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Aaron Hernandez, the former tight end for the New England Patriots, who tragically ended his own life earlier this year while serving a life sentence for murder, has become the most recent football player publicly diagnosed with chronic traumatic encephalopathy (CTE). This neurodegenerative disease is associated with symptoms such as depression, aggression, and impaired impulse control.
What Triggers CTE?
A single violent blow to the head can cause an immediate brain injury, usually in the form of a concussion. However, repeated head trauma over many years seems to be the key factor in the development of CTE.
As described by the Concussion Legacy Foundation,
This doesn’t refer to just a few concussions: most individuals diagnosed with CTE have experienced hundreds or even thousands of head impacts over many years, whether from playing contact sports or serving in the military. And it’s not only concussions that contribute; current evidence points to sub-concussive impacts—those that don’t lead to full-blown concussions—as the primary cause of the condition.
What Changes Occur in the Brain with CTE?
The brains of individuals with CTE display overall shrinkage, particularly in areas like the medial temporal lobe, which is involved in memory. Additionally, certain regions show deposits of tau protein. While tau is present in all of us, in CTE, it forms tangled fibers, similar to what’s seen in other neurodegenerative diseases, such as Alzheimer’s. Researchers are still investigating how these tangles form and how they relate to the symptoms exhibited by living individuals.
CTE Progresses Through Four Distinct Stages
Stage 1: Headaches, difficulty focusing.
Stage 2: Depression, mood swings, memory difficulties.
Stage 3: Worsening memory loss, irritability, and aggression. In a study, 75% of individuals at this stage showed significant cognitive impairment.
Stage 4: Severe cognitive decline, memory loss, dementia. A Parkinson’s-like syndrome may also affect movement.
Does Every Football Player Develop CTE?
No, not every player. CTE has also been found in other groups, such as military veterans, boxers, and abuse survivors. Players with longer careers in football or those who start playing contact sports at a younger age appear to be at higher risk for developing CTE.
If you're interested in specific individuals, Wikipedia maintains a current list of NFL players diagnosed or suspected of having CTE.
How Can I Tell If I Have CTE?
At present, CTE can only be definitively diagnosed after death, by examining the brain, meaning a clear diagnosis can't be made while someone is still alive. Some football players exhibiting symptoms similar to CTE have been diagnosed with amyotrophic lateral sclerosis (ALS), and CTE symptoms can overlap with other brain-related conditions. Researchers are working on ways to diagnose and treat it, but for now, there is no specific treatment available for CTE.
If you're experiencing symptoms like depression, memory loss, or difficulty controlling impulses, it’s important to seek treatment. However, understand that healthcare providers will likely first explore other possible causes for these symptoms, as there is no specific treatment for CTE (at least not yet). For instance, if you are feeling depressed, the treatment you receive may be the same as someone without a history of head trauma.
If possible, consider seeing a specialist who is knowledgeable about CTE. There is also a CTE diagnosis research program that is enrolling both NFL and college football players. Additionally, if you're interested in contributing to CTE research after your passing, you can look into Boston University’s brain donation program.
