criticize and the president for his lack of effort to secure the border, are opened to have their motives questioned. i hope they will be when they do an additional interview on your network. thanks, everybody. have a good monday. >> a discussion of the legislative agenda in congress. the senate anding committee looks at sports injuries to the brain. the wilson center host a forum on the israeli-palestinian conflict. >> now you can keep in touch with current using any phone at any time.

plan every weekday listen to a recap of today's events at 5:00 p.m. eastern on "washington today." you can hear audio of the fifth networks beginning sundays at noon eastern. c-span on audio radio now. long distance and phone charges may apply. >> members of congress are returning to washington for a four week session before the august recess. up next, from "washington journal," a look what's ahead on capitol hill. this is 40 minutes.provider. >> "washington journal" continues. host: joining us now to discuss capitol hill, gail chaddock and susan ferrechio. thank you both for joining us. guest: morning. host: morning.

guest: morning. host: what is the biggest issue facing capitol hill lawmakers this week? guest: there could be authorization on the executive action lawsuit. that could get a lot of press because the republicans are upset that the president has used his so-called pen and phone change regulations that he cannot get congress to agree with him on. that will be an interesting storyline to follow this week. a lot of legislation is churning through the house and senate right now. there are only a few weeks left until the big august break and i think we will be seeing slow progress on a lot of those bills. the big, more interesting piece of legislation will probably be the house talking about this lawsuit against the white house. actually, i think the lawsuit against the white house is a big symbolic issue.

it does not happen that often. public approval ratings are just lastgly low. week congress has moved it to seven percent, which is as low as the polling for any institution in the history of gallup polling. there is a lot of pressure to respond in a way to look at what the public is saying and it is not clear for the out that is going to be to get anything accomplished. >> of course the reason behind that is the upcoming pivotal midterm election where republican yield than leaving the majority in the senate is truly within their grasp more than it has been in any other election year. i think republicans are plotting their strategy with that election in mind and this is a part of that.

telling their base, them they are trying to do something to stop an administration that their base is not particularly happy with. the more people that they can get out, the more likely they are to win those seats in the you mentioned the upcoming august recess. can you tell me what must pass prior to august 1 of what does congress have to get done? nothing. they could leave for august and not do a thing. that would not be out of the russian, either. i we have been hearing a lot in the news on sweeping legislation to reform the veterans administration. with an theyigher

want to accomplish before they leave town. the house is passing spending legislation. they would never get this done on time, but the house is managed to pass these bills with their big majority there. that is really one of the main things. there is the possibility that they could take of legislation that would rein in the power of the nsa to use their surveillance abilities on americans. negotiations are on knowing and talk over that legislation. >> we basically only have a couple of weeks in july. then they head out pretty much until after labor day. when you have a very short. of time like that, the house can keep asking things with their big majority. but in the senate, everything slows down. there is a 60 vote threshold for just about everything and the rules of the senate are slower by nature. making the likelihood of passage of these things pretty small at

this point, just because of the timeframe. >> there is a curious coincidence this year -- the money for funding government runs out on october 1. so does funding for the import export bank. americans are probably saying -- have we ever even -- what is -- what does it do? have we ever even? this one could produce a crisis this year over funding. it has become an important issue for house republicans. they see it as an example of crony capitalism. why are we helping caterpillar ?o fund its sales overseas should this money go somewhere else? this is another issue where the chamber of commerce is strongly in favor of passing it and republicans are at odds with the chamber. ted cruz and the tea party could go to the wall over this one. especially if it is linked to

the appropriations deadline. on a similar note, the transportation funding bill, running out of money for highways. both sides agree on passing something. maybe a short-term measure. that is likely to be under heavy discussion, because that money is going to run out in august and they are gone when that happens. roadwork could slow down. people could lose their jobs. because of that there will be heavy negotiations to pass something short-term, but the problem from any spending bill standpoint right now is a divided congress. republicans and democrats don't agree on how to pay for it. until they come up with a plan, there is really a threat that our highway funding approach could dry out in august. that they would get reduced funding during august to help slow down. >> if you are interested in the discussion over the import

export bank, we will be joined later by a journalist from "the financial times yuriko the topic for this segment is the week ahead in congress. i am joined by gail russell .haddock and susan ferruccio if you want to join the conversation this morning -- host: the first caller this morning is lena, from sudden valley, pennsylvania area and >> susan, i would like to know how go againstmericans the gop for not doing their job for the last six years? we always talk about suing the president.

will you please answer that question? thank you. of people wereot surprised to hear the congress could sue the president. i think that the outlet for voters is to go to the polls and register your feelings there, tell people in office that you'd think could help move legislation more quickly. the of the issue is that on one hand people feel that congress is there to pass laws and add laws to the books. i think that there are another group of people who feel that congress may be passes too many laws and makes too many changes and that government should get out of the way. divide is pretty much what the two parties are about. that is part of the reasons -- part of the reasons the republicans are against the president, they disagree with his move to make changes to our laws without consulting with congress. remember, we have three branches of government for a reason.

they are supposed to moderate each other. of course, this is frustrating to people who say that they like the president is doing and they are tired of congress getting in the way, which is part of the debate we are having right now. to look at an article from "the christian science monitor." "straight -- states can expect rationing this summer." just how big of a deal is this? guest: a very big deal. it is yet another example of halting in the high-end construction season. it is not easy to build roads in january and february, so now is the time. for two parties who talk a great deal about jobs, the idea of pulling the plug host: arthur is in virginia.

caller: i wanted to make a comment on suing the president. he is doing the best he can. i would like to say this. you've got all of these rich people down there on the border for years. they did nothing. they are looking for cheap labor. they let people work for them for slave wages. neither the president is trying they should've,

taken care of this a long time ago. immigration is such a difficult issue for both sides. republicans know that if they like they don't care about therespanic population, is a push to come up with something that looks as if you are supporting the law. you're right about business. republicans are one business oferests is very in favor more labor. you also have elements in both parties of what is the impact on americans that are here now. they are not as well organized. what about workers were being displaced? it is a very tough issue for both parties.

they are thinking about it. you have seen a lot of shuffling within party leadership over this question. some people think that the reason that eric cantor who was viewed as the next speaker and was preparing for his next job, immigration was a big part of his defeat. it was entirely unexpected. it sent shockwaves to the party. i think you're right about that issue. this,let me ask you president obama says he wants to fix immigration or make changes to executive power. lawsuit, have the which is probably more for show. i don't know what it will accomplish. it will take years before that ever reaches resolution. i think part of the reason the president is moving on executive action is to force republicans

to come to the table and talk about legislation. provide says can't -- citizenship or allow people to stay. are you can allow them to not be deported. he can change the deportation communities soe people are not being sent away as quickly. but republicans can do is to win the senate that way they can control the house and senate and the president is in the final an years, they will have immigration plan that is more for a ruled what they want. it would follow by expanded visa program.

