Paul Oliver, Andre Walters, David Duerson, Junior Seau, Ray Easterling, Shane Dorness and Terri Long have three things in common. They are all former NFL players, they all have taken their own lives and they all suffered from chronic traumatic encephalopathy (CTE). CTE is caused by repetitive traumatic brain injuries (TBIs) and usually does not start to appear until after the athlete’s sports career has come to a close. Unfortunately there are no accepted guidelines for a clinical diagnosis of it.
When the brain is jarred, for example due to a big hit to the head during a football game, there is a stretching and overall disruption of neuronal and axonal cell membranes. Once this occurs, there is an influx of potassium and calcium ions across the membranes, eventually leading to an increased release of neurotransmitters. The brain tries very hard to keep itself in equilibrium by turning on different pumps in the cell membrane to try and restore itself. This activity takes up a lot of energy so the cell must produce large amounts of it. Picture having to turn on the heat in the house when it gets cold outside. As it gets colder, it takes more energy to keep the house at the temperature desired. This cascade of events ultimately causes the cells to go into a state of hyper metabolism. Protein plaques and neurofibrillary tangles can form, cell to cell communication can be at a loss and worst-case scenario, cell death can occur.
It is said that 3 in 10 ex-NFL players will face some type of neurological problem including but not limited to CTE, Alzheimer’s disease or dementia. So what is being done? For starters with regards to the NFL, the organization has proposed a $765 million settlement for ex-players over concussion-related injuries. But is money enough to cover chronic memory loss, the inability to sleep, personality changes or even suicide?
TBIs, especially concussions in football players, have been of high priority and discussion in recent years and at this point in time there seems to be a lot of finger pointing. It is the NFL’s fault because it doesn’t warn players of the risk, it’s society’s (and the NFL’s) fault for pushing players past their limit and encouraging them to continue playing even after a head injury, it’s the players fault for not reporting their concussions, it’s the helmet manufacture’s fault for producing faulty helmets. The list could go on. Regardless of whose “fault” it is or how much money a player will get from a settlement if they develop concussion-related injuries, education and prevention should be of upmost importance at all levels of the game.
TBIs, such as concussions, have occurred often enough that signs and symptoms as well as tests can be administered to determine if one is present as well as determine its severity. Clearly several players knew they had severe problems and wanted to do something to spare future players. Dave Duerson took his own live by a self inflicted gun shot wound to the chest (not more commonly the head) and in an eerie postmortem letter specifically stated that it was his wish to have his brain studied. As stated earlier, CTEs cannot be diagnosed and are only able to be accurately diagnosed post mortem. I can only hope that more studies are done so that we have the ability to better understand the human brain and the affects that repeated traumatic events, like CTE, have on it.
Putting A Price On The Brain: Concussions And Football
