In January 2020 American Legion Magazine, the efforts of the Concussion Legacy Foundation (CLF) were featured. In addition to highlighting its mission to support those affected by concussions and chronic traumatic encephalopathy (CTE) and to end CTE through prevention and research, the article also had a request: for anyone – veterans , former athletes, and anyone willing to do so – to pledge to donate their brains after death to the Boston University Department of Veterans Affairs-CLF Brain Bank on the Jamaica Plain Campus of VA Boston Healthcare System.
And less than a month after the magazine’s issue hit the mailboxes, more than 330 veterans and military brains have signed up to CWF’s Project Enlist program. Eventually, CLF co-founder and CEO Chris Nowinski told members of the American Legion’s TBI/PTSD Suicide Prevention Committee on March 5 that that number had reached nearly 500 pledges, more than double the amount of pledges the foundation had received the entire previous year.
Nowinski made a similar request during the committee’s virtual 2022 Washington Conference meeting, noting that the following year the CWF received a record 10 brain donations from families of deceased veterans. Nowinski said six people told the foundation they decided to donate after seeing The American Legion Magazine item.
“The big picture is how we can continue to use (American Legion) assistance to reach veterans to accelerate the rate of brain donation, so we can understand how to better treat injuries. traumatic brain injury and ETCs,” Nowinski said. “Why it’s relevant here is that…research that you’re no doubt aware of links mild traumatic injuries to an increased risk of suicide. We also find that suicide is a very common cause of death in our population (CTE) because it causes changes in your thinking, changes in impulse control, emotions. But we don’t even know how to diagnose CTE in living people. We can only diagnose post-mortem, which is why brain donation is so important.
“We appreciate all you are doing to slow down and stem this terrible suicide epidemic. The Enlist Project is really trying to move upstream a bit. We know that a certain percentage of people who die by suicide, that brain injury, and potentially CTE, is sort of the initiating event. It’s what changed the way their brains work. So by studying these brains, we’ll better understand both how to identify who is at risk, who has suffered a cerebral lesion which modifies its functioning, and then also how to diagnose it and how to treat it.
Nowinski was an All-Ivy League football player at Harvard University before a brief career in World Wrestling Entertainment, where a kick to the chin caused post-concussion syndrome and ended his career. He said those who play higher levels of football are at high risk for concussion, “and they go into the military with a history of concussion. What’s becoming clear, especially with the risk of CTE, is that if you’re a former college football player who then joins the military, you already have a risk factor for CTE. And then your serve makes it worse.
Nowinski said it was more difficult for the foundation to obtain brains donated by families of veterans than those of professional athletes – referring specifically to the National Football League. “We’re now getting the brains of one in three NFL players who die each year, which is sort of an unprecedented sample in any population,” he said. “When NFL players die, it becomes news within hours. The team puts out a statement. It’s all over the internet, and we’re able to find and trace families. We don’t have that head start with veterans With most of the brains of veterans coming back to us, the family needs to start reaching out.
Nowinski thinks increasing the sample size of veterans’ brains from the Brain Bank can lead to real breakthroughs in critical research. “There’s definitely a perfect storm when we hear that our veterans are exposed to TBI, develop PTSD…and then some of them develop CTE,” he said. “We already know that there is a relationship between TBI and PTSD. But the CTE is that mysterious third element that nobody really talks about in the military. This is part of the Enlist project. I’ve lived in the world of brain banks for 15 years. Studying the brain under a microscope is really how we unlock the mysteries of exactly what is wrong, and how can we identify places to stop degeneration or fix it.
CWF’s short-term goal for Project Enlist is to diagnose 100 cases of CTE among veterans exposed to a blast or TBI while on duty. The hope is to create a culture of brain donation within the veteran community to develop effective treatments for CTE, TBI and PTSD.
The American Legion Magazine The article played “an important role in accelerating this research,” Nowinski told the committee. “The reality is that we are all losing people close to us. This is really where you can activate and help bring something positive out of a tragedy.
TBI/PTSD Suicide Prevention Committee Chairman Ronald Conley said he would like to see the CLF’s Enlist project further amplified in the American Legion media. “I think now more people are starting to understand and know (CTE),” Conley said. “It’s been very enlightening.”