this would likely have a pathway to citizenship. they feel it they have a less favorable legislation of that weight until the have control the senate. robert is on the republican line in texas. caller: i enjoy watching c-span. while i was listing a while ago i heard you report the number of executive orders by president. that would leave the impression that president obama has not done a very many executive orders compared to other people. no one ever centers that many of these are for things like declaring a holiday or naming a post office or something of that nature. president obama's executive

orders have massive impact. genuine --is disingenuous to report the numbers that way. there have been some very big executive orders. raising the minimum wage for federal contracts at a time when that is a controversy of issue in congress. islooks as if the president supporting their will. commissions, that is going to have a huge impact across the country in places like new england that depend oil for their winter. the difficulty here is there is a big constitutional issue. it doesn't have to be.

when the president changed the implementation of obamacare, it flashed to a personal level. you need to say that. what he might've said was all complicated legislation goes through something like this. president bush had the prescription drug bill and he had to change the implementation. it becomes personal very quickly and things that would not be much of a problem are. that is where we are right now. we have a question from twitter. would changing deportation policy create a bigger influx of illegals? that has encouraged the

influx that we are seen on the border right now where thousands and some accompanied by parents and some not are flooding the borders. these communities are having a hard time dealing with it. they are coming over the borders and it sounds as though they are encouraged by the idea that if they do it now they will be able to stay. philosophy that immigration reform encourages more people to come and make it more difficult for our workers or our communities to support and areho come here dependent on government services. there are others who say that if we just reformed the system, that would improve people can gain access legally to the country.

that would help stop people from coming into the country illegally. it would bring them out of the shadows so to speak. it would make them contributing parts of society. it would make it a safer society by knowing who is here. there are arguments on both sides. there are people who believe the executive actions have encouraged people to come here illegally. host: the next caller is in ohio. caller: hello. your first color made the comment that the republicans have stopped all progress of anything being passed. susan neglected to say that for the first two years the democrats had the house and they had the senate. they did absolutely nothing in two years. what happened to those first two years? guest: i think the health care

reform is a pretty significant legacy. it is hard to think of a president who has established a legacy like that so quickly. it is not as if nothing happened. capacity to work with congress as a fine art. when i first started covering congress 15 years ago it wasn't to that point yet. the senate is distinctive. you could debate things in the senate. the two bodies look remarkably alike. it is not that difficult to obstruct the bill if you the majority leader of the senate. you just don't allow it on the floor. you don't allow amendments to be discussed. is so intense at

this point that it is possible to say nothing is going to happen in congress unless a presidential election happens. guest: i think gail makes an excellent point. there is a bill that everybody wants to see past. it would extend tax breaks for small businesses. it is stalled in the senate even though republicans like it. leader wouldjority not allow amendments to the bill on the floor of the senate. republican said we like this tax bill and we know businesses are waiting for it. we will hold out. that has serious consequences for our economy. for the republicans in the senate it is about having some right to amend legislation. it is at the point now where items both sides like or not knowing anywhere because of things that are happening. the public cannot figure out

what is going on. it is about an amendment process that has gone into the weeds. it has a very serious impact on peoples lives. of the puzzling things about the political system right now is americans hate the congress. and but when you look at the elections, how many competitive seats are there, even in the house? only a handful of races that the experts think are at risk. how does that fit? how could it be that most members have a better chance of being hit by a meteor than they do of losing the election. the public really doesn't like what they're doing. is on the democrats line in pennsylvania. caller: i have a quick comment.

you talk about everything that is important and has an impact on american families. i am one of the long-term unemployed. i want to see this unemployment extension get through. i think top of the list should be the of -- unemployment being unemployment. i am losing my house. we should get together and assemble and force and protest. you know and what do you think about this extension? this is most important. guest: i am sorry to hear about your heart situation. it is true that the house and senate have been arguing about extending it.

about 3 million people would be eligible right now but are not receiving it. it is an extension of benefits beyond with the state offers. they gives people more of a lifeline beyond that. in this economy where long-term unemployment is the big problem, that wouldproposal extend unemployment insurance. it would not be retroactive to december when a lot of people lost their insurance when it expired. this would extend it. leader hasrity indicated that he is not willing to take it up at this point. that is disappointing to a lot of people. i can offer some hope by saying that it is a bill is still has a shot. republicans in the house have suggested that they are open to

the idea, they just want to find a decent way to pay to it -- for it. they don't want to raise taxes. wouldpossible that they taken up by the end of this year. this is an election year. ome a political weapon. at the moment you are right and it is stalled and frustrating to many people. host: bill is on the republican line in virginia. caller: good morning. i believe that the professional politicians who have been in office for such a long time, they are ruining the country. they seem to be controlled by lobbyists. -- they have have to run for election they don't get things done.

is thatr aspect of it if you had somebody for eight years and they knew that was all your job was going to be, say thanks for serving your country. i think that would reduce the effects of lobbyists to extent. they know they're not going to be around forever. i think they would be more focused on getting bills passed. they would be working for the country versus the lobbyists. that is my point. one of the interesting issues with the culture of the congress is the use via timer people would come here and love being a senator and be a senator for a long time. ted kennedy is an example. senator byrd is another example. the congress is hard to figure out. it takes a long time to learn the job. it is no accident that they are

connected to important legislation. the thing that is useful to think about is who are the lobbyists? increasingly they are members of congress to leave and become a lobbyist. what if while you are a member of congress you are thinking about how i can become an effective lobbyist and making decisions that are geared toward your next job. a that is very destructive. it is one thing to have a lobbyist come to congress and give information and try to make a case. personhe thing for the to say they only have four terms and they will be a lobbyist. are you making decisions in legislation that are pandering to your next employer?

. of our guests are gail russel chaddock and susan ferrechio. next up is idaho. i would like to stay on the line and hear the answer. i am puzzled by what republicans mean by secure the border. we have the fence they wanted. we have more personnel. it is not doing any good. the only way i see to secure the fix the legal immigration system so that people don't have weights of 10 years to get here. what are the ideas on how to secure the border short of machine-gunning people to try to come across? i think there are arguments to be made that the order could be more secure with

additional border security, more physicalmbers, barriers to keep people out. are getting in because it is ready for us. just porous. legalizing immigration and making it easier for you to come near for a guest worker program through visa expansion for high and low skilled workers is part of the discussion. we'll have fewer people trying to sneak in illegally and become part of the system. those are the opposing views. one reason you're seeing

opposition is the last time we allowed people to come in legally in the 1980's the border was not secured. it did not stop illegal immigration. it didn't have the intended effect. a lot of people are wary of a new conference of land that doesn't really make moves to stop illegals from coming in for whatever reason. that is an intense part of the debate right now. if you think about people here illegally, the image are people crawling over a fence or digging a hundred or something. a lot of people came here illegally and then never left. discussion during 9/11 was we need some sort of identifier to know who is here and when they leave.

that is another concept of securing the border. you put higher sanctions on people who hire people and take incentive tothe come and the incentive to stay. linda is in jackson, mississippi. caller: i want to remind people the and she was the birth certificate. they would talk about his birth certificate. host: guest: i will say that when george bush was president there was a lot of discussion and criticism of him as well. it was pretty intense from the

democratic side. i think it had less to do with personality and more to do with politics. the president is very liberal. and theyo congress expected him to be a post-partisan president. he came in and republicans were very excited. i had never seen them excited over a democratic president like that. he met with him privately any came out and i talked to them and they said he said we are going to do it my way. i am not negotiate with you. that set the stage for what the next five or six years of turned into. there is a real animosity between the republicans and the president. it has gotten personal. it has gotten unfair. it started with politics.

