Scientific American Mind - Vol. 25 Issue 1 May Dec 19, 2013
By Jacqueline C. Tanaka and Gregg B. Wells
(Partial Article)
The rise of chronic traumatic encephalopathy among some athletes suggests that repeated blows to the head may trigger the brain's unraveling
Repeated traumatic brain injuries increase a person's chances of developing a neurodegenerative disorder called chronic traumatic encephalopathy (CTE).
Players of many sports, but most notably football, appear to be especially vulnerable.
New techniques for observing the disorder's warning signs promise to help coaches and clinicians identify vulnerable players before they fall victim to CTE.
Mike Webster played for 17 seasons in the National Football League (NFL). He was instrumental to the Pittsburgh Steelers' four Super Bowl victories during his career. In 2002 he died of heart failure in the coronary care unit of Allegheny General Hospital at age 50. His medical history included serious neuropsychiatric problems beginning around the time he left the NFL.
After Webster retired at age 38, his family watched him disintegrate into a tormented, wandering soul living out of his Chevrolet S-10 pickup truck. After his death, an astute neuropathologist at the University of Pittsburgh, Bennet Omalu, performed an autopsy on Webster and preserved regions of his brain for later microscopic analysis.
When Omalu examined the specimens, he observed atrophy similar to that seen in Alzheimer's disease patients—but in different areas of the brain. Omalu recognized the abnormalities as chronic traumatic encephalopathy (CTE), a form of brain deterioration previously reported in boxers and associated with the repeated traumatic brain injuries experienced in that sport. The 2005 report that Omalu published on Webster's brain was the first known case of CTE in a professional NFL player.
In the eight years since, the number of reports of the behavioral and cognitive changes experienced by NFL players has exploded. And the athletes themselves have taken notice. When Chicago Bears player Dave Duerson committed suicide in 2011, he shot himself in the chest and left a note requesting that his brain be donated to science. Analyses revealed that he, too, had developed CTE. The year of Duerson's death, approximately 4,500 players sued the NFL for concealing information about the dangers of traumatic brain injuries. Last August the league agreed to an out-of-court settlement for $765 million. Since then, former players have launched new suits against the NFL, the National Collegiate Athletic Association (NCAA) and a helmet manufacturer, Riddell.
The legal furor has been matched by a frenzy of activity on the scientific side. More than 100 NFL players and athletes from other sports have pledged their brains to the study of CTE. So far few of the mysteries of this disorder have been solved, but scientists have nonetheless gleaned compelling insights. Participating in contact sports and sustaining brain trauma raise a person's risk of several forms of cognitive impairment and dementia, not only CTE. Yet the neuropathology of CTE is distinct, and its link to sports raises important questions regarding athletes' safety. Science is progressing rapidly, and its message is clear: to preserve the game and its players, the culture of football must change.