Suicides in sport and chronic traumatic encephalopathy (CTE)
Another case of suicide in sport, likely associated with chronic traumatic encephalopathy (CTE), brings renewed attention to the impact-induced brain disease.
On May 16th, professional football – ‘grid iron’ for those outside the US – player Adrian Robinson Jr. committed suicide. Robinson played for several football teams during his careers, including the Tampa Bucaneers and the Pittsburgh Steelers. The autopsy revealed that he had signs of a chronic brain disease called chronic traumatic encephalopathy (CTE). “He went from being one of the nicest guys you’d ever want to talk to, to having a darker edge at times,” Robinson’s family lawyer Ben Andreozzi told ESPN.
Chronic traumatic encephalopathy is usually associated with boxers who, later in their careers, display symptoms such as difficulty in learning, loss of memory, impaired executive function, depression and even suicidal thoughts. It is thought that repeated blows to the head and associated brain injuries induce the release of an abnormal protein, called tau, which builds up and damages the brain’s cells. Similar proteins are also found in the brain of Alzheimer’s patients, but while in CTE the tau proteins accumulate mainly on the surface of the brain, in Alzheimer’s patients they are more spread out and found deeper in the tissue.
Cases of CTE are mainly found amongst soldiers, football players, hockey players and wrestlers; they have also recently been found in people participating in low-impact sports such as soccer or rugby. Over the last few years, a list of ‘high-profile’ suicides in sport has brought greater attention to CTE. In 2011, retired NFL football player Dave Duerson shot himself in the chest and in his final note to the family asked for his brain to be examined for the disease. The autopsy revealed indeed signs of CTE. A 2012 study in the journal Neurology found that NFL players have a four-time greater chance of dying from Alzheimer’s or amyotropic lateral sclerosis (ALS) then the general population – the study however, could not exclude CTE as the actual cause of death in the cases examined.
It is extremely hard to extract some numbers and try to relate CTE with a specific amount or type of blows. Genetics might also play a role and, to be thorough, it should be pointed out that it is not known how widespread the disease actually is amongst athletes involved in ‘high-impact’ sports. Before 2013, CTE could only be revealed by autopsy; now positron emission tomography (PTE) scans can detect an abnormal build-up of tau protein in the brain hinting to CTE.
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