congressdent came to as a rock star. everything was excited about them. the negotiations and the compromise never materialized. that is how we led to where we are today. host: what is the status of tax reform and regulations? economy and jobs, what concept. chairman advanced is owned tax reform agenda. it's one of those issues that takes a lot of time. why haven't they done anything? one of the things it could be very interesting is if the republicans to take back the senate. they need six seats to do that.

a lot of the seeds that are up for grabs are seats in districts that tend to be conservative. it is possible to see something change. if they recalled the house and the senate, tax reform could come through. then it would become an issue with working with the president. what would be the terms of a veto? it depends on how he response to that. i think about dwight eisenhower who came in his first two years with a republican-controlled congress. he had terrible relationships with them. joseph mccarthy was there. his ownnvestigating president. it was a disaster. the republicans lost in the next election. the president is now facing a democratic risk and he invited them over to the white house.

they talked about what they could do together. they came up with the interstate highway system. that is not an inconsequential legacy. even with the congress of a different party it is something you can pull a legacy out of or in it would require a character transformation on both sides. it is not inconceivable. everybody knows it is needed for them to work together. host: the republican line in illinois. caller: the democrats need to think about. presidente republican can do whatever he wants. that is true.

both sides of argued that republican presidents have used a lot of executive actions. both sides use the executive action to get things done. there is no question about that. you set the tone for trying to circumvent congress, that will continue. i know in the senate they have changed the rules so a disease you to confirm appointees as well as judicial branch appointees. everyone is wondering if republicans take charge of the senate will they hold on to that rule? it starts away the way that the present -- senate has functioned. it could change the shape of the supreme court. there are questions as to

whether these rules changes will continue. whoever is in power might abuse them. that is a great open question. a lot of us are wondering about that. guest: there is one caveat there. when president obama first came in he pledged to close guantánamo. he did in his first week. it cost $80 million to close it. unless he wrote a check for that himself he would need congress to agree. there are limits to what a president can do on his own. there is a piece of legislation that includes money taken away from the epa so they are not able to enforce the new regulations that would change the way ceiling fans are made. thatis an epa regulation

the president would like to put in place to executive action. will block that by taking away funding for it. they have tried to do that in a number of ways. they have done that with health care to a degree. they have tried to put checks on the president's executive action. congress controls the checkbook michael is on the line for independence. caller: it is a real pleasure to speak with you. won't burden you with my processes. here are some conclusions. abundance ofire an the poor. there is a lot of wisdom in that. i would rather not talk about republicans and democrats. i think it is a fake fight. just change the names.

it doesn't matter. the knee-jerkf republican and democrat thing. we fall into automatic conclusions. let's approach the problem. we want to solve the problem. here's the way i am going to go out it. there is no stopping it. they have been talking for a number of years about how the country got stolen from them. philadelphianed to lawyers. host: bring it back to congress. caller: they need to shake off their party affiliations. there are good men and women.

some of them get discouraged and quit. that is a tremendous loss to the congress and the nation and the world. we need more women and good hearts in congress. interesting. the voterly, population is becoming not republican or not democrat but independent. , thecities and states voting population is majority independent. i think that is the reflection on what you are talking about. you are tired of partisan politics and they went to see congress and government work. they're tired of the gridlock.

mentioned in the 7% approval rating for congress. that is an example of people's frustration. .ll they do is argue you mentioned your senators from maine. olympia snowe retired. were known as moderates among republicans in the senate. they helped bring about real compromise. they were two that were considered the most likely to compromise. they were very popular at home. there is a real appetite for that type of legislation. what it boils down to is who people elect. these swing elections we have had where we go from the left to haveight, that is why we this huge gulf in congress and nothing gets done. until they start voting for candidates that are willing to compromise we will see more of the same. host: we will have to leave it

there for this >> we'll look at global oil production and a report that shows the u.s. has surpassed saudi arabia and russia as the world's largest oil producer. our guest is mark shank. "washington journal" is live on c-span everyday 7:00 a.m. you can join the conversation on facebook and twitter. >> the senate aging committee

looks at a sports injuries on the brain. then reair the "washington journal" discussion on the legislative agenda in congress. >> tune into book tv for the harlem book fair for the state of african-american literature and the black arts movement. live coverage starts saturday morning at 11:45 eastern. >> more than 4500 former players filed suit. some of accusing them of illegal fraud. the now the senate aging

committee examine sport injuries that executive -- former nfl player ben. this is an hour in a half. >> good afternoon we're going to do to be creative because we are going to have a series of votes at 2:30. what i'll do is recess the committee and we'll go over and vote until the very last vote and we'll cast the vote at the very beginning of the last vote

then race back over here so that we can continue the hearing. there's also some breaking news just an hour ago. the nfl agreed to eliminate $675 million cap on concussion related claims available to thousands of players as part of a major lawsuit. so without objection i will enter the nfl's statement in the record. part of what we're going to discuss today is traumatic brain injuries, a bump, a blow, a jolt to the head or penetrating head injury that disrupts the normal function of the brain. more mild t.b.i.s, more

commonly referred to as concussions have been the center of increasing discussion within the sports community in recent years as a growing number of current and former athletes say that they are suffering from memory loss and other impairments caused by repeated blows to the head. of course, we are seeing the t.b.i.s that are coming home from overseas with our men and women in uniform and the performance of their duties as well. the centers for disease control and prevention have looked at 1.6 to 3. 8 million recreational sports related t

.b.i.s. they say they occur in the u.s. each year. such head injuries are not limited, obviously, just to one sport. they occur in a wide range of sports. and most recently, we were reminded that the story in the "new york times" with the graphic pictures of the games going on in brazil right now in which one of the soccer players was completely knocked out. over the last few years, much has been done to increase awareness of the risks posted by sports-related concussions and thanks to a number of partnerships and initiatives, research is under way to help us better understand the cause and the long term impact of concussions and what we can do

to prevent them. these initiatives involve a number of organizations. while we're making progress, it's important to note that much more research is needed. and to see all of the links to other things such as alzheimer's. today, we're going to hear from two former professional athletes who had their careers cut short due to concussions. now they're going to wonder about their function in the future. we're going to take testimony from two prominent medical researchers who will discuss the latest research and i'm going to give that privilege of introduction to senator warren after i turn to our great

ranking member, senator collins >> thank you very much mr. chairman. i very much appreciate you calling this important hearing so that we can better explore the relationship between traumatic brain injury and diseases associated with aging such as alzheimer's, parkinsons and lou gourig's disease. as the senate cochair of the alzheimer's task force, i am particularly interested in the research conducted over the past three decades that is linked moderate and severe traumatic brain injury to a greater risk of developing alzheimer's

