It’s been six years since the bombshell documentary and accompanying book “League of Denial” blew the lid off a simmering crisis in football. America’s most popular sport, put simply, was doing a lot more to players than just breaking bones and tearing ligaments. It was affecting players’ brains, causing severe mental illness and early onset dementia, and the brains of dead players, many of whom died young, kept showing signs of a devastating brain disease, chronic traumatic encephalopathy, often shortened to CTE.
At the time, some believed it would spell the end of football. “League of Denial” was not the first time such findings were reported, but it was a powerful, profound telling of a harrowing story. In one of the documentary’s most poignant moments, Dr. Bennet Omalu, the doctor who first published the discovery of CTE in the brain of a former football player in the early 2000s, recalled being told, “Bennet, do you know the implications of what you’re doing? … If 10 percent of mothers in this country would begin to perceive football as a dangerous sport, that is the end of football.”
Those predictions, at least to this point, have proven untrue. Football is still America’s most popular sport, and high school, college and professional football still capture the attention of the nation the way no other event can. Still, football’s stakeholders have not been able to ignore the danger of the game. Countless efforts to make the game safer have been suggested or implemented to various degrees, everything from banning tackle football before high school to redesigning helmets to the NFL-backed Heads Up Football program that teaches proper tackling form. Medical protocols have been implemented across all levels of the sport to better diagnose and treat concussions, although they fail to address the reality that sub-concussive hits appear to do just as much damage as a single, violent blow.
In truth, as most observers now acknowledge, football is by its very nature a dangerous sport, and there is no way to fully prevent brain trauma during a football game. But what if everyone has just been looking at the problem the wrong way? What if the key is not stopping heads from banging together in football but instead in preventing blows to the head from causing brain damage? And what if the secret to doing just that has been lying hidden this whole time in a patent-lapsed blood pressure medication with no significant side effects?
Dr. Braxton Norwood graduated from Flathead High School in 1999 and has spent the past two decades training and working as a neuroscientist, studying the mysteries of the human brain. He and David Booth founded Expesicor in 2016 to find treatments and cures for a handful of neurological problems, and decided to base their company in Kalispell, Norwood’s hometown, with lab facilities at the University of Montana in Missoula.
Five years ago, another researcher in Missoula, Dr. Thomas Rau, led a study of phenoxybenzamine that reported a hard-to-believe discovery. Rau and his co-authors found that the drug, first approved by the Food and Drug Administration in 1953 and used primarily to treat patients with high blood pressure, also protected the brains of rats from degrading after an injury. What’s more, the drug slowed brain tissue degradation even if administered 16 hours after a traumatic brain injury (TBI).
Rau and Norwood did not know each other in 2014, but the pair would eventually meet and helped found a Missoula company together, Fyr Diagnostics. Rau was working at the University of Montana when he conducted his phenoxybenzamine study, and in the years after it was published, the university licensed that study’s patented findings to Norwood and Expesicor.
This fall, with the exclusive license to pursue testing based on the study’s findings, Norwood and Expesicor are recruiting varsity and junior varsity football players in the Flathead Valley to determine if the dramatic impact shown in rats will translate to teenagers. And if it does, it could the first step toward a breakthrough that would do nothing less than revolutionize how we treat TBIs, and alter the future of football.
Administrators at Flathead and Columbia Falls high schools have both eagerly signed on to the study, although participation is up to the individual athletes and their parents. Players at Whitefish, Glacier and Bigfork high schools are also invited to participate. Those who do sign up will go through a preseason and postseason evaluation that involves an MRI and a cognitive test (Savonix) in order to set a baseline and measure the drug’s impact. During the season, subjects will be given either a 10-milligram dose of phenoxybenzamine or a placebo within two hours of the end of every game. Norwood and his colleagues are anticipating at least 60 participants this year.
One of the perks of working with a drug that has FDA approval is that the side effects are well known and in this case minimal. Phenoxybenzamine has “proven safe for a very long time,” according to Norwood, and the worst possible side effect he anticipates would be a temporary drop in blood pressure.
While there is little to no risk in taking the drug, particularly in the mild dose used in this study, exactly how and why phenoxybenzamine works to treat brain tissue is mostly a mystery. One thing scientists do know is that, somewhat counter intuitively, the full extent of damage to brain tissue after suffering a TBI is not immediate. It’s unlike, say, a broken bone, where the fracture happens on impact. TBIs cause a mechanical injury (the brain impacting the skull), the breaking of axons (the wiring between neurons) and inflammation on the brain.
“There does seem to be this window of opportunity where we can intervene … and we can stop the injury from happening,” Norwood said. “It doesn’t make sense. I always thought, and this is the predominant perspective in research, ‘Well, no, you hit the brain, it’s injured.’ Well, actually it’s not. There seems to be a delay which I can’t explain.”
Norwood and his colleagues are currently recruiting participants for this fall’s season-long study, and interested players and parents, or those seeking more information, should email email@example.com. Norwood will hold one-on-one meetings with potential subjects to outline the study in more detail and answer any questions. Any players under 18 years old must have parental approval to participate.
Preseason and postseason testing is being conducted at Kalispell Regional Medical Center and participants will be paid $25 for preseason tests and another $25 for the postseason tests, both of which can be completed in about two hours. The first preseason tests will be conducted the last weekend of July, and potential subjects should contact Expesicor by mid-July to sign up or learn more.
For more information on Expesicor, visit www.expesicor.com.