CTE: The NFL’s Headache

So, as promised, I’ve done some more research on chronic traumatic encephalopathy, (I can pronounce it now!), or CTE, and concussions in general, and I think I have a more accurate mental picture of the head trauma issue in football.

Before I begin, I must say that there is one huge obfuscating factor in the whole business - the topic of long-term brain damage in football is a very political one. (This was my big takeaway from Mark Fainaru-Wada and Steve Fainaru’s League of Denial.) On one hand, there are the giant professional leagues, collegiate leagues, all associated networks, etc., standing to lose mounds of money. On the other hand, there are opportunistic scientists and investigative media – mostly the latter - looking to capitalize on the concussion media craze.

So what is CTE? CTE is a long-term degenerative brain disease that affects cognition, mood and behavior, and progresses toward dementia. It was first known as dementia pugilistica, because it had only been observed in boxers. Later, when it became clear that the condition was present in individuals outside of the boxing community, the term “chronic traumatic encephalopathy” was adopted. In addition to boxers, CTE has been found in football players, hockey players and professional wrestlers.

Although the direct linkage between traumatic brain injury and CTE has not been discovered, everyone who has been diagnosed with CTE has had a history of repetitive head trauma. Fortunately for people with a history of concussions or who play contact sports, CTE is not present in all with a history of repetitive head trauma. People with CTE also usually have been exposed to repetitive head trauma for a long period of time, so it is very rare to find the disease in high school or college athletes*.

NFL players, who may play football for up to a quarter century, are at a much higher risk. However, since diagnosis requires special testing of the brain of a deceased person (which requires consent of the player or immediate family), fewer than a hundred former NFL players have been tested, and most of them were already expected to have CTE. Consequently, the incidence of CTE in NFL players is unknown. Many NFL players appear to be – and likely are – CTE-free.

Though CTE is in many ways similar to Alzheimer disease, it usually affects its victims much earlier. The symptoms of CTE typically set in during a person’s forties or fifties. In the early symptomatic stages of CTE, a person will begin to have problems with short-term memory, impulsive behavior, depression, and apathy, among other symptoms. As time goes on, symptoms will gradually progress to the point where the affected individual is prone to violent outbursts, has difficulty with executive function (planning, multitasking, using judgment), and everyday tasks such as finding the grocery store, expressing complete thoughts, and walking. Suicidal thoughts and behaviors, as well as drug abuse, are also relatively common. These later symptoms tend to severely inhibit the ability to function normally in social and occupational settings. Prominent players who have tested positive for CTE include Junior Seau, Mike Webster and Dave Duerson. Seau and Duerson both committed suicide.

I could probably bore you with some more details, but these are the essentials of what I’ve learned about CTE. I wish I could tell you everything I’ve learned, not only about CTE, but also about concussions, second impact syndrome, and traumatic brain injury… Oh wait, I can! Come to my presentation, eh?

*This is because of the shorter length of amateur athletes’ careers, not because brain injuries have a lesser effect on younger people. Research indicates that younger people are more prone than older people to traumatic brain injury.

~Jared