NFL player autopsy shines light on CTE

The release of the autopsy results for former New England Patriot Aaron Hernandez has renewed questions about CTE-related deaths and safety in football, leading to research on the disease and changes in the sport.

Chronic Traumatic Encephalopathy is a neurodegenerative disease that scientists believe is caused by repeated brain trauma. The trauma causes tau proteins to form depositions in the brain, which spread and kill brain cells.

Joel Morgenlander, a professor of neurology and orthopaedic surgery at Duke University, said there is no definitive answer to what causes CTE.

“Defining the disease is still a process,” he said. “There’s not even a distinct test to diagnose CTE.”

He said diagnosis of CTE is limited to postmortem cases. 

Kevin Guskiewicz, director of the Matthew Gfeller Sport-Related Traumatic Brain Injury Research Center at UNC and dean of the College of Arts and Sciences, said depression is found in former players that are later found to have CTE. 

“The media would lead you to believe that suicidality is higher in former NFL players, which is actually not the case," he said. "It’s just the opposite.” 

Aaron Hernandez's lawyer announced last Thursday that Hernandez had a severe form of CTE when he committed suicide in April. 

Guskiewicz said he thinks individuals are genetically predisposed to be CTE-prone.

"I think that genetic testing should be part of a free participation exam, so if you have certain genetic makeups — which we’re still trying to figure out — that are the most predictive of having this, you’re advised very differently about participating in the sport,” he said.

Guskiewicz said autopsies submitted for study represent a self-selecting pool, degrading the conclusion’s credibility.

“There’s no cause and effect relationship that’s been identified yet,” he said.

Guskiewicz said CTE is different from Alzheimer's disease.

"It happens in different structures of the brain, and we believe that it’s caused by repetitive head traumas,” he said.

Symptoms of CTE include memory loss, confusion, erratic behavior, depression and issues with executive functioning over time.

To address the issue of head trauma, UNC has placed accelerometers in football players’ helmets to measure collision magnitudes, Guskiewicz said. 

He said football at all levels has decreased hits in practice, increased emphasis placed on hit technique and changed rules to promote safety. This has impacted kickoffs — the most dangerous play in football — the most.

In 2011, the NFL moved kickoffs up five yards to decrease the frequency of returns. The league moved the touchback up five yards in 2011, decreasing the advantage of returns even more.

The NFL is trying to improve safety in the sport at every level and has been willing to change rules, Guskiewicz said. 

“I think they realize that the sport’s in trouble, and therefore they recognize that it’s in the best interest of the player to minimize the amount of head contact they have in a season,” he said. 

Guskiewicz said some players are opposed to the various new rule changes, and Roger Goodell, the commissioner of the NFL, has been the target of these criticisms. 

“Many of them don’t like him," he said. "They think he’s softened the game."

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