Experts warn about repeated brain blows in football

Monday, June 28, 2010
By Chuck Finder, Pittsburgh Post-Gazette
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Ernest Coleman/Cincinnati Enquirer
Chris Henry


The brain of the late Cincinnati Bengals pass receiver Chris Henry contained so many signs of chronic disease -- sludge, tangles and threads associated with late-in-life dementia or Alzheimer's -- that it shows a football player can sustain life-altering head trauma without ever being diagnosed with a concussion.

The brain damage may have contributed to Mr. Henry's troubled behavior and, ultimately, his death in December at age 26.

These conclusions, among others following tissue study by scientists affiliated with West Virginia University, make Mr. Henry the first active National Football League player to be discovered suffering from the progressive generative disease known as Chronic Traumatic Encephalopathy, or CTE.

Julian Bailes and Bennet Omalu, with the Brain Injury Research Institute in Morgantown, W.Va., have examined 10 other retired players, among them ex-Steelers Mike Webster, Terry Long and Justin Strzelzcyk. The researchers found frightful similarities between those brains and that of Mr. Henry. Those men were older than Mr. Henry and had taken thousands of blows to the helmet during long football careers.
Finding CTE in a current pro football player wouldn't surprise Robert Cantu, whose Boston University research group has received funding from the NFL.

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In a microscopic view of tissue from the brain of the late Cincinnati Bengals receiver Chris Henry, the brown spots are Tau protein stains that surround and damage the brain cells. "It's blue normally," said Julian Bailes, a brain injury researcher. "I look at it like sludge. [The brain] tries to clear it, and it can't." The wispy lines are neuritic threads, dead and leftover connections between cells. "You shouldn't see any of this, ordinarily," Dr. Bailes said.

"It also wouldn't surprise me that somebody as young as 26 would have it, either," Dr. Cantu said of Mr. Henry. "What would be a big surprise is if the amount of Tau protein. ... would be as excessive as it is in people who had much more lengthy careers and died at a much later age."
Mr. Henry never missed a game because of a concussion with either the Bengals or WVU, where he played in college.

"It didn't look like the brain of a 26-year-old," said Dr. Omalu, a former Allegheny County pathologist who first found CTE in an autopsy of Mr. Long in September 2005. "This is not something to celebrate. It is not something to be joyful about. It is something that is very humbling, very introspective. It is a call to action.

"I'm not calling for the eradication of football; no, I'm asking for full disclosure to the players. Like the surgeon general considers smoking to be dangerous to your health, repeated impacts of the brain are dangerous to your health and will affect you later in life. Period. The players need to know this.

"I think it's an epidemic. It's beneath the radar. We simply didn't identify it [early and properly]. The more I encounter NFL players, the more I realize ... it is much more prevalent than we had identified."

Added Dr. Bailes, who serves on the NFL Players Association brain-trauma committee: "Is it an epidemic? I don't know. But it was pretty alarming, that study."

Among the Henry study's findings, scheduled to be announced today at a news conference in Morgantown:
• The single, highlight-video concussive blow isn't the most dangerous part of the game. Rather, it is the constant thumping of the helmet and the brain inside the skull that causes long-term harm. The scientists found in Mr. Henry's tissue "chronic changes that have been there for several years," Dr. Bailes said. "And these are not all NFL-caused," meaning they stem from youth, high school and college football, as well.
• A gene that is a precursor -- an identifying factor for susceptibility to CTE -- has been found in 70 percent of the late athletes researched by Dr. Bailes and Dr. Omalu at the institute, among them former professional wrestler Chris Benoit, who killed his wife and 7-year-old son before committing suicide in 2007. An autopsy found steroids in his system.

The gene identified in Mr. Benoit is Apolipoprotein E, known as APOE, and is found in roughly 25 percent of the general population.

"Maybe what our research will lead to is the realization that, maybe in the future, genetic testing would be important for these athletes to know," Dr. Bailes said.

• Multiple or repetitive brain impacts appear to be the leading cause in an athlete's behavioral changes, akin to the onset of dementia, though it is an area that scientists agree remains open for more study.

Mr. Henry died Dec. 17 from a fractured skull and other head injuries sustained when he fell from a moving pickup truck in the driveway of his fiancee's family home near Charlotte, N.C. Those injuries were visibly separate from Mr. Henry's chronic condition caused by football, both doctors said.

