interview
On Sunday the NFL will be visiting Frankfurt for the second time this season. While the fans in the stands watch the moves Indianapolis Colts and the New England Patriots celebrate, the players on the pitch risk their health and, in the worst case, their lives: everyone Tackle, any collision can trigger CTE – an irreparable brain disease. Neuropathologist Dr. Ann McKee is a luminary in this field of research. She is often attacked by football fans and the NFL league for her unpleasant truths. The sports show has them in the world’s largest brain bank Boston met for an interview.
Sports show: What exactly is Chronic Traumatic Encephalopathy – CTE for short?
Dr. Ann McKee: CTE is a neurodegenerative disease that, in almost all cases, is caused by repeated blows to the head. And these hits can come from contact sports, poorly controlled epilepsy, or interpersonal violence. The blows cause buildups of an abnormal protein called tau at the lesions in the brain. It begins in small areas of the brain and, as we age, affects the entire brain, the cerebellum, the brainstem and even the spinal cord.
Sports show: What kind of symptoms do these patients have?
McKee: We see a type of dementia in patients with very severe CTE. So the inability to think clearly, difficulty caring for oneself, no memory. In people with milder illness, we see a lot of behavioral and mood changes. This can include depression, hopelessness, even suicidality, but also irritability, impulsivity, anger, violence, and in some cases even homicidal thoughts. Often those affected know that something is wrong with them, but they have difficulty naming it exactly.
Sports show: How old are the people affected?
McKee: We actually had a 17 year old who High school football was playing and suddenly died. And he already had a small amount of CTE in his brain. So it’s possible to see the earliest stages of CTE in teenagers. The fact that we are finding CTE in brains that are not even fully mature is, in my opinion, very concerning. And one reason why we really need to make every effort to ban head contact from these sports.
Sports show: The NFL did not receive its research results with excessive enthusiasm…
McKee: So, football is the most popular sport in America. It’s a lifestyle. It’s culture. It’s identity. For some communities it is even their most important identity. So of course there is enormous resistance to my research. How dare I say anything negative about her favorite sport? And of course football involves a lot of money, especially at the professional level. That’s why the hostility never really stopped. But we have still managed to build a body of scientific literature over the years that shows there is a risk of CTE in football. Especially in the NFL. And the longer you play, the more likely you are to get CTE.
Sports show: The NFL is investing millions in helmets with better padding…
McKee: Yes, but the helmets won’t prevent CTE. There is an acceleration-deceleration of the head in this sport. And this acceleration-deceleration leads to the actual injury. The brain stretches and twists with this injury, and this is what causes the damage to the nerve cells. It’s not so much the impact, but this stretching and twisting that takes place under the helmet, under the skull. The helmet is a kind of second skull bone, if you will. The damage occurs underneath. So even a helmet can’t prevent this.
Sports show: What is the goal of your research?
McKee: First and foremost is education: CTE is a preventable disease! If we count the number of head impacts that a footballplayers in a given game or during a season, it would dramatically reduce the risk of CTE. However, this means that the rules have to be changed in a way that is very unpopular: fewer players on the field, a larger playing field, fewer games overall, fewer minutes played per player, no hits to the head in training. Increasing the age at which children, teenagers and young adults can play full-contact football. These are the things that need to be done now. And I think it would also be important to closely monitor the active players. It should be checked how many hits to the head they received over the course of a season. And if they’ve already gotten a lot, they have to miss a game. However, at the moment there is no attempt to observe live players. At the moment the motto is: If we don’t talk about it, it will go away again. That is a mistake. This disease will not go away. We have to change the rules of the game!
Sports show: How does the disease develop?
McKee: CTE is progressive with age. So even if you stop playing football at a certain point, CTE in the brain will continue to worsen as you age. Even if you no longer practice contact sports. At a certain point it is independent of further head trauma. It has a life of its own and only gets worse over time.
Sports show: What do you hope to achieve from the world’s largest brain bank? Bostonwhere you conduct your research?
McKee: Well, we absolutely want to ensure the safety of athletes and all other vulnerable groups. The most important thing is to learn how to diagnose the disease while you are still alive. I think we’re getting closer and closer. We are developing blood tests for the abnormal tau protein and some other proteins that can cause inflammation. These tests are not yet good enough, not specific enough. But we are well on the way there. And I think that in the next two, five, ten years we will be able to diagnose this disease.
Sports show: Then it would be good if the NFL would cooperate…
McKee: We don’t necessarily need cooperation with the NFL: if we can diagnose CTE in living people, that will make a huge difference. People will then be more likely to respond that CTE is a risk in some sports. I think if we can recognize it in young athletes and show them what this means for their future, there will be a big change in the way these sports are played and the way we care for these athletes.
Sports show: What are the reactions from families who donate brains?
McKee: When a family donates a brain, it is often a relief for them to hear that there is a diagnosis of CTE. He explains so much in retrospect: the men were suddenly quarrelsome, violent, impulsive, depressed, didn’t behave like themselves and were quite unsympathetic and even hostile towards other family members. Many families say they wish they knew this could be a result of contact sports. If they had known more, if they had been better informed, perhaps they would have made different decisions for their lives and those of their loved ones.
Sports show: You’re talking about contact sports – not just that football?
McKee: Correct. We have over a thousand football player brains here. But we are also becoming more and more involved with ice hockey. It was recently revealed that two-thirds of all rugby players have also been diagnosed with CTE. We know that wrestling is a risk for CTE. Our next goal is therefore to establish an international research collaboration. I’m also thinking about football in Europe, especially when it comes to headers.
Sports show: Thank you for the interview.
The interview was conducted by Gudrun Engel.