For several years, researchers have been trying to understand a condition that’s haunting players of contact sports with symptoms similar to Alzheimer’s disease.
The tragic death of Junior Seau, the former professional football player who shot himself last week, has the potential to provide valuable clues, researchers said.
Seau, 43, played almost 30 years of football from high school through the National Football League. Now his family is weighing whether to donate his brain to research. If so, his longevity may offer new insight into the condition known as CTE, or chronic traumatic encephalopathy, said Julian Bailes, a former Pittsburgh Steelers team physician who now runs one of two major medical centers studying the ailment.
Seau is “way out on the spectrum, considering how long he played,” said Bailes, chairman of the neurosurgery department at NorthShore University Health System in Evanston, Illinois. “The thinking more and more is that the risk is cumulative.”
Bailes has identified CTE in the brains of other professional football players who have died, including the Steelers’ Mike Webster, Justin Strzelczyk and Terry Long, he said by telephone. None played as long as Seau. The average career of a National Football League player is 3.2 years, according to the NFL players union.
“Altogether the science has only examined 60 or 70 brains,” Robert Fitzsimmons, a lawyer in Wheeling, West Virginia, said in a telephone interview. “The more researchers and the more brains that we have to evaluate, the better data we get, and the more we learn about this devastating condition.
‘‘We are still in the early stages of this research,’’ said Fitzsimmons, who successfully sued the NFL retirement plan for disability for Webster, who was 50 when he died in 2002.
CTE is thought to be a progressive condition that affects those with a history of repetitive brain trauma, including concussions. It was initially discovered in boxers in the 1920s, according to the website of the Boston University Center for the Study of Traumatic Encephalopathy. Behavioral symptoms include impulse control problems, depression, aggression, memory loss and eventually, dementia.
Researchers aren’t sure whether the athletes’ condition as they get older is due to a sped-up version of the aging process, or whether CTE is a separate, distinct neurological illness, said Gregory Ayotte, director of consumer services for the Brain Injury Association of America based in Vienna, Virginia.
‘‘We see this, but we don’t know what causes it,” Ayotte said by telephone. “Would it have happened anyway?”
Seau, a 12-time Pro Bowl linebacker who retired from football in 2010 after a 20-year career spent mostly with the San Diego Chargers, committed suicide May 2 by shooting himself in the chest at his home in Oceanside, California, according to the San Diego County medical examiner’s office.
Dedicated to Science
Former Chargers chaplain Shawn Mitchell, a pastor with New Venture Christian Fellowship, said the family is debating whether to donate Seau’s brain to science.
They will decide “within days,” he said. “They’re bringing in what they call elders, who are personal friends and guides who help them during times such as this.”
Bill Johnston, a spokesman for the Chargers, said the team had no direct information about the family’s decision.
While there’s been no motive attributed to Seau’s decision to shoot himself in the chest, it echoes previous deaths of NFL players Dave Duerson, an 11-year veteran who played for the Chicago Bears, and Ray Easterling, an 8-year player with the Atlanta Falcons.
Duerson, whose four children have filed a wrongful death suit against the NFL, also shot himself in the chest last year, leaving behind a note saying he wanted his brain to be studied by the researchers at Boston University’s center.
The group there has reported that it found abnormalities in his brain, particularly in the areas that influence impulse control, emotion and memory.
Easterling, 62, one of seven former players who sued the NFL last August in Philadelphia over the league’s handling of concussions, shot and killed himself last month at his Richmond, Virginia, home. His widow, Mary Ann Easterling said he began showing signs of brain damage 20 years ago, including insomnia and depression, leading to dementia.
It’s not known where Seau’s brain would go, should the family decide to donate. The Boston University scientists who studied Duerson’s brain have declined to say if they’re talking with Seau’s family.
‘Thoughts and Prayers’
“It is our policy to not discuss any completed, ongoing or potential research cases unless at the specific request of family members,” said Jenny Eriksen Leary, a spokeswoman, in a statement. “Our thoughts and prayers are with Mr. Seau’s family, his many friends and former teammates.”
NorthShore’s Bailes said he has no agreement to do research on the brain.
“I hope we get to look at it, but even if we don’t, the last thing we want is for it not to be examined at all,” he said. “I’m not sure what we’d find, but it would give us an idea of what happens to someone who’s had as much exposure as he had, someone who was seemingly doing well until right at the end. You begin to accrue more and more cases. That’s part of how you build scientific evidence.”
Christopher Randolph, a neurologist at Loyola University in Chicago, said there are still more questions than answers surrounding CTE research.
In July 2011, Randolph presented research at the Alzheimer’s Association International Conference in Paris that compared football players with similar civilians split two ways, those who were the same age as the players and an older group showing signs of mild cognitive impairment. The football players matched best with the cognitive-impaired group, he said.
That suggests the problem may be that concussions somehow lessen the cognitive reserve, or the brain’s ability to resist damage over time, Randolph said in a telephone interview.
Randolph also worries that media coverage of CTE since the deaths of Duerson and Easterling, and now Seau, may discourage depressed football players from seeking treatment.
“Imagine you’re a retired football player and you’re depressed,” he said. “You’re thinking you’re hopeless and there’s no future and probably it’s due to CTE and you’re going to get demented and die. That’s different than thinking you’re depressed but with the right treatment you’ll get over it.”
Lack of Data
Conclusive data doesn’t exist on whether NFL players experience depression, substance abuse and suicide at a different rate than the population as a whole, Randolph said. Besides the concussions, NFL players have different lives than most people: an early and brief period of fame, with an outsized paycheck. Many of these athletes then fade into obscurity, and some also quickly spend their money, he said.
“I don’t know if that necessarily contributes to what we’re seeing, but it’s a complicating factor,” Randolph said. Patterns of substance abuse and depression also exist in other sports, such as baseball, where fleeting fame and fortune are common and concussions are rare.
Pete Carroll, coach of the NFL’s Seattle Seahawks, said professional athletes need help making the transition after their playing days are over.
“Getting ready for that is more significant than people think and it’s more difficult being a player of the magnitude and scope that he lived by,” Carroll said of Seau in an interview May 4 on Fox Sports Radio. “These guys need care, and they need consideration and help because it’s such a difficult transition and nobody’s ready for it. And it can really take away a whole reality for some of the guys, and we need to help them as much as we can.”
Randolph said his group is trying to recruit a large sample of former NFL players to compare with similar members of the population, short term to see if they have a higher risk of depression, dementia, and cognitive impairment, and over time to see how the problems may change.
“That’s never been done,” he said. “That way you can look at the correlation in a group between pre-death behaviors and autopsy results.”
Kirk Pope, a plaintiff lawyer at Pope, McGlamry, Kilpatrick, Morrison & Norwood based in Atlanta, said in a phone interview that lawsuits have been filed against the NFL on behalf of roughly 1,500 former players alleging damages associated with concussions and brain injuries.
Pope’s firm represents 170 of those players who have a variety of health concerns, including chronic headaches, sleeping difficulties, personality changes and memory loss, he said.
Some players “are suffering symptoms of dementia at a very early age,” he said.
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