Earlier this month, the senior vice president of the National Football League’s health and safety policy spoke at a hearing in Washington, D.C., where he was asked if there is a link between football and chronic traumatic encephalopathy, or CTE. Jeff Miller replied, “The answer to that is certainly, yes,” moving the ball down the field in a longtime debate among independent researchers, former athletes, and the NFL.
Alongside Miller stood Dana Alliance member Ann McKee, M.D., whose latest study was just referenced in a story on CTE in the New York Times on Sunday, March 27. At the hearing, McKee presented findings from her ongoing research on the relationships between traumatic brain injury, neurodegenerative disease, and contact sports. As director of the Brain Bank for Boston University’s Center for the Study of Traumatic Encephalopathy, she has been making headlines over the past several years for revealing that “deceased athletes, including at least 90 former NFL players, were found to have had [CTE].”
While the NFL’s recent acknowledgment is a step forward (after years of denying any scientific studies pointing to the connection), the larger issue rests in the hands of scientists, such as McKee, who are working to identify the risk and susceptibility of athletes, veterans, or anyone prone to repeated head trauma.
As of now, CTE can only be detected after death, leaving researchers with a small frame of reference for their studies. McKee told the New York Times that because the brains were donated to the center by families of athletes who already showed symptoms of severe brain injury, “We can’t say from this sample whether the rate of CTE in pro players is 1 percent or what; we have no idea.”
McKee’s lab has accumulated the largest CTE brain bank in the world, including former NFL All-Stars such as Lou Creekmur and Dave Duerson. Her team determined four pathological stages that reveal themselves as psychological problems (e.g. depression, explosive anger) before leading to the diagnosis of CTE. While it remains a preliminary component, co-founder and executive director of the Concussion Legacy Foundation (formerly the Sports Legacy Institute) Chris Nowinski is hopeful that this discovery “should allow CTE to soon be diagnosed in living people.” Nowinski, a former Harvard University football player and professional wrestler, decided to focus on helping CTE researchers in 2007 after he sought medical advice for his own post-concussion symptoms.
In 2013, Nowinski, on the recommendation of McKee, wrote an article for our research-based Cerebrum journal. “Hit Parade: The Future of the Sports Concussion Crisis” was published at the start of the legal battle between former NFL players and the league for “allegedly misleading them about the risks of brain injury.” Nowinski has worked with McKee to help collect more than 100 brains from athletes that aided in the investigation to identify a crucial marker of neurodegenerative disease in dozens of them. Three years later, the NFL has now acknowledged the scientific evidence, and CTE researchers are gradually using advances in imaging to find answers that may lead to a better understanding of the disease’s risk factors.
The next step is to develop methods of diagnosing CTE in living people. Scientists are using a variety of tests, including MRI scans, blood tests, and measures of proteins in spinal fluid, as well as cognitive and genetic assessments, in hopes of a major breakthrough that would inevitably change the future of sports and concussion awareness. A major funding milestone took place in December 2015 when DETECT (Diagnosing and Evaluating Traumatic Encephalopathy Using Clinical Tests) at Boston University’s CTE Center became the first project study to be funded by the National Institutes of Health.
– Seimi Rurup