Revolutionized scientific research and our understanding of the long-term effects of concussions, including chronic traumatic encephalopathy, in veterans and athletes

It is no exaggeration to call Dr. Ann McKee a trailblazer in the field of head trauma. Not only is she the leading expert in chronic traumatic encephalopathy, or CTE, a neurodegenerative disorder that disproportionately affects military veterans and athletes who play contact sports, but her research has revolutionized our understanding of brain diseases. 

“Dr. McKee’s research has been the dominant force in advancing medical science regarding the long-term effects of concussion, subconcussion and chronic traumatic encephalopathy,” said Dr. Carolyn Clancy, a deputy undersecretary for health at the Department of Veterans Affairs. “Her work has transformed the prevailing science regarding head trauma and demonstrated that repetitive mild head trauma is not just an acute injury—it can provoke a progressive neurodegeneration.” 

McKee, a physician and neuropathologist at the VA Boston Healthcare System, has studied the human brain for 38 years. Initially trained in Alzheimer’s research, her focus shifted to environmental impacts on the brain when she discovered CTE in the brain of Marine Corps veteran and professional boxer Paul Pender, who had been misdiagnosed with Alzheimer’s disease during his lifetime.  

“She basically put CTE on the map,” said Dr. Karen Antman, dean of the Boston University School of Medicine, where McKee is on the faculty.  

McKee found that the brains of CTE patients exhibited an unusual buildup of the same proteins that accumulate in the brains of patients suffering from Alzheimer’s and other disorders related to mental deterioration. After Pender’s case, she began to collect more brains from deceased athletes for the brain bank she had helped to establish in Boston. In 2008, she found CTE again, this time in the brain of a former National Football League player.  

With funding from VA and the National Institutes of Health during the next 10 years, McKee investigated the connection between impact sports and CTE. She found CTE in hundreds of brains from former athletes in contact sports, as well as veterans who had experienced head trauma and victims of domestic abuse.

“Her work has been a wake-up call,” said Dr. Michael Charness, chief of staff at the Boston VA Healthcare System, who calls the trajectory of McKee’s career and its impact on public health “meteoric.” He said McKee has played “by far the largest role of anybody in raising awareness about the impact of brain injury, especially earlier in life, on the development of neurodegeneration.” 

Dr. Neil Kowall, director of the Boston University Alzheimer’s Disease Center, said McKee “clearly feels a responsibility because of her background and training as a physician to link together her scientific work to the person, and beyond the person, to society and the public health aspects of it.” 

Clancy highlighted McKee’s ability to explain the significance of her work to audiences outside the scientific community. 

“She gets people excited about her work and helps them understand its importance,” Clancy said. “Most people who are doing research do not have that ability.” 

McKee has raised public awareness around concussions and brain injury, and in 2018 was on TIME magazine’s list of the nation’s 100 most influential people. 

In addition to drawing attention to CTE and its dangers, McKee has been working toward early detection and treatment options. In 2017, McKee’s team from the Boston University School of Medicine and the VA discovered a key biomarker for CTE that they hope marks the first step toward being able to diagnose and ultimately treat the disease. 

McKee’s persistence has paid off. The military has adopted more dependable procedures for screening veterans for head trauma and its chronic effects. An estimated 375,000 military service veterans have been exposed to repetitive head trauma since 2000, making McKee’s work essential to their treatment. 

In addition, the NFL reached an estimated $1 billion settlement with retired football players over brain injuries and has committed about $200 million for neuroscience research. The NFL also has revamped its approach to treating player concussions and made changes to the rules of play, in large measure because of McKee’s findings. 

The National Hockey League, however, has resisted the idea that contact sports are destructive to their athletes’ brains. But public pressure resulting from McKee’s work persuaded the NHL to institute a new concussion protocol for their 2016-2017 season. And last November, the NHL reached a $19 million legal settlement with about 100 retirees from the league to go toward neurological testing and medical care related to brain injuries. The NHL denies liability for the claims. 

McKee’s research continues to inform the science of other neurodegenerative diseases, especially Alzheimer’s. “I would expect that this work is going to be seminal in our understanding of very common brain disorders,” Charness said. 

Whatever fame her research may bring her, McKee has never lost sight of the human impact of her work. She is determined to find clinical applications so patients with CTE can receive adequate treatment during life. 

“We want to make sure that these veterans, as well as athletes, aren’t forever impaired by this injury and that they don’t develop an untreatable neurologic disease because of repetitive head impacts,” she said.