who continue to suffer long after they have suffered the injury."
Dr. Tartaglia is well on the way to finding some answers. Her recent publication in the
Journal of Neurology showed that, as a group, the brains of former professional athletes do show notable differences from those of the control group they were compared to.
When analysing the imaging results of the participants, the research team noticed that the former players had a loss of white matter tract integrity – or damage – in a certain part of the brain and that could explain some of their memory impairment.
"Imaging isn't a tool that can show disease pathology, but we can see that there is damage to the white matter in these football players' brains," Dr. Tartaglia explains.
In another study presented at the recent Alzheimer's Association International Conference in Toronto, her team showed that the hippocampi – the brain's memory organ – of the former Canadian Football League players were shrinking faster than what is considered normal for an aging brain; another hint that the brains of these players are experiencing something that is different from those that did not suffer multiple concussions.
"So far, this research analyzes the trends of a group, however these findings are giving us clues as to what areas of the brain we should target to better diagnose CTE in individuals," she says.
In addition, Dr. Tartaglia's group is the first in Canada to investigate a new tag for tau proteins in the brain so she can diagnose CTE while people are alive.
"We are excited about this research because, if this study works out, we may find a biomarker that allows us to diagnose CTE when a person is alive," says Dr. Tartaglia. Ultimately, she wants to conduct clinical trials with drugs to target the tau of individuals with CTE in order to stop its spreading, or even reverse the disease.
"Funding in concussion research is very competitive, so I'm grateful for this professorship," Dr. Tartaglia says. "It's a great opportunity for us to continue this important research."