"This is not a picture of acute brain swelling and edema. This is not an X-ray. This is a piece of tissue taken out of his brain," Dr. Bailes said. "This is chronic and long-standing."

Mr. Henry played in 55 games, including 12 starts, in his five-year Bengals career, one that included five arrests in a 28-month span and three suspensions totaling 14 games. He was once suspended at West Virginia by then-coach Rich Rodriguez, who called Mr. Henry an embarrassment to himself and the program. CTE and his chronic brain trauma could well have played a role, the scientists contend.

"The circumstances of somebody jumping onto a moving truck ... ," Dr. Omalu began.
He noted how a witness to the accident reported that Mr. Henry's last words were to his fiancee, Loleini Tonga, who was behind the wheel: "If you take off, I'm going to jump off the truck and kill myself."

"From what I know about his manifestations, I think there was ... neural-behavioral syndrome," Dr. Bailes added.

Bengals officials declined comment, as did NFL officials without knowing the specifics of the findings. But NFL spokesman Greg Aiello added in an e-mail: "We have invested $1 million in CTE research with the Boston University group. CTE was an important part of the agenda at our recent medical conference on brain injuries in Washington. We will continue to proactively address the issue through the medical experts."

Kevin Guskiewicz, a Latrobe native and former Steelers graduate-assistant trainer, is the research director at the University of North Carolina's Center for the Study of Retired Athletes. He added in an e-mail: "There is still much to learn about CTE. We do not yet know the cause, but there is increasing speculation that a contributor might be the hundreds of subconcussive -- non-injurious -- head impacts sustained over the course of a player's career."

As for those who wonder whether steroid use is linked to head trauma, Dr. Bailes said his previous research found that anabolic steroids do not appear to increase a player's chances of brain injuries from concussive blows.

Dr. Bailes, once a Steelers team doctor and currently the neurosurgeon for WVU athletic teams, maintains that this study is not advocating radical changes to the NFL or other levels of football.

But he reiterated a stance that he and other experts heralded most recently at a brain injury seminar at Duquesne University in March: Take the head out of the game to make it safer.

This research got its start in September 2005, when then-Allegheny County coroner Cyril Wecht announced that Mr. Long had died the June before as a result of traumatic brain injuries sustained during his Steelers career. The cause of death was later amended to suicide, but the discovery of CTE by Dr. Omalu, in the coroner's office, became part of football's mainstream discussion for the next half-decade and more.

The disease was previously restricted to the "punch-drunk" syndrome known to afflict boxers since the 1920s. Dr. Omalu opened the door to football; he and later Dr. Bailes studied tissue samples from a handful of NFL veterans. Since then, deceased football players as young as age 18 studied by a Boston University group and the Morgantown researchers were found to have Tau-protein stains and other signs of the disease.
The Brain Injury Research Institute was started three years ago by Dr. Bailes, the West Virginia School of Medicine's chairman of neurology; Dr. Omalu and Wheeling-based attorney Bob Fitzsimmons. (Mr. Fitzsimmons represents two Post-Gazette reporters in a pair of lawsuits not related to sports.)

Dr. Omalu, now medical examiner for San Joaquin County, Calif., studied the donated Henry samples first. "I think it was the fourth slide. I stopped. I was like, 'Whoa.' I was saddened by it, really," he said.

"This is not a mild case," added Dr. Bailes. Under a microscope, Mr. Henry's slides showed the same number of Tau-stained brown spots normal for "an 80- or 90-year-old."

The doctors said they hope the Henry case will prompt players and officials at all levels of football to take notice, if not action. Practices without helmets? Standing up linemen from a three-point stance? There are, to them, questions deeper than how many games to sideline a concussion sufferer.

"The NFL wants us to believe that documented concussions are the issue. I've always believed that it's not about documented concussions. It's about repeated impacts to the head ... sub-concussions," Dr. Omalu said. "Concussions are the extreme [end] of the spectrum. The issue is repeated impact, repeated blows to the head.

"We need to be more proactive. This is an issue of health risk. It is a public-health issue. Chris Benoit exhibited violent behavior. Many of them have died broke, without jobs. There's a societal implication. And also an issue of public safety. We need to take it more seriously."



Read more: http://www.post-gazette.com/pg/10179...#ixzz0s8qx5zyx

You see an incident like the one in which Strzelczyk died and wonder what might have possessed what seemed like just a regular Joe to behave in that way. How many shots did Webby take? He was a zero when he passed.

