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Latest brain study paints grim picture for NFL players
A major study out Tuesday, July 25 found that nearly 90 percent of former football players
 studied had CTE — chronic traumatic encephalopathy. (Reuters)
  
Researchers studying the link between football and chronic traumatic
 encephalopathy found that 99 percent of the brains donated by families
of former NFL players showed signs of the neurodegenerative disease, 
according to a new study published Tuesday.
In all, researchers from Boston University School of Medicine and the 
VA Boston Healthcare System examined 202 brains that belonged to 
men who played football at all levels and were later donated for research. 
They found CTE in 177 of them — 87 percent.
While they found evidence of the disease across all levels of play, the 
highest percentage was found among those who competed at the highest
 level; all but one of the 111 brains belonging to ex-NFL players were
 diagnosed post-mortem with CTE.
“Obviously, this doesn’t represent the prevalence in the general 
population, but the fact that we’ve been able to gather this high a 
number of cases in such a short period of time says that this disease
 is not uncommon,” said neuropathologist Ann McKee, the researcher 
credited with some of the most high-profile CTE diagnoses. “In fact, 
I think it’s much more common than we currently realize. And more 
importantly, this is a problem in football that we need to address and 
we need to address now in order to bring some hope and optimism to 
football players.”
The study drew the immediate attention of lawmakers on Capitol Hill 
who have been monitoring the issue.
 Play Video 2:00
What is CTE?
CTE, a brain degeneration disease, has been found in the brains of deceased NFL Hall 
of Famers. Here's what you need to know about it. (Monica Akhtar/The Washington Post)
“The time for denying facts and looking the other way is over,” 
Congresswoman Jan Schakowsky (D-Ill.) said in a release. “We must 
now actively seek out ways to protect the health and [well-being] of 
players from Pop Warner to the NFL and every league in between.”
In addition, four Democrats on the House Energy and Commerce 
committee called the study “a heartbreaking reminder that we must 
continue the fight to protect current, former, and future NFL players
 from CTE.”
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“We know that there is a direct relationship between football and CTE, 
and we cannot afford to wait to take substantive action to protect players
 of all ages from the risks of head trauma in contact sports,” read a 
statement, signed by Schakowsky, Rep. Frank Pallone, Jr. (D-N.J.), 
Rep. Gene Green (D-Tex.) and Rep. Diana DeGette (D-Colo.). “This 
study also demonstrates the importance of continued scientific research
 on CTE, which is why we must continue to support the important work 
carried out by the National Institutes of Health (NIH) in this area,
 including on the relationship between this degenerative brain disease 
and contact sports.”
McKee cautions that the study, which was published Tuesday in the 
Journal of the American Medical Association, has some limitations and 
doesn’t attempt to pinpoint a CTE rate. The brains studied were mostly
donated by concerned families, which means they weren’t random and 
not necessarily representative of all men who have played football.
“A family is much more likely to donate if they’re concerned about their
 loved one — if they’re exhibiting symptoms or signs that are concerning 
them, or if they died accidentally or especially if they committed suicide,” 
she said. “It skews for accidental deaths, suicide and individuals with 
disabling or discomforting symptoms.”
While the study isn’t focused on causality, McKee says it provides
 “overwhelming circumstantial evidence that CTE is linked to football.”
The NFL pledged $100 million for concussion-related research last 
September — $60 million on technological development, with an 
emphasis on improving helmets, and $40 million earmarked for
 medical research — and in a statement a league spokesman expressed
 appreciation for the latest study.
“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,”
 NFL spokesman Brian McCarthy said. “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.”
The study marks the largest CTE case series ever published. The research 
was drawn from a brain bank established and maintained by the VA 
Boston Healthcare System, Boston University School of Medicine and 
the Concussion Legacy Foundation.
The 177 brains found to have CTE belonged to former players who had 
an average of 15 years of football experience. In addition to the NFL 
diagnoses, the group included three of 14 who played at the high school 
level, 48 of 53 who played in college, nine of 14 who competed 
semiprofessionally and seven of eight who played in the Canadian 
Football League.
“To me, it’s very concerning that we have college-level players who have 
severe CTE who did not go on to play professionally,” McKee said. “That 
means they most likely retired before the age of 25 and we still are 
seeing in some of those individuals very severe repercussions.”
The researchers distinguished between mild and severe cases of CTE, 
finding the majority of former college (56 percent), semipro (56 percent) 
and professional (86 percent) players to have exhibited severe pathology.
The impact of concussions and head trauma meted out on the football 
field has been an active area of study in recent years. And while much
 of the research has highlighted the potential long-term dangers posed
 by football, JAMA Neurology published a study this month that showed 
not all former players suffer from cognitive impairment.
Researchers at the University of Pennsylvania looked at Wisconsin men 
who graduated high school in 1957, comparing those who played football
 in school and those who didn’t. The men were assessed for depression
 and cognitive impairment later in life — in their 60s and 70s — and the 
research found similar outcomes for those who played high school
 football and those who didn’t.
That study also had its limitations, and the authors noted that the
 game 60 years ago is different in many ways from the present-day
 high school football experience, from playing style to equipment to the
 rule book.
The Boston University study doesn’t necessarily reflect the same era of 
football. According to the researchers, the vast majority of the brains 
studied belonged to players who played in the 1960s or later. In addition
 to examining the brains, researchers interviewed family members and
 loved ones of the deceased former players and found that behavioral
 and mood symptoms were common with those who suffered from
 CTE, including impulsivity, signs of depression, anxiety, hopelessness 
and violent tendencies.
While the disease can currently only be diagnosed post-mortem, the 
researchers urge for a wide-ranging longitudinal study to better 
understand the impact head trauma has on football players across all 
levels.
In the meantime, the brain bank has about 425 donated brains at its 
disposal, including those from men and women who played a variety 
of sports, as well as military veterans, with many more pledged.
“It’s not an inert study,” McKee said. “This is a very large resource that 
will advance research in many directions. . . . The whole point is to 
advance and accelerate our knowledge of CTE in order to aid the 
living people who are at risk for it or who have it.”