This is a phrase that millions of Americans hear come across their televisions every weekend during football season. Just like the masses, I love sitting down and watching ridiculously fast over-sized men run around a rectangle and hit each other with similar G forces of a severe car crash. The players that play in the NFL are some of the most well compensated professional athletes in the world. However, this is not without its consequences. Chronic traumatic encephalopathy (CTE) is one of the fastest growing concerns of the NFL in recent history. This concern is on the rise because of the exponential increase in the amount of former players being found to have developed the disease. It is believed that this disorder is the result of repetitive brain trauma, or in layman’s terms, concussions.
One of the issues with diagnosing CTE is that it predominately must be done postmortem. During the autopsy of a patient with CTE we notice extensive atrophy of the hippocampus, amygdala, mammillary bodies, and entorhinal cortex. Another sign of CTE is the accumulation of tau protein within the brain. These tau protein accumulations are actually dead neurons within the brain. In addition to the atrophy we can see an overall reduction in the size of the brain. CTE is characterized by an assortment of symptoms including progressive decline in memory and cognition, depression, suicidal behavior, poor impulse control, aggressiveness, dementia, and parkinsonian symptoms. The individuals that we commonly see these symptoms arise in are contact sport athletes such as boxers, football players, professional wrestlers (yes, the WWE is a real sport), etc.
These conditions arising from CTE sound horrible don’t they? However, ponder on this. Who are the individuals that we typically think of as football players/ boxers/ wrestlers? Individuals that do not mind violence and are aggressive by nature. I mean think about it, you are not going to be a good football player if you are not flying to the ball wanting to hit someone. This is where I run into an ethical issue with the employers of these athletes. They are paying their athletes millions of dollars to entertain us yet at the end of it they are doing nothing to protect their former players from this disease.
One example of the extent that this disease can take over the life of an individual is the tragic story of Chris Benoit. For those of you that do not know, Chris Benoit was a world champion wrestler in the WWE in the late 90s and 2000s, and was adored by fans and colleagues for being an outstanding individual. Additionally, Benoit had one of the most insane “finishing” moves in the WWE, the flying headbutt. During the move he would stand on the top rope and jump through the air and headbutt his opponent. However in June of 2007, Chris Benoit, age 40, murdered his seven year old son and wife by asphyxiation shortly before committing suicide by hanging. During an autopsy of Benoit’s brain, researchers found an extensive amount of CTE, especially in the area that controls emotions. Though Benoit’s finishing move we can predict that the amount of impact to his brain was extensive.
Just think, if the effect of repeated brain trauma can turn a normally kind hearted individual into an individual that would murder his own family, what will it do to all of these former football players down the road?
Gross pathology of CTE. Top: Coronal section of a normal human brain. Bottom: Coronal section of a brain from a retired professional football player, showing the
characteristic gross pathology of CTE. Changes noted include severe dilatation of
lateral ventricle (1) and third ventricle (2), cavum septum pellucidum (3), marked
atrophy of the medial temporal lobe structures (4), and shrinkage of the mammillary
bodies (5). Reprinted with permission from Stern et al. 2011 (Stern et al. 2011).
Lakhan and Kirchgessner SpringerPlus 2012 1:2 doi:10.1186/2193-1801-1-2References:
http://www.springerplus.com/content/1/1/2
http://journals.lww.com/neurotodayonline/Fulltext/2007/09180/Brain_Damage_May_Have_Contributed_to_Former.1.aspx
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ReplyDeleteI find this interesting. It is in the media all the time. Just last week, the University of Michigan came under fire for not taking Shane Morris out of the game when he could barely stand up after a hit. The new procedures are supposed to be in place so that after a significant hit, the player sits out to be evaluated by the team physician. In reference to diagnosing CTE, I thought you might find this interesting. Up until now it could only be diagnosed at autopsy, like you mentioned, but now doctors at Mt. Sinai are able to identify the tau proteins while the patient is still alive through a brain scan, allowing them to differentiate between Alzheimer's Disease and CTE. I do not know how the scan specifically works or how they are able to isolate the tau proteins for identification.
ReplyDeleteVideo from CBS News 09/23/14:
http://www.cbsnews.com/news/new-test-to-shed-light-on-football-players-brain-injuries-cte-dementia/
I thought this topic was very interesting! As I love the brain and learning about potential injuries, I noticed that within the last year or so the attention brought to NFL players and brain injuries increased tremendously. When football is talked about, the glorification of the sport and the “right now” mentality comes to mind. I don’t feel people associate the detrimental affects that these players are susceptible to. I saw this article as well from TIME on a study from the nation’s largest brain bank that said, “96% of deceased NFL players’ brains had degenerative disease.” The doctors had also completed research from college and high-school football players, semi-professional, and professional and their incident rates of CTE were 80% (still very high). As we can assume, the longer a football player continues the sport, they have an increased chance of CTE. They did note that since CTE is done postmortem, those players donated their brains to research, as they probably knew they suffered from CTE.
ReplyDeleteNonetheless, the association is still prevalent, linking an aggressive sport like football and increased degenerative brain diseases and at younger ages than the normal population, such as Alzheimer’s (3 in 10 are expected to get this disease). It is also alarming that the judge overseeing the settlement of “$675 million for treatment of former player, $75 million for neurological testing and $10 million for research… expressed concern that the funds might not be sufficient to cover the estimated 6,000 former players who may suffer from brain disorders.” It really makes you think if the years of playing are worth the long-term quality of life.
http://time.com/3450674/nfl-brain-disease/
http://time.com/3342795/nfl-concussions-alzheimers-dementia/