Databyte: Taking the Hit

Brain injuries and chronic disease in American football players

Published on February 3, 2013by Joshua Brooks

In 2011, former Chicago Bears defensive back Dave Duerson shot himself in the chest after leaving a note requesting that his brain be examined for trauma. A little over a year later, Junior Seau also committed suicide by a self-inflicted gunshot to the chest. In the months leading up to his death, Duerson, complained about his deteriorating mental state. Samples of brain tissue from Seau and Duerson indicated that they had sustained chronic traumatic encephalopathy (CTE), a degenerative brain disease originally referred to as “punch drunk” syndrome in boxers. Former NFL player, Tom Dempsey, now 66, was best known as a kicker for the New Orleans Saints, but was also known for delivering vicious hits when playing other positions, which was common for kickers early on in the NFL. As a result, it seems, he may have put himself at greater risk for the dementia he currently endures.

These stories of football-related brain injury are not merely anecdotal. Some 3,800 football players have sued the NFL over head injuries, including Seau’s family. And, researchers at Boston University, examining the post-mortem brains of 35 former professional American football players showed that 34 had some form of CTE (Figure A). A total of 15 individuals, or 42.9 percent, had some form of CTE and another associated disease. Diseases included forms of dementia such as Alzheimer’s disease and Lewy body disease, frontotemporal lobar degeneration, the most common cause of dementia, and motor neuron disease, which is responsible for progressive disability, and ultimately, death.

Twenty two players were diagnosed with a particular stage of CTE, ranging from the less severe Stage I, marked by headaches and concentration difficulties, to Stage IV, characterized by severe cognitive impairment and memory problems. Of these 22 individuals, some overlapped with the group that had CTE and another disease. What’s more, nearly half of these players had CTE in the most impairing stages at the time of death. Three players (8.8 percent) had Stage I CTE, three (8.8 percent) had Stage II CTE, nine (26.5 percent) had Stage III CTE, and seven (20.6 percent) had Stage IV (Figure B).

(data from McKee, et al., 2012)

The researchers also examined the positions played those with any form of CTE. Unsurprisingly, the positions that sustain the most trauma were overrepresented: 26 percent were offensive linemen, 20 percent were running backs, 14 percent were defensive linemen, 14 percent were linebackers, 6 percent were quarterbacks, 6 percent were defensive backs, 6 percent were tight ends, and 6 percent were wide receivers (Figure C).

This Sunday, as the Baltimore Ravens clash with the San Francisco 49ers in New Orleans, with each player vying for a piece of Super Bowl bling, we will be watching not only the game, the multimillion dollar commercials, and Beyoncé’s halftime show. We will be watching to see which players take hard hits. And, as the debate surrounding sports-related brain injuries and how professional leagues should respond continues, other cases of CTE are likely off and running, past the first down to the hardest hit of them all.

Edited by Dana March.