New study going after concussions

The story of how a piece of downtown Las Vegas real estate not far from the Strip became a research headquarters for sports-related brain injuries and Alzheimer’s disease began two decades ago, when a Las Vegas liquor magnate’s father got sick.

For a year, doctors misdiagnosed Lou Ruvo, father of Larry Ruvo, who’d gotten rich off the Vegas-based liquor distributorship he’d founded with Steve Wynn. Doctors said it was a problem with Ruvo’s father’s carotid artery; doctors said it was heart trouble. Finally, Ruvo learned his dad had Alzheimer’s disease — “one of the worst diseases to ever hit the planet,” Ruvo now calls it. He couldn’t find decent neurocognitive care for his father in Nevada. Doctors seemed flummoxed by the disease, and Ruvo became his father’s caretaker.

In 1994, two years after his diagnosis, Lou Ruvo died. Yet Larry Ruvo still felt he had to do something about the sad, painful way his father’s life ended. What he did could end up having far-reaching impact in the world of sport, especially among the players whose careers have been maligned by concussions: players like Sidney Crosby or Eric Lindros, Troy Aikman or Steve Young, Justin Morneau or David Wright.

On a recent morning in Las Vegas, Ruvo stood in the center of his massive creation and beamed at what his father’s memory has become: A stunning, futuristic Frank Gehry-designed building that seems straight out of a Tim Burton film. At 65,000 square feet and costing more than $100 million, the building sends a big message: Big things will soon be coming out of the Lou Ruvo Center for Brain Health.

“(We all) can thank your grandparents and our ancestors for eradicating the scourge of polio — we don’t have to worry about that,” Ruvo said. “It’s our job to eradicate these brain diseases so our children and grandchildren don’t have to worry about these brain diseases … It’s the family (who) will have to take care of these people, whether it’s a football player, a sports legend, any other athlete, or a veteran coming back from the war.”

Architecture aside, Ruvo was standing among plenty more reasons why the cure for Alzheimer’s or strategies to reduce concussions could very well come from this building. A staff of leading doctors and researchers from the Cleveland Clinic. An ambitious study of more than 100 boxers and mixed-martial arts fighters, aiming to figure out why concussions and post-concussion brain diseases happen to some fighters but not others. Cutting-edge technology like a Bluetooth-enabled mouth guard that measures how hard an athlete is hit.

And as the concussion problem has risen to the consciousness of sport, as the NFL, the NHL and other sports are taking measures to protect their players, Larry Ruvo’s brain-disease clearinghouse couldn’t come at a better time.

Sitting near Ruvo were the past and the future of brain diseases in contact sports: Leon Spinks, the 58-year-old retired boxer who beat Muhammad Ali in 1978 to become the heavyweight champ — and who was recently diagnosed with dementia. And Jesse Magdaleno, 20, a baby-faced and up-and-coming featherweight who is in the middle of the study about concussions in contact sports.

“It’s something all of us who are involved in boxing owe to the participants, to get them the greatest degree of research, of medical supervision, so that we prevent any type of long-lasting detrimental effect they may experience from participating in the sport of boxing or MMA or any other contact sports like football,” said boxing promoter Bob Arum.

The hope? That the research being done here — with an annual battery of tests and MRIs for the fighters — can help a young fighter like Magdaleno avoid someday becoming a retired fighter like Spinks.

And that researchers can learn more in a medical field filled with so many unknowns. How big of a head trauma do you need to sustain a concussion? How many years of continued head trauma can lead to chronic medical problems like chronic traumatic encephalopathy, the degenerative brain disease found in brains of deceased athletes such as former NFL players Dave Duerson and Andre Waters?

“The most important thing is following boxers over time and seeing how each fighter changes,” said Dr. Charles Bernick, a neurologist who is the principal investigator of the study of boxers and MMA fighters. “We have to understand before we can cure. We (need to) identify when changes in the brain start … These diseases (like CTE) are not like a virus that just comes on. These things extend over many, many years, decades, which is good because there’s a window of time that you can intervene. But you have to be able to detect changes in the brain early.”

An advantage to studying fighters is that boxing and MMA are essentially planned head trauma. You know that, on a certain date, a fighter will step into the ring and get pummeled. You’re able to count the numbers of head shots a fighter takes. In football or hockey, though, big hits to the head are more random, making them more difficult to study.

It’s longitudinal research done in real time. Eventually, the goal is to detect the earliest changes in brain function to determine when an athlete appears to be heading downhill — and intervene as soon as possible.

It could be, however, a Sisyphean battle. The aim is to understand concussions in order to reduce them. But short of completely changing these sports — eliminating punches to the head in boxing, or designing football helmets that stop all head impacts, or banning hockey players from fighting — ending the scourge of concussions will be impossible.

“The whole goal of doing this type of work is prevention, not eliminating the sport,” Bernick said. “It’s being able to detect a person who is at risk and hopefully preventing these long-term complications from happening.”

As the neurologist spoke, a sad example of the seriousness and urgency of his work sat nearby. Leon Spinks wore a black leather hat commemorating his stint as undisputed heavyweight champion of the world. Next to him sat his wife and caretaker, Brenda. Spinks ate his lunch slowly, with pieces of food sometimes dropping from his mouth. He sometimes appeared to be falling asleep. When he spoke, the words came slowly and sounded as if his mouth were filled with marbles.

“We gotta see what’s going on with ourselves,” Spinks said. “We don’t know what (boxing) did to us yet. Just starting to learn about it.”

Out of her husband’s earshot, Brenda Spinks mentioned he’d recently been diagnosed with dementia but didn’t believe the doctors. She was excited that attention was finally being paid to athletes like her husband instead of writing them off as "punch drunk." When she met Dr. Bernick, one of the doctors caring for her husband, Brenda Spinks got goosebumps and teared up.

“Until you live with somebody that has that type of injury, you can’t realize how difficult it can be,” she said. “It’s frustrating. You just feel helpless sometimes, the forgetfulness, the anxiety he has when he can’t find something.

“I’m excited they’re finally doing research on this now, and that people are recognizing that there are problems with contact sports,” she said. “People are finally seeing there’s a need.”

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