As much as I love the Steelers, I really have to wonder what needs to be done here. The melon wasn't designed to take this abuse.

Following this line, one might even wonder if this affected a certain young QB that displayed otherwise unexplainable behavior one sordid evening in March. The kid has been blasted a number of times.

http://sports.espn.go.com/nfl/news/story?id=5333971
June 28, 2010, 7:28 AM ET
Researchers find brain trauma in Henry

By Peter Keating
ESPN The Magazine
Archive

Chris Henry, the Cincinnati Bengals wide receiver who died in a traffic accident last year, had chronic traumatic encephalopathy (CTE) -- a form of degenerative brain damage caused by multiple hits to the head -- at the time of his death, according to scientists at the Brain Injury Research Institute, a research center affiliated with West Virginia University.

"We would have been very happy if the results had been negative, but multiple areas of Chris Henry's brain showed CTE," said Julian Bailes, Director of BIRI and chairman of neurosurgery at West Virginia. Bailes and his colleagues plan to present results of their forensic examination at a news conference Monday afternoon.

Researchers have now discovered CTE in the brains of more than 50 deceased former athletes, including more than a dozen NFL and college players, pro wrestler Chris Benoit and NHL player Reggie Fleming.

Repeated blows to the head are the only known cause of CTE, researchers say. Concussive hits can trigger a buildup of toxic tau protein within the brain, which in turn can create damaging tangles and threads in the neural fibers that connect brain tissue. Victims can lose control of their impulses, suffer depression and memory loss, and ultimately develop dementia.

While the links between CTE and behavior are still being studied, many of the former athletes diagnosed with this form of brain damage died under unusual circumstances. Ex-Steeler Justin Strzelczyk, for example, was killed in 2004 after experiencing hallucinations, leading police on a high-speed chase for 40 miles before driving his car into a tanker truck. In 2007, Benoit strangled his wife and 7-year-old son, then put Bibles next to their bodies and hanged himself. Tom McHale, a guard for three NFL teams remembered by teammates as smart and dependable, sank into depression and died of a multiple-drug overdose in 2008.

Henry, 26, died on Dec. 17, 2009, a day after he either jumped or fell from the back of a moving pickup truck being driven by his fiancee, Loleini Tonga. The two had been involved in a dispute before Tonga got into the truck and Henry jumped in. One witness told reporters that Henry said, "If you take off, I'm going to jump off the truck and kill myself."

It is still not clear whether Henry jumped or fell, but as Tonga was driving at about 19 miles per hour, Henry crashed to the ground, suffering a fractured skull and massive head injuries. Police ruled the incident an accident. No traces of alcohol were found in a toxicology report, which didn't include any other tests for drugs. No charges were filed against Tonga.

After Henry's death, his mother, Carolyn Henry Glaspy, gave BIRI permission to examine his brain in detail.

CTE can be pinpointed only by autopsy, and even under regular post-mortem analysis, its effects are invisible. But using cell-staining techniques discovered and developed by Bennet Omalu, a neuropathologist who is co-director of BIRI, scientists can see the dangerous tau proteins and telltale tangles that characterize CTE. After staining, normal brain cells are blue and uncluttered under a microscope, while Henry's brain cells were discolored, clumpy and filled with threads, according to the researchers.

Now, Bailes -- and likely Henry's family, friends and fans -- will wonder if his neural damage contributed to his emotional volatility, including whatever problems he was suffering the day he died.

"I think it did," Bailes said. "Superimposed on the acute brain injuries Chris suffered when he died, there was fairly extensive damage throughout his brain that was fully consistent with CTE. This syndrome is expressed not only as changes in the brain, but clinically, as behavioral changes. And starting with Mike Webster, we have seen common threads in these cases: emotional disturbances, depression, failed personal relationships and businesses, suicidal thoughts, sometimes alcohol or drug use."

"I'm just trying to learn what happened, and what the situation was with Chris' brain," Glaspy said. "Whatever I can do to help anyone else who is going through this, I'm willing to do."

For years, the NFL and its affiliated researchers disputed a scientific evidence linking concussions to long-term brain damage. However, referring to reports of CTE among former players, NFL Head, Neck and Spine Committee co-chair Richard Ellenbogen told The New York Times earlier this month, "They aren't assertions or hype -- they are facts."

