Researchers investigating head trauma in the Canadian military want veterans to 'pledge their brain'

Canadian Forces veteran Dennis Manuge has been thinking a lot about his brain health lately, and the impact of repeated concussive incidents from his time in the military and beyond.

“I had multiple concussions, probably double-digit between military service and athletics,” says Manuge.

He recalls one incident while in forces training, in which we went down on his head hard.

“I didn’t know who anybody was around me, for almost an hour,” he says. “And then I was back to work.”

Best known for leading a successful legal class action against Veterans Affairs over disability payments, Manuge is now in a battle to recover from his military injuries and post-traumatic stress disorder (PTSD).

He says it was NHL star Sidney Crosby’s openness about his concussions on the ice that led him to think about the hard knocks he suffered in his own lifetime.

So, when the 53-year-old heard about Project Enlist Canada, which is recruiting veterans to donate their brain tissue to science after death, he signed up.

“The first thing I did was let my wife know, because you never know. When your time's up, your time's up,” he says.

Project Enlist Canada is an awareness initiative working in partnership with concussion and brain researchers to create a better understanding of chronic traumatic encephalopathy (CTE) - a degeneration of the brain due to repeated head traumas, like those suffered by professional athletes such as football players.

Right now, CTE can only be accurately diagnosed by autopsy, but its symptoms are very similar to PTSD.

“We've got a lot of veterans who are misdiagnosed with PTSD, when in fact, they have a brain injury or also have a brain injury,” says Michael Terry, a Nova Scotia veteran living in Ontario and the project’s outreach coordinator.

“CTE is basically an accumulation of small hits over time, of micro-concussive events, [and] when you look at our service… firing the 84mm recoilless rifle, which is a shoulder-fired heavy weapon, firing the 81mm mortar, you’re right there next to it,” says the infantry veteran. “Even Navy, Air Force, we all take these ‘knocks in the head’ over our career."

“You need to start asking these questions, have you had these head impacts in your life,” says Ryan Carey, Project Enlist Canada’s director of military engagement.

The former CFL player and 14-year CAF veteran is passionate about the effort to create a bank of post-mortem brain tissue from Canadian men and women who served in the military.

“Doctors, therapists, they may not be looking for head injury, [they say] 'Well, you were in Afghanistan so you must have trauma from that,'” he says. “Absolutely, that’s all valid. But understand the amount of head injury that veterans face during their careers, not only in combat, on ranges, in ships, in planes, there’s a lot of these things that happen in training as well.”

For Carey, it’s about helping veterans now, but also about helping with CTE prevention for everyone.

“These things are very serious, there’s a movement across all sports… to limit head impacts with young kids, and my emotional response to that is, ‘It’s not happening fast enough.’”

Project Enlist is working in conjunction with the Concussion Legacy Foundation to support researchers at the Boston University CTE Center and the CAMH Brain Health Imaging Centre to investigate the causes and effects of repetitive brain trauma.

At CAMH, Chief Radiochemist Neil Vasdev is leading the effort to enable the diagnosis of CTE in a living patient via brain scan.

“Researching veterans’ brains will give us insights on how to stop the injuries in their tracks and treat them,” says Vasdev.

“I'm hopeful that we will be doing this in the next three to five years. We already have new imaging agents that we plan to advance to human studies this year,” he adds.

If successful, it would be a scientific first.

It would also offer hope, says Terry, to anyone living with the often devastating effects of repeated brain trauma.

“Treatment protocols are going to come from that, reporting protocols are going to come from that, and prevention is going to come from that,” he says. “We’re really trying to hit it from all angles.”

Veterans who want to donate their brain tissue after their passing can fill out of a form on Project Enlist Canada's website.