It's easy enough to shake off a mild concussion if you're a serious athlete; for football players in the National Football League (NFL), getting knocked around is practically part of the job description. But unbeknownst to professional, collegiate and even high school players at the time of injury, these athletes may be incurring long−term neurological damage.
Brought to light in a Feb. 19 New York Times article, Dave Duerson, a retired Chicago Bears defensive back, committed suicide on Feb. 17, but not before he asked that his brain be studied post−mortem. Duerson seemed to believe that he was suffering from chronic traumatic encephalopathy (CTE), a degenerative brain disease that manifests in dementia−related symptoms, including depression and aggression. Duerson's family contacted Boston University's Center for the Study of Traumatic Encephalopathy (BUCSTE).
CTE can only be confirmed post−mortem due to the fact that it involves extensive staining of brain slices, and it takes several months to complete the process, according to Christine Baugh, the research coordinator for BUCSTE. Thirteen out of the 14 deceased NFL players whose brains have already been studied by Boston University researchers have been found to have suffered from CTE.
"The main thing that we know [about CTE] is that it is caused by repetitive brain trauma," Baugh told the Daily. "Although repetitive brain trauma is necessary, it is not sufficient — there are other things involved as well. We have a lot to learn. Other critical components are genetics, age, types of hits and time between them."
While the disease itself is not necessarily fatal, sometimes the impulsivity problems will lead people to behaviors that they would not otherwise have, raising the risk of suicide, according to Baugh. As CTE is a progressive neurological disease with no known cure, symptoms will only worsen with time.
"Every case is a little different," Baugh said. "The main symptoms we see in people with CTE — diagnosed after death, which is all we can do at this point — are impulsivity, a short fuse, depression, increased irritability, memory problems, cognitive deficits, changes in personality and behavior and, depending on age and duration, finally full−blown dementia."
When head injuries are so commonplace in a sport, it can often be difficult to link later behavioral changes and mental deficits to an incident that was shaken off and forgotten, Professor of Psychology Robin Kanarek said.
"One of the problems with [CTE] is that you have something that occurs with someone when they're older, and you're trying to connect it with something that happened when they were younger," Kanarek said. "If you think about the brain, it makes sense: As we get older, we lose nerve cells anyway, and if you've got damage early on, you may not see it … and it's not until later when the cells start dying that you've got deficits."
While it may seem easy to classify CTE as a disease that can only hit NFL−caliber athletes, this couldn't be further from the truth. Baugh said.
"We don't know necessarily how many hits or what kind of hits or what age, but we do know that CTE can start early. It was found in an 18 −year−old and a 21−year−old athlete, the captain of the football team at [the University of Pennsylvania] who passed [away] recently," she said. "These repetitive hits to the head are a casual thing, but any athlete who is incurring hits to the head is putting themselves at an increased risk, from the youth level to the high school level and beyond."
Boxing is the sport perhaps best known to lead to neurological damage, but the real surprise, Kanarek said, is that CTE can develop with a much lower level of damage.
"The concept of being ‘punch drunk,' fighters taking so many punches to the head is [familiar]," Kanarek said. "I don't think that [most people] realize that it's extending down to college and even high school athletes — I think that's where the new information really is."
Sophomore Sam Stone, who is a center on Tufts' football team, has been playing the sport since eighth grade, though his injuries have not proven particularly severe.
"I've gotten two concussions," Stone said. "They were both pretty mild, though … both happened during practice. One was from the whiplash of tackling somebody, the other I just went head−to−head with somebody."
Stone said that both of his concussions occurred during high school and that Tufts' Athletics Department has provided necessary provisions and education to prevent and treat injuries.
"Recently the school's done a better job in teaching kids how not to tackle," he said. "We started doing these concussion tests in the beginning of the year that all freshmen have to do. It tests your memory and establishes a baseline so that if you do get a concussion, they can tell right away."
Though he is aware of football's inherent danger, Stone doesn't let the threat of brain trauma affect his attitude on the field, he said.
"I do think that the consequences of these injuries that I've sustained are on the back of a lot of people's minds," he said. "It's not something that [I] dwell on too much though, because there are so many other things to worry about, too."
Despite researchers' progress on uncovering the details of the disease, Baugh stressed that the research on CTE is still in its early stages.
"We're fortunate that word got out fairly quickly about our initial findings, and we're now trying to find out more about the intricacies, [like the] genetic components," Baugh said. "There's a lot more that we can still learn. … We want everybody to be able to play whatever sport they want to, but we want them to play it safely."
Duerson's last wish to donate his brain to research may help to increase the awareness of the sporting community, though even before the athlete took his life, measures were already being implemented on a national level to protect athletes.
"I think that not long ago, a concussion was something that people would just shake off and not think about too much, and I think that is changing drastically," Baugh said. "Changes in [national] legislation [have been made] to protect youth athletes by not allowing them to play after they're been concussed, and the NFL started penalizing brutal hits and put up posters in the locker rooms."
