There is no subject more pertinent and controversial within NFL circles than that of concussion protocol and chronic brain trauma.
As the 2017 regular season shifts into focus, the discussion of Chronic Traumatic Encephalopathy (CTE) is once again thrust into the spotlight with the unveiling of new research.
For those in need of a refresher: CTE is defined as a progressive degenerative disease of the brain found in athletes (and others) with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head.
Since 2011, notable deceased former NFL players whose autopsies revealed CTE include the likes of Frank Gifford and Junior Seau.
Since 2011, nine other current and former players have committed suicide: Dave Duerson, Ray Easterling, Junior Seau, Kurt Crain, O.J. Murdock, Mike Current, Paul Oliver, Adrian Robinson, and Aaron Hernandez.
There are many questions behind the condition and if it is affecting football players as much as we think it is.
On Tuesday, researchers at Boston University School of Medicine published a study on their findings after examining the brains of football players who have passed. Out of 111 brains of former NFL players tested, 110 of them were diagnosed with CTE. That is an astoshing and starrtling number. In total, they tested 202 subjects who had played football for at least 15 years. Out of the 202 tested, 177 were diagnosed with CTE.
One of the doctors involved in the research, Dr. Michael Alosco, joined the Sports Junkies Wednesday to further discuss the researchers' findings.
"We've been studying this project since about 2008," Alosco said. "There was quite a wide range [in time]. It went from 1940's all the way up to the 2010's. Most of them played from the 1960's and beyond, with only about 21 or so before the 1960's."
The brain is a complex organ, so what do doctors see when looking at a brain with CTE?
"There's this protein called tau," Alosco said. "What tau does is it helps to stabilize the cells in our brain. What happens in CTE is the tau becomes abnormal. With CTE though, there is a really unique pattern of this protein tau. Specifically, the tau kind of accumulates around the blood vessels in our brain. And it occurs at a location kind of right below the surface of the brain. That lesion of tau is very unique, it's different from anything else that's ever been seen."
We see football players take countless, brutal hits throughout their careers and Dr. Alosco described the symptoms a player with CTE may have.
"There's not one specific side effect of CTE. We see a lot of different changes in behavior, so we see aggressive behaviors, we see a lot of changes in mood such as depression, and then also with thinking and memory loss is what we see often as well. So, it's kind of a combination of different symptoms."
Researchers are in contact with current players who are experiencing similar symptoms. The hard part is that doctors can't diagnose CTE while a person is living.
"We can't diagnose the disease in life, yet. It can only be diagnosed through looking at the brain tissue under a microscope. A lot of these symptoms from CTE are kind of non-specific and you can see them in a lot of different other things. So, we really gotta pin point what's exactly specific to CTE in order to help us diagnose it in life."
Dr. Alosco said they need to do more research on players who have played football throughout different stages of their lives, such as youth and high school athletes, to figure out how much contact is too much contact. None the less, he was surprised by the the distribution of CTE across all different levels of play, from high school to the NFL.
So, what does the future hold for CTE research and will we be able to diagnose it during someone's lifetime?
"At Boston University now, we have a large study doing exactly these things, looking at different test that can detect CTE in life. It's a pretty large scale study. It's over five or seven years, involves different sites across the country. And yeah, I would agree I would think that within the next five to seven years we'll have some kind of tool, some kind of test that will help us detect CTE in life."
Dr. Alosco said the most important thing to gain from these numbers is awareness and facilitating efforts to further figure out this disease to make contact sports safer.
"One important limitation of the study too is that we're dealing with people who donated their brains. That's associated with certain type of biases. And really what these numbers and what these findings mean to the general population is unclear. And we really can't extend these numbers to the general population because we don't really know how common it is based on these numbers."
In a statement release to several media outlets, the NFL responded to the report findings, stressing the importance of this research.
The medical and scientific communities will benefit from this publication and the NFL will continue to work with a wide range of experts to improve the health of current and former NFL athletes. As noted by the authors, there are still many unanswered questions relating to the cause, incidence and prevalence of long-term effects of head trauma such as CTE. The NFL is committed to supporting scientific research into CTE and advancing progress in the prevention and treatment of head injuries.