Chronic Traumatic Encephalopathy
The Philadelphia won the Super Bowl, and their fans rejoice. Kevin Hart was so drunk that he had to cautioned by the security man from climbing up the podium with the trophy. However, the dangers of this game only remind me of the Roman Gladiators. That is why in a way I regard these athletes as Gridiron Gladiators.
CTE is a progressive neurodegenerative disease of the brain discovered in people with a history of repetitive brain trauma (blows/hits to head) accompanied with symptomatic concussions and asymptomatic concussions. This injury causes a progressive degeneration of the brain tissue, especially the build-up of a soluble protein called tau that becomes misfolded, insoluble and tangled, thereby losing the stabilizing capacity it provides to the microtubules. The function of the microtubules in the brain is related to signaling, conduction, transportation and they also play a structural role, hence, as they lose their stabilizing capacity they become incapacitated to carry out those responsibilities. This leads to the altered function of the frontal lobe of the brain whose degeneration leads to memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, progressive dementia and eventually leading to death.
Also found in Alzheimer’s disease, the tau protein presents as neurofibrillary tangles which become insoluble and hyperphosphorylated intracellularly. The higher the number of these tangles the more severe the degree of dementia and decline in mental ability. Alzheimer’s had initially been thought to be the primary culprit, but it turns out CTE is the main villain behind the whole brouhaha that has to do with neurodegenerative diseases.
CTE and the Gridiron Champions
CTE also affects young professional American football players or any contact-sport athlete at any level, including hockey players, rugby players, and others. It has also been found in veterans and military men suffering from blast injuries and post-traumatic stress disorder, in domestic abuse victims, in people suffering from chronic seizures like epilepsy, and in virtually anyone exposed to repeated head trauma. The primary challenge in CTE is that diagnosis can only be made during the autopsy. Symptoms experienced are similar to that of Alzheimer’s, Parkinson’s, Frontotemporal dementia and Amyotrophic Lateral Sclerosis.
The resultant effects noticed are signs of people who seem to have lost their minds. They were considered to be social misfits, unremorsefully abandoned by their families, some of them could not even recognize their family members, left their homes, started living in trucks while some killed their families before killing themselves. Though, CTE was initially called the Punchdrunk syndrome or dementia pugilistica and was diagnosed in Boxers and Wrestlers. A familiar one that comes to mind is Christopher Michael ‘Chris’ Benoit, the wrestler who hanged himself after killing his wife and son.
NFL Denial and Battle with CTE
The new disease was named CHRONIC TRAUMATIC ENCEPHALOPATHY, and the American National Football League (NFL) fervently denied that it was connected to its players, just like the tobacco companies did in the 90’s. These were the thoughts of the American writer and Professor Jeanne Marie Laskas, the GQ (Gentlemen’s Quarterly) correspondent in her article, Game Brain. She wrote explicitly about the opposition Dr. Omalu faced from the NFL in her book titled Concussion in 2015 and in that same year a movie of the same title was released starring Will Smith playing Dr. Bennet Omalu.
It took seven years before a U.S. Court of appeal confirmed Omalu’s autopsy, ruling that Webster had died from brain trauma which he suffered from playing professional football. He had merely made so much money only to pay for his addiction, loneliness, erratic behavior, while in the long run, the money was just a payment for a lost mind. He played hard and died young at the age of 50. These retired American football players are like gladiators whose glory only lasts in the arena for a short while before they lose it all. Every single match for them was a hit, head to head or if you may say brain to brain. In their pursuit of short-term fame, they gradually lost their mind as they settle for long-term disability.
Controversies about CTE with Fellow Doctors
Doctors on the NFL’s Mild Traumatic Brain Injury committee [MTBI] claimed his findings were full of misinterpretations, false, flawed, preposterous, speculative, confusing, inappropriate science and even mentioned he was practicing voodoo, so they asked for the retraction of his publication. This unsettled him leading him to question the integrity of the NFL’s MTBI committee and he was left bewildered to find out that a neuropathologist was not even on the board at all while the MTBI was headed altogether by a rheumatologist, “A rheumatologist? You picked a joint guy to lead your brain study?” he said.
Since 2002 when Omalu discovered CTE in the brain of Mike Webster and published it in the journal, Neurosurgery, three years later, he has devoted his life to helping those families and individuals affected by the disorder. Omalu’s work has revolutionized our understanding and changes the way we deal with all types of traumatic brain injuries. The disease has since been found in nearly 90 NFL players in 2007 and again in 2010. It was also diagnosed in Vietnam, and Iraq war veterans who suffered from post-traumatic stress disorder (PTSD), one of whom had committed suicide.
The Irrevocable Reality of CTE
By this time he was examining the brain of Terry Long, who died at 45 after drinking antifreeze. On microscopic examination, he discovered the diffuse, sparse to frequent tau-immunoreactive neurofibrillary tangles he was looking at were only meant to be seen in a 90-year-old with advanced Alzheimer’s but Terry long was only 45years old when he died, How? That was the question that kept resonating in his mind. Amidst warnings and threats from different angle especially the NFL, he would remind himself, it was not about him, but the safety of these players, their families and loved ones and the glaring scientific truth.
He was fortunate to meet Julian Bailes, a neurosurgeon, a former Steelers team doctor and a close friend of Mike Webster, especially in his final years. Dr. Bailes had come to see many of these players when they suffer a concussion during a match and sent back to the pitch with painkillers to carry on. He then introduced Omalu to Dr. Fitzsimmons, and they continue to work alongside other doctors across a variety of specialties on this crippling disease to expand our understanding of this debilitating and life-threatening disease, more particularly athletes in contact-sports, war veterans, and victims of domestic abuse.
Families of these unfortunate athletes and veterans are grateful to know the explanation behind the sudden changes in the character of their deceased and many of them have even come to regret not being around to bear with them in their pain and illness. But, for the ones already seeing similar signs, researchers use some classifications to describe the process the symptoms will take so that prompt medical care may be requested. Symptoms like a headache, loss of attention and concentration as depression sets in later, short-term memory loss and in the final stages Decision-making dysfunction and cognitive impairment which then leads to Dementia, word-finding difficulty, aggression and ultimately death. But there is still no way for sure to know if it is CTE as it can’t be seen on MRI or CT but only in microscopic brain tissue which can only be observed only after death.
References
Freckelton QC, I. (2016). Concussion, by Jeanne Marie Laskas, Penguin. Psychiatry, Psychology And Law, 23(3), 483-486. http://dx.doi.org/10.1080/13218719.2016.1188677
Jeanne Marie Laskas, J. (2018). Game Brain: Football Players and Concussions. GQ. Retrieved 11 February 2018, from https://www.gq.com/story/nfl-players-brain-dementia-study-memory-concussions
Johnson, R. (2018). Kevin Hart had a fantastic time at the Super Bowl | Page Six. Pagesix.com. Retrieved 11 February 2018, from https://pagesix.com/2018/02/11/kevin-hart-had-a-fantastic-time-at-the-super-bowl/
Omalu, B. (2008). Play hard die young. Lodi, Calif.: Neo-Forenxis Books.
West, B., McKee, A., Sano, M., & Perl, D. (2010). Alzheimer’s disease and chronic traumatic encephalopathy: An overlapping pathological picture?. Alzheimer’s & Dementia, 6(4), S231. http://dx.doi.org/10.1016/j.jalz.2010.05.749
