Chronic traumatic encephalopathy, or CTE, is a major point of contention among sports fans. And a new CTE study, covered by The New York Times, is only going to add fuel to the fire. Contact sports like football, it turns out, may be more dangerous to your brain the longer you play, but that’s only the beginning. The study opens the door to a much broader, and more worrying, set of questions about CTE. In short, the more shots you take to the head, and the more repeated they are, the more danger you’re in. But does that just apply to football players? Or does it apply to all of us across the long term? In other words, are we all potentially at risk?
It’s important, first, to understand what CTE is. CTE is a neurodegenerative disease which belongs to the same family as Alzheimer’s. Unlike Alzheimer’s, CTE results from repeated trauma to the brain, which causes the organ to lose mass while building up an abnormal protein called tau. As mass declines, it begins to affect behavior — emotional outbursts, memory loss, poor judgement — before leading to more serious problems, including dementia. The brain, for lack of a better description, decays inside the skull.
CTE isn’t just caused by massive, head-shaking hits, either. Players who experience head collisions that don’t cause concussions aren’t immune. Even when not concussive, head injuries add up over time and contribute to CTE. Worse, CTE is impossible to diagnose without an autopsy, meaning there’s no treatment. And that’s why this study isn’t just important, it’s potentially life-saving.
CTE expert Dr. Ann McKee looked at 202 brains of football players, including 111 brains from former NFL players, over the course of the study. Of the NFL players, 110 showed signs of CTE. When McKee looked at all the brains in the study, which included Canadian Football League players, semi-pro players, and college and high school players. 87% of the brains showed at least a mild case of CTE:
Among 202 deceased former football players (median age at death, 66 years [interquartile range, 47-76 years]), CTE was neuropathologically diagnosed in 177 players (87%; median age at death, 67 years [interquartile range, 52-77 years]; mean years of football participation, 15.1 [SD, 5.2]), including 0 of 2 pre–high school, 3 of 14 high school (21%), 48 of 53 college (91%), 9 of 14 semiprofessional (64%), 7 of 8 Canadian Football League (88%), and 110 of 111 National Football League (99%) players. Neuropathological severity of CTE was distributed across the highest level of play, with all 3 former high school players having mild pathology and the majority of former college (27 [56%]), semiprofessional (5 [56%]), and professional (101 [86%]) players having severe pathology.
In other words, the longer one played football or engaged in any activity in which resulted in repeated head injury (even mild injury), the more advanced CTE was found. This stood out in particular in the tragic case of 27-year-old NFL player Tyler Sash, who died from an overdose of painkillers:
Despite Sash’s young age, his family requested that his brain be examined for C.T.E. because he was showing uncharacteristic signs of confusion, memory loss and fits of anger. Their suspicions were confirmed. Dr. McKee said at the time that: “Even though he was only 27, he played 16 years of football, and we’re finding over and over that it’s the duration of exposure to football that gives you a high risk for C.T.E. Certainly, 16 years is a high exposure.”
This raises some serious and troubling questions about contact sports — not just football, but everything from football to hockey to MMA. McKee has found CTE in even junior hockey players. Since the symptoms only manifest years after the player leaves the field or the ring, it seems, essentially, a crapshoot. Players are, in slow motion, gambling with their lives every time they suit up. There’s no way to know whether they have CTE, whether they may develop it, and how advanced their cases might be until they’re dead, and even then, only if their brains are donated to science. The early signs of CTE, like memory loss, attention deficits, and headaches, don’t offer any clear direction for players, coaches, or for that matter the rest of us. Even Sash’s parents only had a suspicion CTE was involved in his emotional problems later in life, something McKee’s study confirmed for them.