C.T.E.

September 22, 2017


Portions of this post are taken from the New York Times, By KEN BELSON SEPT. 21, 2017.

There has been a great deal of discussion in this country about the effect of “impact sports” on cogitative ability.  From the NYTs article highlighted below, you can see the possible implications from repetitive concussions received during a very short time in the NFL.

The brain scan came as a surprise even to researchers who for years have been studying the relationship between brain disease and deaths of professional football players.

Aaron Hernandez, the former New England Patriots tight end and a convicted murderer, was 27 when he committed suicide in April. Yet a posthumous examination of his brain showed he had such a severe form of the degenerative brain disease C.T.E. that the damage was akin to that of players well into their 60s. 

C.T.E., or chronic traumatic encephalopathy, has been found in more than one hundred (100) former N.F.L. players, some of whom committed suicide, according to researchers at Boston University.

Yet the results of the study of Mr. Hernandez’s brain are adding another dimension to his meteoric rise and fall that could raise questions about the root of his erratic, violent behavior and lead to a potentially tangled legal fight with the N.F.L., the most powerful sports league in the United States.

WHAT IS C.T.E.
Chronic Traumatic Encephalopathy (CTE) is a degenerative brain disease found in athletes, military veterans, and others with a history of repetitive brain trauma. In CTE, a protein called Tau forms clumps that slowly spread throughout the brain, killing brain cells. CTE has been seen in people as young as seventeen (17) years of age, but symptoms do not generally begin appearing until years after the onset of head impacts.  If a picture is worth a thousand words, we can see the effects of CTE with the image below:

As you can certainly see, there is a tremendous difference between the appearance of a healthy brain on the left and a brain ravaged by CTE on the right.

Early symptoms of CTE usually appear in a patient’s late twenties (20s) or thirties (30s), and affect a patient’s mood and behavior. Some common changes seen include impulse control problems, aggression, depression, and paranoia.

As the disease progresses, some patients may experience problems with thinking and memory, including memory loss, confusion, impaired judgment, and eventually progressive dementia. Cognitive symptoms tend to appear later than mood and behavioral symptoms, and generally first appear in a patient’s forties (40s) or fifties (50s). Patients may exhibit one or both symptom clusters. In some cases, symptoms worsen with time (even if the patient suffers no additional head impacts). In other cases, symptoms may be stable for years before worsening.

The best available evidence tells us that CTE is caused by repetitive hits to the head sustained over a period of years. This doesn’t mean a handful of concussions: most people diagnosed with CTE suffered hundreds or thousands of head impacts over the course of many years playing contact sports or serving in the military. And it’s not just concussions: the best available evidence points towards sub-concussive impacts, or hits to the head that don’t cause full-blown concussions, as the biggest factor. With that being the case, just who is at risk.  The chart below will give some idea.

SYMPTOMS OF C.T.E.:

Early symptoms of CTE usually appear in a patient’s late twenties (20s) or thirties (30s), and affect a patient’s mood and behavior. Some common changes seen include impulse control problems, aggression, depression, and paranoia. A short list is as follows:

  • Difficulty thinking (cognitive impairment). This might be in the form of confusion or significant delays in taking action.
  • Impulsive behavior. This impulsive behavior is generally “new” to the individual and does not represent normal behavior
  • Depression or apathy.
  • Short-term memory loss. This is continuous short-term memory loss and much more significant that forgetfulness.
  • Difficulty planning and carrying out tasks (executive function)
  • Emotional instability. Emotional instability and impulsive behavior and different reactions to a set of circumstances. You may look at the clinical differences.
  • Substance abuse.
  • Suicidal thoughts or behavior. This is exactly what happened to Aaron Hernandez.  CTE and being locked up 24/7 probably caused feelings of hopelessness.

CONCLUSIONS:

I remember as a kid just about getting down on one knee asking my mom to allow me to play football.  There was a real battle in our house over that.  I was instructed to bring home the equipment I drew from the football inventory so mom and dad could take a look.   We immediately went to Martin-Thompson Sporting Goods to buy me a new helmet with a proper face mask.  Even back in the early sixties head trauma was an issue and every parent knew what could happen.  Equipment improves but so does the size of the players.  STILL A PROBLEM.

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