disease and other forms of dementia. one troubling study cited by the alzheimer's association found that older individuals with a history of moderate traumatic brain injury are more than twice as likely to develop the alzheimer's than a our seniors with no history of brain injury. those with a history of severe traumatic brain injury were found in this study to have a 4 5 time greater risk. finding a way to treat alzheimer's is among my heightest priority as a senator and has been a focus of this committee's work. if we are to prevent alzheimer's from becoming the defining disease of the next generation,

we must strengthen our commitment to research leading to a better understanding of this devastating disease. while researchers still have a great deal to learn about how head injuries affect an individual's risk of developing neurological diseases like alzheimer's later in life, there is increasing evidence of a relationship. women even more than men maybe more likely to experience long term symptoms such as cognitive and visual impairments after sustaining a severe head injury. we know that currently almost two thirds of americans living with alzheimer's are women. there are many important research projects being conducted on t.b.i. and link to neurological disease. for example, the national institute of health and national

football league have embarked upon a $60 million four year public-private partnership to advance research that may lead to the improvement of t.b.i. diagnosis through better imaging technology and improve treatment for those who sustained serious head injuries. indeed, while those who had participated in contact sport or served in the military may face a particular risk for t.i.b.i. related health conditions. the leading cause of t.b.i. among seniors is falls. according to the cdc individuals over 65 have highest rate of t.b.i.s. more research is required to establish definitively the link between head injuries and

neurological diseases. it is clear that this important research could lead to a better understanding of such devastating diseases as alzheimer's and parkinsons. this research could bent our veterans and troops on the ground far too many of whom who have experienced t.b.i. and its painful lasting effect. mr. chairman, thank you for holding this hearing. we have a great panel of witnesses. i look forward to getting their insights and learning more about the current research on this topic. >> thank you senator collins. i want especially recognize kevin turner. kevin was a star fullback at the university of alabama. he played eight seasons with the new england patriots and the philadelphia eagles in the

1990s's since being diagnosed in 2010 with a.l.s., kevin has worked tirelessly to raise awareness about the disease and its possible connection to traumatic brain injuries. kevin, we thank you very much for being with us here today. senator warren if you will introduce two of our panel. >> thank you very much mr. chairman and ranking member collins. i am pleased to have the opportunity to introduce dr. robert stern and chris

nowinski. dr. stern is director of boston university of school of medicine. he is director of the clinical corps of the boston university alzheimer's disease center. he received undergraduate from welllynn university. he served on the faculty of brown medical school and the university of north carolina school of medicine. dr. stern's research has led to more than 250 peer review publications and helped us to better understand the effects of trauma and aging on the human brain. he's here today with m r. nowinski who is the cofounder and director of sports institute. it is focused on addressing the issue of brain trauma through

education, through policy and through research. he received his undergraduate degree from harvard university where he played defensive tackle for the football team. after college, he became a professional wrestler. in his own experience in that sport with head trauma, led him to cofound the sport's legacy institute. he currently serves as an advisor on the nfl players association traumatic brain injury committee and ivy league concussion committee. chris received accolades including distinguish service award for his work advocating for improving safety standards in sports. i am very pleased that dr. stern and mr. nowinski are here today. thank you both.

>> it's my pleasure to introduce ben utrecht. who is a former nfl tight end for the cincinnati bengals and the indianapolisñr colts. if i recall, you were on one of those teams that went into the playoffs and perhaps you can tell us the rest of that story. dr. jacob vanlandingham, he is professor at florida state university college of medicine. what we'll do, we'll start with you mr. nowinski and go down the list what your written statement is entered into the record. if you would just share with us for a few minutes and then we'll

get into questions. >> thank you for that wonderful introduction senator warren. chairman nelson and members of the committee, thank you for inviting me to speak today. i'm founding executive director of the sports legacy institute. it's a nonprofit organization dedicated to solving the sports concussion research. i also have a personal relationship with concussion. tremendous concerns, i increased my risk of developing a brain disease in the future. it's my hope this hearing raises awareness of the urgent need for funding for research on traumatic brain injuries as well as the tremendous opportunities we have for the prevention of their long term consequences. i never had a second thought about concussions or brain injuries until i was 24 years old. i became a prowrestler, known as

a super star with w.w.e. i got to travel the world playing a bad guy or heal. remind you this is a character i played. it was a performance to entertain our fans and it was a lot of fun. in a match, i was kicked in the head by my opponent and my world immediately changed. my head became throbbing, everything got foggy. most importantly, i forgot the script. i couldn't remember how i supposed to finish the match. i was stopped by an athletic trainer who asked if i was all right. i lied when i said i'm fine. even though the headache was killing me. it extended beyond the headaches to depression and sleep walking. i lied about my symptoms for five weeks. i met dr. robert can who helped me understand all the dings i've been getting were concussions.

to think that at 24 i was learning how fragile my brain was. that i am now higher risk. my ignorance cost me my career. cost me at least five years of my health. ....

brains of former nfl players studied have been found positive for this disease and athletes as young as 17. also, my friend kevin turner is here in the room, who is courageously taking on this issue. i will defer to dr. stern, but the reality is, we need answers quickly. it may be massive. least 3.8 million concussions per year. we have to recognize contact sports are constantly evolving. we do not know what the effects are of exposing children to repetitive brain trauma. the sports that our 11-year-olds played in 1950's are not the ones they play today. until title ix, few women were playing contact sports. we do not know the answers.

this is a public health crisis. what we work and we applaud the state laws that have changed the way we play sports, it is not enough. -- one of the things i do if i train wrestlers on concussion. which is fun. before they get into the ring, they have to listen to me. we think we can train adults. we do not know if we can train children. we have kids playing contact sports that will not recognize a concussion. it will become a problem for athletes and most certainly for our military veterans. a new initiative we announced today, oh that we hope will we hopethis -- that will prevent this, we teamed up to educate parents and coaches on the risk of heading in soccer before high school. we were joined by former includingeam players

brandi chastain and our own dr., to say that we do not need headers. it should not happen. underestimate the long-term impact of rain injuries. with one in four boys and one in 16 girls playing contact sports, we old them better. we need to find a way to minimize the consequences of this inevitable brain trauma. thank you. >> thank you. sofirst of all, thank you much for this opportunity. it is truly a privilege to be here to speak about something that has impacted my life in ways that are very scary, and unknowns as a husband and father have put me in a situation where i do not know what my future is going to look like.

as a small kid from minnesota, i do not know how it happened, but i found my way into the nfl. to play withgot the indianapolis colts and then two years with the cincinnati bengals. i am a husband and a father of three beautiful girls. thankfully i do not have any football players in the family right now, but the perspective of a father has really become part of my life. 27 neurologists make up the academy. they are the leaders in the world of neurology, along with their foundation, the american brain foundation, whose goal is to cure brain disease through exactly what chris talked about, the importance of raising money for research. i hope i never forget the night

of february 4, 20 07. it was an amazing night in miami, florida as we stepped out into the stadium, the biggest stage in the world. i do not even know how to put into words. over 100 million people tuned in to watch the face-off against the chicago bears. i will never forget two weeks prior, our all-pro kicker telling the team, don't you dare blink at kickoff. already won three super bowls. he had quite the experience. there i was standing on the field between the manning and peyton manning and tony dunn g. and i remembered his words -- don't you dare blink. his hand drops. he releases the players. he puts his foot on the ball. i have never in my life seen so many flashing lights.

