dr. mckee, can you tell us what the evidence shows thus far in terms of the effect of the hits on the brain and have some subcon cusssive hits in the absence of a concussion diagnose been linked? >> absolutely. sub con "s or just exposure to repetitive impacts that is usually measured in exposure years to the sport, the length of a playing career of the football player or hockey player, that has been significantly associated with long-term cognitive impairment, april pa thee and depression, not cte, because those are living individuals. we've seen it in our brain autopsy series where the longer a football player plays, the higher the risk for cte. we know in high school athletes, if you follow them for a single season in football, hockey and soccer, in the absence of a con kks, you will see mri evidence of brain diagnose at the end of that season, not related to concussion because none of them had a concussion, that's the sub injury stained by those amateur high school athletes in a single seas

dr. mckee, who we will hear from today, was at that round table. representatives frank pallone, and i have been pressing the national hockey league to do more to reduce risk of head injuries. mma is the latest sport where cte is an issue. we have seen some progress at the state level already. new york state included a provision in its mma legislation that recognizes the risk of brain trauma and requires mma promoters to carry insurance to cover treatment of life-threatening brain injuries. if, knowing the risks, adults adults still want to be part of mma fights that is all right. , but fighters and promotions should take some basic precautions and fighters issued have the leverage to stand up for their own safety. dr. mckee has written testimony and she provides some recommendations on the risk of brain injuries in mma. we also need to support further research on the connection between cte and contacts for -- contact sports so adults know , the risk. research is especially critical given the ri

dr. mckee, who we will hear from today, was at that round table. representatives and i have been pressing the national hockey league to do more to reduce risk of head injuries. mma is the latest sport where cte is an issue. we have seen some progress at the state level. new york state, included a provision in its mma legislation that recognizes the risk of brain trauma and requires mma promoters to carry insurance to cover treatment of life-threatening brain injuries. ifingi the risks, fighters should have the leverage to stand up for their own safety. dr. mckee's written testimony, she provides some recommendations on the risk of brain injuries and mma, how they can be reduced. we also need to support further research on the connection between cte and contact sports so that adults know the risk. research is especially critical given the risk to young athletes. according to espn, enestimate d 3.2 million kids perhaps in mma. kids can start classes as early as 6 years old. some leagues ban head

chair recognizes dr. mckee, five minutes for your opening state, please. >> kbl chairman and members of the committee, thank you for the invitation to testify. my name is dr. ann mckee, professor of neurrolly and pathology at the boston university school of medicine. and i'm director of the cte center at boston university. my testimony today reflects my personal professional opinion. i am not speaking officially on behalf of the department of the veterans affairs or boston university school of medicine. cte, or chronic traumatic even accept lop thee is a major problem. such as boxing and football and any other sport that involves a high number of head i am in facts such as mixed martial arts. even though not much research available, we knew it has a high concussion rate and importantly it has a high sub con cusssive impact rate. it is triggered by repetitive head trauma that causes buildup of a protein in the brain. the abnormal protein is toxic to nerve cells. symptoms of cte include memory loss, confusion, im

dr. mckee. five minutes, please. >> mr. chairman and members of the committee, thank you for the invitation today to testify on mixed martial arts issues and perspective. i'm a professor of neurology and pathology. i am chief of the neuropathology service for the va boston health care system and i'm director of the cte center at boston university. my testimony today reflects my my personal, professional opinion. i'm not speaking officially on behalf of the department of veterans affairs or boston university school of medicine. encephalopathy is a major problem in contact sports. such as boxing and football and any other sport that involves a high number of head impacts such as mixed martial arts. even though there is not much research available on the long-term consequences of mma, we know it has a high concussion rate and importantly it has a high substance of the -- high sub concussive impact rate. it's a neurodegenerative disease triggered by repetitive head trauma that causes buildup of an

dr. mckee? >> they can always be prepared and with the head year bleak could he do is considerably the injury with head gear. >> my time has run out. but i need to ask this whole notion of the independent sanctioning is that something that the commissioners have looked at the person who promotes the athlete should not then be controlling the endorsements of that matches could. >> that was set forth with the muhammed all react and it did not require this is something that we favor? i believe in person personally that the muhammed ali act did enhance exploitation of the contract also graced the - - greatly reduced the number of events. >> but talk about the difficulty of earning 11 win even star restricted so the of limitation on your endorsements is a significant impediment. >> that goes hand-in-hand with us power in basic monopoly they have of the sport because they can set their own rankings which it is done in n boxing and that is why we want to have that expanded to include combative sports a