The author’s son was a high school football star in Pennsylvania, and at Dartmouth College who suffered from CTE before he took his own life at the age of 32.
CTE, chronic traumatic encephalopathy, is a brain disease that is degenerative and progressive. It occurs as a result of repeated head impacts.
CTE has been found in people with or without a history of concussions. Concussions may add to the likelihood of getting CTE, but the biggest factor seems to be the length of time exposed to sub-concussive hits. CTE was originally only thought to exist with boxers, but it was later discovered in victims of physical abuse. Now it is being associated with athletes playing contact sports including football, ice hockey, soccer, wrestling, and extreme sports, as well as veterans and military personnel with a history of being exposed to head impacts from training or blasting. But the list can be nearly infinite if you think about repetitive head impacts: cheerleaders, stunt doubles, bull riders, and race car drivers come to mind. One of the largest concerns is the growing discovery of CTE in high school and college athletes – and tragically, even athletes who only played sports at the youth level.
Since the brain doesn’t show pain like an injury anywhere else on the body, the damage of CTE often is done without signs of trouble. Similar to smoking or exposure to cancer-causing substances, the symptoms show much later than when damage is occurring.
The biggest factor for developing CTE seems to be the length of time exposed to repetitive impacts. Science is showing that earlier such impacts start, and the more hits endured, the greater the chances of developing CTE. Children are particularly vulnerable because their brains are still developing.
The brain of a person with CTE gradually deteriorates, and tau proteins begin to become defective and interfere with neuron function. At the current time, CTE can only be verified through autopsy. There is growing consensus among researchers that there will eventually be a clinical diagnosis of CTE, similar to the diagnoses made for other tau-based diseases, such as Alzheimer’s.
A standard CT scan or MRI does not show CTE. But there is progress being made in several areas to be able to detect CTE in the living. Some researchers are creating PET scans, some are trying to use blood tests and spinal taps, and others are looking at blood flow and diffusion tensor imaging.
Right now there are no ways to cure or even stop CTE. However, there is work on the horizon on creating antibodies to fight the misfolded tau. And there is work to stabilize the brain cells to make them impervious to the misfolded tau. But right now, the greatest solution is prevention.
CTE is 100 percent preventable.
We need to limit risk, primarily among our youth.
So far, pathologists looking for CTE have found it in dozens of youth and high school athletes, more than a hundred college players, and hundreds of professional athletes and veterans. We know this is just the tip of the iceberg, though. More and more athletes and veterans are donating their brains for study, and awareness is growing.
In a study conducted a few years ago, the Mayo Clinic in Florida looked at its 2000-plus brain bank. When they looked at the brains of amateur contact sport athletes, they found CTE in about a third of them. Then they researched the brains confirmed to have no history of collision sports. None of those brains had CTE.
Right now in the U.S. we have about 4 million kids and teenagers playing football every year. It is estimated that we have 20 million former high school and college athletes who played sports that involve collisions to the head. If a third of them develop CTE, we could have millions of ex-athletes suffering.
A study released this summer also found CTE indications in brain tissue from blast-exposed military personnel. That study noted that of the troops deployed to Iraq and Afghanistan since 2001, a total of 460,000 veterans could be at risk for CTE. Many scientists believe that many of the veterans being diagnosed with the symptoms of PTSD may actually have CTE. Twenty veterans a day die from suicide.
Because of our heightened awareness, obviously we believe that this is an immense epidemic. It is hidden in plain sight, mainly because the cause is separated from the effect by many, many years. We don’t see this horrific epidemic yet because we aren’t really looking for it.
When you look at the top 10 leading causes of death in our nation, about a third can be attributed in part to CTE (suicides, unintentional death, and degenerative brain type diseases). There are more suicides than homicides each year in this country. We believe the national opioid crisis in can be attributed in part to CTE and brain damage. All over, military veterans and ex-football players that just played in high school and college are committing suicide, dying from overdoses, living in the streets, or committing criminal and irrational acts. One of our campaigns is to get coroners to look for CTE in such instances, but that is not standard practice.
Also, many doctors don’t know much about CTE, the symptoms, and possible treatments, and they treat it like a psychological problem versus a physical problem. When researchers finally have a valid path for diagnosis, the floodgates will open and we will have a huge national crisis.
One CTE foundation gets emails and calls almost daily from families looking for help. And that is just a fraction of what is out there. Families are burying loved ones all over this country thinking they died from suicide, drug addictions, PTSD, depression, ADHD, and irrational behaviors, and often they think that somehow something happened to change the person they loved, and feeling somehow that they failed them. Very few are linking these deaths to CTE. Maybe they don’t know to ask. Maybe a doctor misdiagnosed the patient. Maybe the coroner is rushing to judgment. Maybe the behaviors in their loved ones changed so slowly that no one linked it to previous military or sports history from many years ago. Whatever the reasons, the silent epidemic continues. And we believe the magnitude of this horrific disease has yet to be fully discovered.