it would rival the experience of neil armstrong. it truly felt like i was dancing with the stars. it was the greatest experience of my life. we won the game 29 to 17, and forever i will be able to wear this ring on my finger in remembrance of that game. it was a dream come true. two years later, that dream was shattered. down on ae up face training camp field in georgetown, kentucky, strapped to a board, puts onto an ambulance because of my fifth documented concussion. life,e first time in my my brain became a priority. and the reason why it became a priority was a 29 years old, i started to have memory problems.

mind -- it took losing my mind to care about my mind. my memories began to fade away. one story i have shared is going home to minneapolis and spending time with friends, my wife and i, sitting around the table, and his weddingought up and i said, why was i not able to be there? and i got the strangest look from him. and his wife brought over the photo album from their wedding. page after page. i sang a song at his wedding. and i have no memory of that experience. it is completely gone. then there are behavioral changes. is hearing my five-year-old daughter tell our doctor that ate

times she is afraid of me. father, it puts the idea of the effects of traumatic brain injury on a completely different level. i can't help now but throw myself onto a new target -- numerology. opponent, brain disease, and in particular, traumatic brain injuries and concussions. seen lives ripped apart by brain disease, alzheimer's, epilepsy,s, encephalopathy. can become our new coaches. you can help decide the game strategy, put in the work and research and create policies that can change this nation, connecting people to their most valuable asset -- their mind.

education and awareness. it is changing the nature of a person. it is getting them to truly care so they can take the education and awareness and m clement said because they are passionate about who they are -- implement it because they are passionate about who they are. numerology -- our numerologist's numerologist our create the cradle for our brain. it is time for all of us to realize how special our brains really are. ihave a number of policies would love to share with you and question-and-answer time. thank you. >> thank you, mr. utecht. van landing him. >> thank you, mr. nelson. thank you to the committee for

giving me the opportunity to speak on traumatic brain injury. i am a researcher. with my own experience brain injury. i was not playing football. i was assaulted. i was down in gainesville and a vagrant assaulted me. i had three hemorrhages on my brain. weeks in intensive care and 18 months with amnesia. i was one of the lucky ones. i got my memory back. whatpeople who experience a lot of us have experienced are not that lucky. home to get my phd in neuroscience and focused on research. most of my clinical and recent research over the last 17 years has been focused on traumatic brain injury. i have put the last five years more and to focus on concussions and mild traumatic brain injury. to give you a little bit more background, what causes a concussion is the brains leans

forward, is accelerated, and is against the skull, and it will be kicked back the other way. it goes through this acceleration, deceleration. a lot of people think that the brain is only damaged by hitting the enter part of the skull. actually the brain is sort of like jell-o, and it stretches. the accelerating part of the brain goes faster and it stretches the brain in between. it is that stretching that creates the breakdown in metabolism in the brain. electricity in the brain does not run quite as well as it used to. when we have a concussion, often he will be able to get to the right answer. we are delayed. our thought processes are delayed and getting -- in getting to that answer. i think it is important to note not only are we having concussions in athletics. we mentioned it the -- we

mentioned the elderly. we mentioned the military. we also have a problem with falls in children. we do not want to forget the pediatric population. by midnight tonight, nearly 38 children in this country will die from a traumatic brain injury. folks, a lotthese of these kids will continue to have problems for the rest of their life. it is really important we put focus across the age span, across the lifespan, if you will. if you think about pediatric willatic brain injury, we notice they often take a lot longer to get better after concussion. what may take an adult like myself seven to 10 days to get better, it may take them seven to 10 months. they get behind in school. they do not graduate with their fellow schoolmates. a lot of issues are different and need to be respected when coming up with treatments.

the same goes for the elderly. when we think about sports, we always go to the nfl and professional sports. i think we have an even worse problem in high school athletics. because it is an immature brain. if you do not have a fully developed brain that is injured, it has a harder time recovering. we have a high school player playing football who is to 40 pounds, still big, hit with a tremendous amount of 0 pounds, who is 24 still big, hit with a tremendous amount of force. so, when you have a concussion, most people think you go rest and you just get better. about 20% of people do not get better. they end up with postconcussion

syndrome, which chris alluded to earlier. it takes up to 20 years to get over postconcussion syndrome. we see a lot of sleep difficulties with postconcussion syndrome. if i had a time for every person i knew who had a head injury and sleepeep problems -- and problems, we never recognize that. thoseer put effort into sleep patterns. and that is such a huge part of helping that bring get better. unfortunately, concussions can be difficult to diagnose and treat. every injury can have a different constellation of findings, and these findings can be subtle. the common factor is when folks are injured and they are athletes are in the military, they do not want to tell the truth. they want to intentionally mask it. the same thing goes with an elderly patient. not wanty patient does to lose their independence. they are not engaged and wanting

to give up driving or whatever it may be. the world health organization has stated as the lifespan increases, we are going to see surpass many other diseases as the major cause of death and disability by the year 2020. in conclusion, i would like to transcends generations of populations, from the infant to the elderly. concussion, you are more likely to have two, and so on and so forth. it in my areessional opinion, we dealing with two major research and development issues. first, because concussions are compounding, we need to develop new acute pharmaceutical treatments. we treat everything else with drugs. why don't we put a focus on developing a drug for this condition?

an acute give treatment after concussion, we can reset the brain, curate at that point, and then it is not a compounding issue. you are not more likely to get a second concussion, and so on and so forth. chronicr issue is encephalopathy. these pathologies are being seen down in the spinal cord, leading to lou gehrig's disease or anterior lateral sclerosis. we need to put precedents on developing drugs that can stop this pathology. so, we need to stop concussions in the beginning, prevent it from being compounding, and then we need to put a focus on new drugs that can stop or halt progressions. is developing an .cute treatment for concussion

we will design it as a field deliverable. it will be a nasal inhalant to get more of the drug to the a medic, and ambulance technician, and athletic technician can give it thediately and we can stop consequences and their track. we also looked at be developing steroid drugs this summer which will be focused on alzheimer's disease and lou gehrig's disease area -- neuro trucks. thank you for giving me the time to speak. >> thank you, dr. vanlandingham. issues up deal with here like the cuts to nih and having to restore those. we are very sensitive to what you say. >> [indiscernible] good afternoon. esther chairman, ranking member

collins, distinguish members of the committee -- mr. chairman, ranking member collins, distinguish members of the committee. it is a pleasure to be here today. .y name is dr. robert stern i am a phd at the boston school of medicine. i am the director of the boston university alzheimer's disease center. for the past 25 years, i have been conducting clinical neuroscience research into issues pertaining to the aging brain. in particular, alzheimer's disease. since 20 oh eight, my research is focused on the long-term consequences of repetitive brain trauma and athletes -- in athletes. t.have been studying ce brain a progressive disease that can lead to

dramatic changes in mood, behavior, and cognition, dementia. leading to it is similar to alzheimer's disease, but it is a unique english easily this through postmortem neuropathological examination. orginally called punch drunk dementia appeared to list the listica inentia pugi the early 1900s when it was only got to happen to boxers, it is widespread. it has been found in athletes ranging from football, soccer, and rugby players. for somesuggests, individuals, repetitive impacts to the head trigger a cascade of events that lead to the destruction of brain tissue. these changes in the brain can begin years or even decades after the last trauma -- or

