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Ninety-nine percent of ailing NFL player brains sport hallmarks of neurodegenerative disease, autopsy study finds

The largest study of its kind has found damage in the vast majority of former football players' brains donated for research after they developed mental symptoms during life. Of 202 former players of the U.S. version of the game whose brains were examined, 87% showed the diagnostic signs of chronic traumatic encephalopathy (CTE), a neurodegenerative disease associated with repetitive head trauma. Among former National Football League (NFL) players in the sample, that number jumped to 99%. The findings will likely ratchet up the pressure on leaders at all levels of football to protect their players. Still, the authors and other experts caution against overinterpreting the results, because the brains all came from symptomatic former players and not from those who remained free of mental problems.

"I think it is increasingly difficult to deny a link between CTE and repeated traumatic brain injury, be it through contact sports or other mechanisms," says Gil Rabinovici, a neurologist at the University of California, San Francisco (UCSF), who was not affiliated with the study.

The researchers, led by Boston University (BU) neuropathologist Ann McKee, used brains from a bank maintained by the VA Boston Healthcare System, BU, and the Concussion Legacy Foundation. They were donated by families of former football players. The team defines CTE, a diagnosis made only at autopsy, as "progressive degeneration associated with repetitive head trauma." The designation remains controversial with some, who call it a muddy diagnosis that doesn't include an iron-clad clinical course and the kind of clear-cut pathology that defines classical neurodegenerative diseases like Parkinson's or Alzheimer's disease.

Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football (open, DOI: 10.1001/jama.2017.8334) (DX)

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