In April, the league announced a $1-million gift to the Center for the Study of Traumatic Encephalopathy at Boston University.

Henry, a native of Belle Chasse, La., played collegiately at West Virginia and was a third-round pick by the Bengals in 2005. He played for five tumultuous seasons in the NFL; he was arrested five times during his pro career, and NFL commissioner Roger Goodell suspended him for the first half of the 2007 season for violating the league's personal conduct policy.

But after Cincinnati brought him back in 2008, Henry vowed to put his substance abuse and anger management issues behind him. And he had been succeeding, according to teammates as well as Bengals officials.

Peter Keating is a senior writer for ESPN The Magazine. His blog appears on ESPN.com.

WOW. :jawdrop2: That is some really, REALLY scary stuff. :horror:

While I definitely think the NFL needs to look at this study very seriously, I don't know what they can do to counteract it. :noidea:

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Originally Posted by HometownGal

I don't know what they can do to counteract it. :noidea:

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http://ngffl.com/

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Originally Posted by Vincent

http://ngffl.com/

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:lol: :heh: :lol:

I should have known. ;)

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Originally Posted by HometownGal

WOW. :jawdrop2: That is some really, REALLY scary stuff. :horror:

While I definitely think the NFL needs to look at this study very seriously, I don't know what they can do to counteract it. :noidea:

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I think the only thing they can do is improve the helmets, which they've already started to do, so that they better protect the head. But that's about the only thing they can do short of turning the game into 2-hand touch.

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Originally Posted by HometownGal

:lol: :heh: :lol:

I should have known. ;)

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I'm sorry. Insensitive moment. I meant flag football. No, really.

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Originally Posted by X-Terminator

I think the only thing they can do is improve the helmets, which they've already started to do, so that they better protect the head. But that's about the only thing they can do short of turning the game into 2-hand touch.

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X-term.

I think improving helmets would help. But there is one other rule that would greatly change the game as well I think. It is already in place in Rugby and it makes a vast difference. You MUST wrap when you tackle, or it is a penalty. Of course, it isn't called when someone wraps, but hits the guy so hard that he flies out of your arms. However, you MUST attempt to wrap you arms around the ball-carrier on EVERY tackle. I think that would make a big difference.

I say do what you can in the form of helmets and leave it at that.

Any player, from HS on up, with half a brain knows the risks. You either choose to do it or you choose to not do it. I have no sympathy for them.

As for NFL players. especially starters who make millions per year, cry me a river. You can't have it all your way. "I want the money and fame, but I don't want to get hurt". Screw them.

I see this like the gladiator days in Ancient Rome. Sure, people died, but (except for slaves forced to fight) they chose to entertain the public at a price. Well, pay the price and move on.

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Originally Posted by BnG_Hevn

I see this like the gladiator days in Ancient Rome. Sure, people died, but (except for slaves forced to fight) they chose to entertain the public at a price. Well, pay the price and move on.

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I think you've watched too many movies. Almost all gladiators were slaves who were forced to fight. These were slaves that had been found guilty of offenses against the government and judged as being obnoxious to the state. As a result, they were condemned to the beasts in the arena with nearly no chance of survival or ordered to kill each other. There was nothing glamorous about it even if you survived. Not only did they lose their legal status, they lost their social status as well. If anything, it could be compared to dog fighting...the fighters were regarded as being almost less than human. In no way, shape, or form was it even comparable to current day professional sports.

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Originally Posted by BnG_Hevn

Any player, from HS on up, with half a brain knows the risks. You either choose to do it or you choose to not do it. I have no sympathy for them.

As for NFL players. especially starters who make millions per year, cry me a river. You can't have it all your way. "I want the money and fame, but I don't want to get hurt". Screw them.

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There are a lot of dangerous jobs out there that people still choose to do despite knowing the risks...military, firefighting, police force, etc, but that doesn't mean we shouldn't do all that we can to maximize safety and minimize losses. And no, I don't think the prices these athletes pay are justified by the fame and fortune that some pro athletes achieve. Millions of football players have to endure these same consequences without ever having achieved this fame and fortune simply because they love to play the game. Should we be content with the fact that these people are going to be screwed up for the rest of their lives for doing something they love? I don't think so.

I'm not saying that we can ever totally eliminate the risks involved in playing football, but we can do our best to minimize them.