after the end of that blood involvement -- and can lead to memory loss -- or after the end -- andetic involvement can lead to memory loss, depression, rage, suicidality, boop my problems, and, yes, dementia. problems, and, yes, dementia. i have been privileged to interview the family members of former athletes who were after deathth cet with my colleague and her team. from these interviews, i had begun to learn about the clinical course and presentation of this disease, but more importantly, i have learned about the tremendous pain and suffering the family members experienced while their loved by cet.fe was destroyed privilege ofad the

meeting nfl players who have participated in my study. i hear their stories. i speak with their family members. i listen to their fears that they have cet, or that their fellow former football players have or will get the disease. they have all witnessed firsthand the tragic downward , that sadly seems to become an expected consequence of playing the game they love. study isof the detect to develop objective biological test or biomarkers to diagnose cet during life. note, rightparate now, today, in the next half-hour, the first nfl -- former nfl player in our study is going to undergo a very exciting new that scan that is designed to detect the abnormal

protein found in this disease in a human being while they are alive. this afternoon. this will hopefully improve our .bility to diagnose cet and that ability to diagnose cet during life is the next critical step. it will lead to answering important questions about this disease, such as how common is it? what are its risk factors? how can it the prevented? how can we treat it? veryis point we know little about this disease. one thing we do know is that concussions are just the tip of the iceberg. hearing a lot today about concussions. we have been hearing a lot about concussions in sport and the military. the thing i am most concerned about are the things that we referred to as sub concussive blows, or hits to the head that

rattle the brain and likely do the same type of thing that dr. tolandingham has mentioned those neurons, but without causing the same symptoms of concussion. and those can happen many, many more times than anyone ever expects. 1000 to 1500 times in a typical football lineman, perhaps 100 times during heading in a season in soccer. that is what scares me. in order to tackle the complex onue of cet, we must expand issues to detect nero generative disease. we must break down the silos of individual research labs, institutions, and disciplines, and begin to conduct multidisciplinary, collaborative research across research centers, bringing together the scientists, novel

methodologies, and state-of-the-art technology. i fear we have a major public health crisis looming, and we must act now. as you have been hearing, this requires tremendous financial support. and as you know all too well, current nih funding is all too low. i would like to congratulate this committee for leading the effort on increasing nih funding for alzheimer's disease research. however, we must now have additional funding or research ofusing on cet, and because their similarities, new discoveries about cet will expand and inform our knowledge of other degenerative diseases like parkinson's, alzheimer's, and lou gehrig's. favorite pastimes in this country such as football, hockey, and soccer involve blows

brain head, leading to disease. we much learn as much as possible as quickly as possible to determine who may be at risk for cet and develop a method for treating the symptoms of cet. i would like to close by thanking this committee for your commitment to improving the health and well-being of older americans. thank you. >> thank you, dr. stern. senator collins? you, this or chairman. i would like to thank all for witnesses for truly exceptional testimony. wasutecht, your statement so moving and riveting. you mentioned during your comments that when you were strapped to that structure, that was your fifth documented concussion.

what happened after the previous four? ? didyou treated each time you try to conceal that you had such as mr. non, wednesday mentioned? tell us what happened. >> shore. a number of answers -- have a ever concealed i have had a concussion? yes, i have. there is tremendous pressure in sports to continue to play. not only do you not want to let down your teammates, who at the time your family -- who have become your family. you do not want to let down your coaches who have worked countless hours to put together a successful plan, and an injury can remove you from that plan. so, yes, i was put in a position where, i wanted to play. and that pressure kept me from being honest. i regret that.

worse --ussion got each concussion got worse. as the doctors of talked about today. my third concussion was simply a player jumping over me in pursuit of the tackle, as his foot lightly grazed my helmet, and i was knocked unconscious for 20 seconds. i watched the film. i see myself get up and runoff have noideline and i memory. it was the first time i ever experienced amnesia. that was midway in the first quarter against the denver .roncos in december 2007 i don't member anything from that game and so we went to halftime. -- once iy became began experiencing short and long-term memory issues, which led to my final concussion, and eight-month rehabilitation process. each team at that time was set

up differently. for the indianapolis colts, they who was a neurosurgeon one of our team doctors, who treated the players who had concussions. in cincinnati, it was a neuropsychologist who treated players with concussions. is one of the things we have really wanted to change, making sure players are actually seeing a neurologist. those are the experts who can diagnose and manage concussions properly. >> the comments we just heard reminds me of when i first learned about the link between traumatic brain injury and neurodegenerative diseases, and doctor fromith a maine who had a patient come to him, and he was being treated

stressttraumatic syndrome, and the doctor asked if he had ever had a concussion? and it turned out that he had several and cautions and dramatic rain injuries while he traumatic brain injuries when he was in iraq. he was diagnosed with having posttraumatic stress, when in fact he had a tbi. it turned out that the tbi caused him to have a form of epilepsy, which the neurologist then treated him for. is, is itstion to you your experience that patients diseasesodegenerative often have a hard time getting a proper diagnosis? , senator.ou

that is a great question. the answer is, there is no former applets have a very hard time getting the right diagnosis. -- former athletes have a very hard time getting the right diagnosis. new, they are not trained for it in medical school. when we go through our brain bank records, every person wasnosed with cet originally diagnosed with alzheimer's or some similar disease, but until the last couple of years, none were a diagnosis,s meeting many were probably being mistreated. howr. stern eluded to, horrible this diseases for individuals, and especially their families. do a important we at least better job of trying to treat them while they are alive so they can live a better life. for is something i hope myself. i am 35 now.

onset of the symptoms for most people is about 40. it is a ticking clock for me and a lot of people. >> you mentioned that a produals with cet have team, and i know from my work on alzheimer's, that that protein in people with alzheimer's also. i would talking about the same protein? is there a link here? is a wonderful question. it is one of the exciting things about working in this disease. there is a definite link, and yet they are completely distinct. the difference is in alzheimer's disease, there are two proteins that start accumulating in

abnormal fashion, and an abnormal form of those proteins. one is called tau and one is called amyloid. , we do not see vietnam alloyed. and when we do see proteins, it is indifferent kinds of plaques than in alzheimer's. the places where it starts to accumulate is quite distinct from alzheimer's disease. to answer your question, we have cannotrstand that we right now diagnose these neurodegenerative diseases accurately while people are living, including alzheimer's disease. we have been studying alzheimer's disease since 1905 when it was first discovered. and yet we still cannot truly diagnose it during life. fortunately, we are getting very, very close. in parts due to the help this

committee has given to support research. but we still can't do it. with cet, we have only been studying it in depth for five or six years. what we are able to do, and what we're doing with my research right now is exploiting what we have learned with alzheimer's disease to learn about cet. tau now with a developed forlly alzheimer's and other neurodegenerative diseases, we can quickly come to answers about cet. >> thank you. >> is there something we need to be aware of with regard to helping you involving experimentation on living patients? money, money. that is what it comes down to. it is not just the responsibility of the federal government. this needs to be a partnership ,f the federal government

foundations, and the private sector. these types of research studies -- and to answer the questions the right way -- costs tremendous amounts of money. to get to answers quickly, we must have adequate resources to do so. so, yes, indeed, we need intinued assistance increasing the budgets. not just reducing the cuts, but increasing the budgets at the national institutes of health, for neurodegenerative disease research in general, but i would hope for and ask you to start a special line of research for supporting chronic traumatic encephalopathy, so we can understand the distinctions between this disease that may affect countless people in the future and diseases that have already been receiving funding such as alzheimer's disease. suppose senator blumenthal -- >> senator blumenthal?

