February is American Heart Month, a time to recognize the importance of cardiovascular health and its impact on our families, our communities, and our nation. As President of the Board of the Traumatic Brain Injury Foundation of Seattle, I want to highlight a connection that is not always part of the conversation: heart health is deeply intertwined with brain health.
By Thomas Lehrich, President, Traumatic Brain Injury Foundation, Plus One Foundation of Seattle
A groundbreaking study from researchers at Boston University’s Chronic Traumatic Encephalopathy (CTE) Center has provided the evidence that many of us in the brain-injury advocacy community have long suspected: severe CTE isn’t just associated with dementia, it can be a cause of it.
For numerous decades, families of individuals exposed to repetitive head trauma, from contact sports, military service, domestic violence, and other causes, have watched loved ones struggle with memory loss, confusion, and cognitive decline.
The scientific community has debated whether CTE causes these clinical symptoms or if it’s merely an incidental finding at autopsy.
The Boston University work, published in Alzheimer’s and Dementia: The Journal of the Alzheimer’s Association, is the largest and most definitive of its kind.
Researchers studied 614 donated brains from individuals exposed to repetitive impacts and found those with advanced CTE had four to four-and-a-half times greater odds of having dementia compared with those without CTE pathology.
Importantly, the study isolated CTE from other neurodegenerative conditions, showing that this connection is not merely a correlation but a strong, independent association with cognitive decline and dementia.
Why This Matters
For too long, patients had unclear messages about CTE’s relevance to symptoms. This study of over 600 brains shifts how we think about repetitive brain trauma and its long-term consequences.
CTE should be formally recognized as one of the causes of dementia. Just as Alzheimer’s disease and other neurodegenerative conditions are classified within the realm of “Alzheimer’s disease-related dementias,” so too should severe CTE. This recognition matters, not only for research and clinical diagnosis but for families struggling to understand why their loved one’s cognition deteriorated.
Think About It
At Plus One, we have long championed education as one of the most powerful tools for helping our stakeholders
Our signature initiative, Think About It, is designed to reach the neurological communities with evidence-based education about concussion, repetitive head impacts, and long-term brain health.
Studies have shown that repeated subconcussive and concussive impacts — even those that don’t cause immediate blackout symptoms — contribute over time to cumulative brain injury. CTE pathology is characterized by abnormal tau protein accumulation in specific brain regions, likely driven by repetitive trauma.
Now, with a clearer link to dementia, the message of Think About It is more urgent than ever: brain health matters across the lifespan. Early education, timely recognition, and a culture that prioritizes neurological safety can change outcomes for countless individuals.
The Think aBout It education program, developed by the Plus One Foundation, is at the forefront of community engagement and public awareness in neurological health. Launched as a year-long initiative to demystify complex brain science and emerging clinical developments, the program has become a trusted platform for exploring topics from neurobehavioral disabilities and therapeutic interventions to cutting-edge research in traumatic brain injury (TBI) and related neurological disorders. Its goal is simple yet profound: to empower individuals, caregivers, clinicians, and the broader public with education that can transform outcomes and enhance quality of life after neurological injury.
Pseudobulbar affect, also called PBA, is a brain condition in which a person suddenly starts to laugh or cry and can't manage the reaction. It is a serious neurological condition and the etiology is unknown.
The term pseudobulbar means a condition in the brainstem's corticobulbar pathways that control facial and emotional expression. The corticobulbar tract is composed of the upper motor neurons of the cranial nerves. The muscles of the face, head and neck are controlled by the corticobulbar system.
PBA usually occurs in individuals with certain neurological conditions or injuries that affect how the brain controls emotions.
A major risk factor is traumatic brain injuries.
One of the main signs of pseudobulbar affect is suddenly beginning to cry or laugh when you don't feel sad or find something funny; or those behaviors may be an overreaction to the situation. The reaction may happen at any time and may last for several minutes. You may start laughing, but it often turns into tears. Crying appears to be more common than laughing.
With PBA, you often cannot manage when you laugh or cry. For example, you might laugh too much in response to a mildly amusing comment, or you might laugh or cry at something others don't see as funny or sad. These emotional responses are not how brains would typically react.
Pseudobulbar affect is often mistaken for depression because of the crying. While some people with PBA also may have depression, the two conditions are different. With PBA, crying lasts only a short time. Depression is a feeling of sadness that doesn't go away. People with PBA also do not have problems sleeping or eating, which are common signs of depression.
The exact cause of pseudobulbar affect is not completely understood. While further research is needed, a possible cause of PBA may be an injury to the pathways in the brain that manage how you show emotions. Increases and decreases in certain brain chemicals that send messages between nerve cells also play a role in PBA.
People with certain neurological conditions or injuries have a higher risk of pseudobulbar affect.
Early diagnosis is important. If you or someone you know experiences sudden laughing or crying that doesn't match emotions, talk with a healthcare professional about PBA. Early treatment can help manage symptoms.
Think aBout It
Brain research is one of the last frontiers in medical research. Plus One Foundation's education campaign Think aBout It features educational information and outreach on contemporary neurological topics. Education is at the heart of what we do; our Think aBout It campaign aims to dig deeper into all aspects of TBIs and neurological conditions.
Did you know that the Plus One Foundation mentors students and volunteers through our student programs? Whether a student with the University of Washington or a member of our university chapter we have been mentoring students from the very beginning.
January is best known for National Mentoring Month.
Plus One knows that success comes with learning and learning is what mentoring is all about.
The custom of mentoring is so traditional it dates back before Greek mythology. In the book, The Odyssey, there is a character—called the mentor—whose sole purpose is to guide others in life. Mentoring includes professional development and learning life skills and how to tackle challenges.
The Plus One Foundation thanks our mentors and mentees for their work in delivering programming to those with TBIs and neurological conditions.
