Keeping Score

CTE Detected in Living Ex–NFL Players; Junior Seau’s Family Sues: What Now for Football and Concussions?

While the NFL faces more litigation, a breakthrough could help manage head trauma

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Junior Seau during Super Bowl XLII in Arizona on Feb. 3, 2008.

The latest head-trauma news in football is decidedly mixed: not good, but now there’s at least some hope for improvement.

First, the bad parts: the family of Junior Seau, the former All-Pro football player who committed suicide in May — and was subsequently diagnosed with chronic traumatic encephalopathy (CTE), the degenerative brain disease associated with head trauma in football — has joined a class action against the NFL. Some 4,000 ex-players and about 2,000 spouses, family members and other representatives have joined the suit, which alleges that the league knew about the high risks of concussions and other head trauma for decades but did nothing to combat the problem and even glorified violence. The Seau suit notes that ”in 1993’s ‘NFL Rocks,’ Junior Seau offered his opinion on the measure of a punishing hit: ‘If I can feel some dizziness, I know that guy is feeling double [that].” In a statement released to the AP, the Seau family said, “While Junior always expected to have aches and pains from his playing days, none of us ever fathomed that he would suffer a debilitating brain disease that would cause him to leave us too soon. We know this lawsuit will not bring back Junior. But it will send a message that the NFL needs to care for its former players, acknowledge its decades of deception on the issue of head injuries and player safety, and make the game safer for future generations.”

The NFL has consistently denied the merits of these suits.

In a paper published in the American Journal of Geriatric Psychiatry, researchers found five additional former NFL players whose brains showed a buildup of tau protein consistent with those diagnosed with CTE postmortem. All these players had suffered at least one known concussion during their playing careers; one player said he had 20 concussions. Each of the players had experienced typical CTE symptoms like memory impairment and depression.

The good news: these players are still living.

(MORE: Will Junior Seau’s CTE Diagnosis Cause More Players to Sue the NFL?)

Previously, CTE could only be diagnosed postmortem, in a brain autopsy. But scientists at UCLA have developed a method to detect tau protein in living brains through a PET scan. Their proprietary compound, 2-(1-{6-[2-[f-18]fluoroethyl)(methyl)amino]-2-naphthyl}malononitrile — or FDDNP — attaches itself to tau. So they injected the five ex-players — and five control-group volunteers, who had similar ages, body types, educational histories and family history of dementia as the players but hadn’t banged heads nearly as much — with FDDNP. A radioactive molecule attached to the chemical allowed imaging technology to read where the FDDNP was clinging to tau.

The results were striking. Each ex–NFL player had markedly higher tau levels than the control group. And the patterns of tau deposits were consistent with those seen in the autopsies of deceased NFL players diagnosed with CTE. One player, a 73-year-old former offensive lineman with dementia and depression who had 20 concussions, had a particularly dense deposit of tau in his brain. One of the players in the study, 65-year-old former backup quarterback Wayne Clark, told ESPN.com that he wasn’t “suffering from any real symptoms at this point, and didn’t have any sense of anything going on except normal age-related issues.” (According to the study, Clark showed signs of  “age-consistent memory impairment” and “experienced momentary loss of consciousness and 24-hour amnesia following one concussion.”) Another player in the study, former Minnesota Vikings linebacker Fred McNeill, 60, has become “afflicted by early-onset dementia,” according to ESPN.com. The other three players have not been publicly identified.

Being able to detect signs of CTE in living people — and help them manage future head exposure and get access to proper psychotherapy, antidepression medications and such — is what Dr. Julian Bailes, a prominent CTE and concussion researcher and a co-author of this study, calls “the holy grail” of head-trauma studies. “It gives us a chance to intervene,” Bailes says. But he’s quick to emphasize that the study doesn’t get us there yet. “It’s the first step, the first glimpse, the first hope,” says Bailes, chairman of the department of neurosurgery at NorthShore University HealthSystem, in the Chicago area.

The authors are up-front about the study’s limitations, especially the small sample size of players and the “lack of autopsy confirmation” that these players in fact have CTE. Plus, this scan for now is not easily accessible. As a parent of a young football player or the spouse of a current NFL star, you might read this and scream, “Sign me up!” You’d want to know if your loved one shows signs of CTE. So where would you go? “Right now,” says Dr. Gary Small, a professor of psychiatry and biobehavioral sciences at UCLA and the lead author of the study, “you’d pretty much have to be part of a research study.” Small says that since the release of the paper, ex-players have contacted him and volunteered for future research.

Small says this scan costs about $5,000 for one person. Further, this particular test can be done only at UCLA: the compound has not been commercialized yet, and that can take years. (Small says it’s being working on.) That’s not to say that, in theory at least, a concerned NFL team couldn’t offer to send its players to UCLA and pay for PET scans. Would any team — or the league — take that step forward, in the interest of protecting player health?

Even if more players and former players get such scans, the result may not provide definitive answers. What if, say, a college-aged player shows some tau in his brain: Is there a certain threshold level of tau at which he should quit playing football right away? Does some level of tau in a player’s younger years predict more tau down the road? These questions will take years of longitudinal study to answer.

Still, the study is a significant breakthrough. There’s a path toward early CTE detection in living people. “Trying to protect a healthy brain,” says Small, “is a more reasonable strategy than trying to repair a damaged one.”

(MORE: Study Details How Brain Injury from Concussions Progresses)


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