chairman, formr. holding this important panel. each of you has been extraordinarily insightful, and that is based in part on research that you bring to this to be and just to add chairman from question -- money, money, money is often very importance. it is also how the money is spent. and also, what can be done to prevent cet? one of the areas as education. the corey stringer institute at the university of connecticut, as you know, has released nine recommendations for lessening incidents and reducing long-term effects of dramatic rain injury --traumatic brain injury, and the experience of the states in adopting those recommendations is very, very mixed. connecticut has implemented only

for. most states have implemented even fewer of them. there is a lot of work to be done in educating parents, trainers, but also public officials, as to what can be done. you know, one of the areas of meury that was unknown to concerns respect riding -- horseback riding, which is in fact the leading cause of sports ,elated traumatic brain injury of all recreational sports. think about it. iding is the leading cause. why? a lot of young writers are wearing helmets need a velvet -- s are of young rider wearing helmets made of velvet with no real protection. think of a football player wearing a velvet helmet, nothing

more. i am planning to introduce a measure, which i am naming for a o'donnell,, kristin from connecticut, who was thrown from a horse while riding, suffered a traumatic brain injury, and died the next day. ore one of these traditional velvet caps. her parents had no idea that they were buying a decorative helmet, rather than a real, protective gear. so, the bill i will introduce, the kristin o'donnell equestrian safety helmet act, would require helmets sold in the united states to meet minimum safety standards. i do not want to go too much into detail, because i have limited time, but i want to

, ink you for the support terms of the factual background you have provided for this kind of measure, which i think can be replicated in other sports areas as well, and i'm sure we will be talking about them in the near future. ask mr. nowinski -- you are now 35. your injury occurred when you were 24. how are you feeling now? >> thank you for asking, senator blumenthal. it is up and down. these days, i still get way more headaches than i would like to. right now, i feel pretty good. but, you know, as part of dr. stern's study, i did my annual phone call testing my cognition. there was stuff i was proud of. there is stuff i do not feel so good about. i am happy where i am, but i am

always wary of where i am going. head thatk in the caused your injury was, in a sense, a routine part of the sports? >> it was an accident. we were not supposed to actually do that. just so you know. >> but accidents in that sport frequently occur? of thee sort of part routine? you say in your own words -- but when you are in a contact sport wheret kind, particularly the routine, so to speak, is to actually do damage -- at least fake damage -- to another person, it is easy to make a mistake. just like if you are throwing a fake punch. if you do it the wrong way, it you will hit the person. >> with a real punch. [laughter] have happenedst to you repeatedly before that

when, as you say in your testimony. you suffered repeated blows to the head. of course, the sport and so forth. in your experience, our people and that sport -- i will call it wweort for the moment -- wrestling or similar kinds of this repeatedof impact of the blows that are struck? actually, yes. wwe has become a close partner. we honor them last year because they have become a real leader on this issue. >> and you participate in some of the educational sessions? i go back and train the whole roster. when they get new rosters, i train them before they get into the ring.

they made a unrestricted gift to support our research at boston university. it has been rewarding to see that culture change so quickly. many of my friends are still wrestling there. they are in a much safer place. they have protections in place that will hopefully minimize the risk of long-term damage. >> in terms of the contact sport area -- and any other folks on the panel should feel free to comment as well -- how is the insurance coverage for that sport and others, so far as you know, relating to this kind of injury, which, as you have just , is noty compellingly just a one month or one year recovery period, but it can be used literally a lifetime? difficult to speak to all insurance programs, because i know there have been a lot of changes, especially recently in many sports.

i think you make a good point that this is extraordinarily expensive to deal with these consequences long-term. i can pass that down the panel, but it is a significant issue. quick.ll comment real and we have hmo's in the state of florida that will not even reimburse for a concussion diagnosis. even in the tallahassee area. with othercome up things, like claimed that there is memory impairment, and we get reimbursed based on that code, but there is still not a specific code for multiple hmo's that will reimburse a concussion in the civilian world. >> is that true in medicare as well? >> in medicare, people are fornitely supported dementia-related conditions and weessments, but often what

are seeing with this disease of chronic traumatic encephalopathy is it does not develop exactly the same way as alzheimer's .isease and other dementias there could be mood changes without the memory problem, initially. in those cases, they may be treated as having a psychiatric disease or illness. the funding is quite different in those cases and much more limited. before i return to you, i want to get an understanding of how could concussions have an effect upon lou gehrig's disease? als. that our special guest is with?ed with -- afflicted i want to stress it is not necessarily concussions. it is repetitive brain trauma, including subcontracts of hits,

that does not include being knocked out or having changes in symptoms. it is the little hits over and over again that could start the cascade of changes in the brain cells that lead to the death position of this abnormal tau that leads to the destruction of the brain as people live longer. what we have seen is in some cases, the abnormal tau, and another protein called tdp 43, is not just in the brain of an individual with repetitive brain trauma, but also in the spinal cord. it leads to the same types of alterations in motor functioning, in strength, in weakness, as one would see in run of the mill als. it is not that it leads to the same type of als that might be caused by another underlying factor. it results in the same type of motor neuron disease caused by

repetitive brain trauma, is what we currently think. >> senator, please continue. >> thank you. mr. chairman, you are very, very gracious. i am over my time, out of my time, and i'm going to yield to some of my colleagues in light of the vote we have coming up. >> senator warren. >> thank you very much, mr. chairman, ranking member. there are places like boston university that focus on traumatic brain injury, and have revealed that athletes and veterans with chronic traumatic encephalopathy or cet exhibit structural changes to their brain that are similar to the brains of people with alzheimer's disease. and the patients exhibit similar symptoms. i know we have been talking some about this. but i want to ask the question a little bit differently. we do not know the root causes

of these conditions, because not everyone with a history of head trauma develops cet, and not everyone who develops alzheimer's disease as they age. currently lack effective diagnostic tools or treatments for either disease. so, the question i would like to ask for dr. stern and dr. vanlandingham, how can you use what you learn about traumatic brain injury to inform study about other age-related neurodegenerative diseases. dr. stern? senator warren, thank you for that question. that was the question that got me involved in the study of chronic traumatic encephalopathy. as an alzheimer researcher -- alzheimer's researcher, i was never very interested, except i once was at a lecture and mr. roommate was in the

