An autopsy confirmed that a 25-year-old former college football player had chronic traumatic encephalopathy (CTE), according to research published online Jan. 4 in JAMA Neurology. A neurodegenerative disorder associated with repetitive head impacts, CTE can only be diagnosed after death by examining the brain.
The young man in the report died of cardiac arrest that was secondary to a heart infection. The researchers noted that in addition to his age, what makes his case so significant is that he had undergone neuropsychological tests when he showed CTE symptoms – apathy, decreased appetite, excessive sleepiness, feelings of worthlessness and suicidal thoughts – a year before his death.
“Focal lesions of CTE have been found in athletes as young as 17 years. However, widespread CTE pathology, as found in this case, is unusual in such a young football player,” wrote the researchers.
The 25-year-old played football for 16 years, beginning when he was 6 years old. He experienced 10 documented concussions, the first when he was 8.
An NCAA Division 1 defensive linebacker in college, he suffered a concussion with momentary loss of consciousness in his freshman year. The hit resulted in headaches, neck pain, and other symptoms that included memory and concentration problems. Though a good student in high school, he began failing his classes. He stopped playing football and left college during his junior year.
“Most times, there’s a latency between the time of experiencing repetitive trauma and the time the symptoms develop, but in this instance he was symptomatic while he was still playing, so we thought that was notable,” co-author, Ann C. McKee, MD, director of the Neuropathology Core at Boston University’s CTE Center, told Medscape Health News.
At age 23, the young man, who had a family history of addiction and depression, had difficulty keeping a job and began using marijuana to treat his headaches and anxiety and to help him sleep. He also exhibited a drastic personality change, becoming verbally and physically abusive to his wife.
“This shows you don’t have to be a professional athlete to develop this disease,” McKee said in an interview with The American Journal of Managed Care.
The authors acknowledged that there are many unanswered questions surrounding CTE: Are there genetic factors that make some players respond differently to concussions? Do some athletes need more time to recover from concussion than others? Is CTE related to the number of hits, the intensity of each hit, or a combination of factors?
And although it still isn’t possible to diagnose CTE before death, progress is being made in the research into this area. “The optimistic party line, which I share, is that in the next five or 10 years, we will have some reasonable successful biomarkers for this condition,” McKee told Medscape Health News. “Because this affects young individuals and it’s a public health issue, there’s an added urgency to be able to identify this early on.”