audience, and it led me to find out about this burgeoning topic of chronic traumatic encephalopathy. and the reason i got involved was for just that reason. it was a close enough cousin to alzheimer's and other diseases that have been studied that we could exploit what we find out about one to learn about the other. and so with chronic traumatic encephalopathy, we know the necessary variable for developing this disease. the necessary variable is repetitive brain trauma. articulately said, that is not the only variable. who hasnow everyone this disease has a history of repetitive brain trauma. by that nature, we are able to then look at a group of people at high risk, very high risk for developing this disease, and study them longitudinally, and

use new tests and follow them until death and have my colleague and other narrow pathologists examine them. that is a very unique thing. in alzheimer's disease, we do not have that ability. we do not know who is at high risk for getting it, until we might be able to do a special kind of pet scan that can test the amount of amyloid in their brain. now we can use both sides of the picture to inform the other and make us get to answers in a much faster fashion. , did younlandingham want to add anything to that? >> i will reiterate, one of the most common questions i get from parents are, when should i make my son or daughter stop playing the sport? how many concussions? and i am like, well, everybody is different. you would like to say after

three, they are predisposed to cet. everybody is different. but i agree with dr. stern, it is a population that can be studied in years to come and you'll get closer to the right answer. i would like to add one comment to the lou gehrig's issue. i do a lot of clinical research with animals. we can give one single concussion to an animal and we protein in theau spinal fluid. that not only bathes the brain, but also the spinal cord. bathing thetely spinal cord after a brain injury. your comments, both of you, dr. stern and dr. vanlandingham, reminds me the wonderful thing about science is discoveries do not occur in isolation, that

what we learn about studying one disease can pay dividends in shedding light on other diseases. the director of the national institute for mental health told the health committee last year that we are on the cusp of a revolution and brain research because of the incredible tools that are now available, that have not been there before. yet at this critical moment, we are cutting back on in age funding. year after year, adjusted for biomedical inflation, and i age from budget has shrunk to the point that we are investing less in research with nih than we were in 2001. let me ask the question this way. if we could double the budgets of your centers, what could you do, and how much faster could you do it? go first?want to >> i will go first. >> you have to show was the aspiration here, dr. stern.

>> with a double budget, we would not just double the speed at which we could answer important questions. it would be an exponential increase. one of the things that has been happening across the nation has been the loss of young investigators and senior investigators. young investigators because there are no jobs for them, because of nih cuts. there are no jobs for young postdoctoral fellows or new researchers trying to get in the an assistant professorship. senior researchers are having to close their labs because for the first time ever, they have no funding. havese of that, we cannot continuity and research. we can have the numbers of people to focus on a particular question at any given time. the startingf

points. why we would be able to have much faster answers. have aad money, we would real meaningful staff to answer the questions. to do would also be able much more with technology. and that is what is so wonderful about doing this type of research in 2014. when senator warren was out, i was mentioning just now, this moment, we are putting one of our former nfl players in a pet scanner to look at how the tau protein is in their brain. it is the first time we're doing it. it is very exciting. to have support for that, to double our budget, to continue that research, not to close it down, we would be able to life very,t during very accurately within the next five years. >> dr. vanlandingham? by saying i work for two different nonprofit

companies, a for-profit company, and i am a professor at an academic institute. there are various thoughts that go through my mind to answer this question. i think if we had funds from the federal government, let's say, that was sponsored private be easier that would for private companies to get investors. it would improve the value to the investor by having federal government support. that is a little out there. the eighth pharmaceutical companies do not do r&d anymore. small pharmaceutical companies are the ones that have to go out there and either raise the money or fight for the grants just to get this to a point where it can go into clinical trials. professors and academic institutes of wonderful ideas, but they hardly ever try to commercialize them, because they do not have the means in which to do that. ,our question on how much money doubling the budget -- for $20 million in a year, i could be in a phase two clinical trial for

concussion, a first drug, if i had $20 million today. >> i appreciate it. ,e talk a lot on this committee for example, about alzheimer's. the alzheimer's association says is our nation continues to age, alzheimer's disease is projected to cost our nation $1.2 trillion by 2050. over and over, we understand the importance of research. not just for people's lives, but the importance in terms of how much money we have to spend to care for people. it clear.t to make we cannot stand by and do nothing. we must increase our federal investment in medical research, not slash it. is our only chance to bring

costs under control and give people a better quality of life. thank you for your work. thank you for being here to raise awareness around this issue. and thank you, mr. chairman, for letting us go over. >> amen to your comments about research. senator -- to squeeze ustry in before we have to go to vote. the vote will be called momentarily, but we do not have to go right at that time, and i will wait until the last possible minute. offer see if i can quickly a number of questions that are left. dr. stern, how does a tbi differ in a military combat injury versus a sports injury echo -- sports injury? >> the brain does not know what is hitting it. however, there is something new that has been occurring in the last 12 years in the military

in iraq and afghanistan, and that is these roadside blast injuries that occur to our servicemen and women. the blast injuries are not a direct hit to the brain or the the blastthrough waves. and often what happens with that type of injury, the person not only has the effect of the blast on their brain and those brain cells, but the person is also thrown and hits their head within their vehicle, on the ground, etc. that is a different type of injury. on ans a double dose individual, who is already been exposed perhaps to similar injuries. but just like the stories you of our football players and other athletes who want to hide their injuries to be able to

help their team be strong, our military personnel to the same, all too often. what we need to do is make sure we reduce the repetitive nature of those types of injuries. the type of injury that one gets, let's say, in a foot all , isium -- football stadium not necessarily going to be that same type of last followed by followed bylast hitting, but it is going to be some kind of impact to those brain cells. the was described early, stretching and sharing of those neurons that lead to this within thosesis nerve cells. it does not matter how the hit happens. the same changes going to occur, leading to the same acute symptoms. >> i want to ask, mr. nowinski , do you have any

observations about player suicide? >> clearly, it is a concern. whether it is in wrestling or in the nfl. last thing you would ever want to see occur. i think at this point, there's just not enough information to be able to say that they are connected. i think that is one more thing wouldunding into research help us to provide, more context between a relationship with depression and traumatic brain injury, but at this point, it is not there yet. when we look at some of these players who have come to this point, it is really hard, i think, to make that connection yet today between traumatic brain injury and suicide. >> thank you for the question, chairman nelson.

is extraordinarily complicated. there are some them -- there are some things we do know. one is a cute traumatic brain risky does increase your of suicide or suicide ideation within the next year from certain studies. we do have in our brain bank some teenagers who have taken hours ofes with in 24 suffering a concussion. there is something going on there. in long-term cases, people suffering from cet, it is hard to know if there suicide was linked to anxiety or depression issues the disease brought on. certainly what is consistent in it hasases is alienated them from their families. they are unable to work. that guilt had some role in their conscious decision to take their lives. but it shows how much this

disease does affect families. toif i could add something that, just talking about the science of it -- suicide is a very complex, very tragic occurrence. but what we do know is they can indeed be to changes of the motion and the changes of impulse control. fose are two of the big thing -- affected by this disease. the amygdala, the home of a emotional regulation. and the bottom parts of the frontal lobe where we control our impulses, where we stop our inappropriate behavior. if you have an individual who sadness ande and emotional this control -- discontrol