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How CTE affects the brain

A MARTÍNEZ, HOST:

Study my brain. As we just heard, that was in the note written by the gunman in Midtown Manhattan, according to authorities in New York. So it was a claim that he got the brain disease, chronic traumatic encephalopathy - or CTE - from playing high school football. Now, only an autopsy can conclusively diagnose CTE, but to better understand the signs and symptoms, we called up Chris Nowinski. He played college football at Harvard and was a pro wrestler before becoming a neuroscientist and the CEO of the Concussion Legacy Foundation.

CHRIS NOWINSKI: The early signs aren't exactly clear. And that's why it's important that people who have these symptoms seek medical help because while people with CTE often have mental health issues, have problems with cognition, have all these other things, especially when you're in your 20s and 30s, like, we don't exactly know if it's CTE causing this or it's another treatable condition. It's one thing when we were talking about older people who have dementia and played 20 years of football, like, that - you can often predict CTE somewhat accurately there. But these younger people, you know, we just published a study of 152 people who died before 30 whose family was all concerned they'd taken too many hits and only 40% had it. And so it's important for people to realize if they're concerned, they're better off - seek treatment because you might have something that's very easily treatable. Even if you have CTE, the symptoms are treatable.

MARTÍNEZ: As far as we know, Tamura only played organized football in high school. Is that long enough for someone to get CTE?

NOWINSKI: So it's entirely possible to get CTE just from playing through high school. The bigger question is, when did he start? Because your odds of developing CTE double every probably three to five years. And so if he started at 5, he's got a dramatically higher risk of having CTE versus if he started as a ninth grader or a 10th grader.

MARTÍNEZ: So is it more of a cumulative hits on the brain, or can one big hit cause it?

NOWINSKI: In theory, one big hit can cause it, but in studying brain banks of people who had had one big hit, it's extremely rare.

MARTÍNEZ: It was in 2005 that Dr. Bennet Omalu performed an autopsy on former NFL player Mike Webster and concluded that Webster was the first to be diagnosed with CTE. What has been learned in the 20 years since about CTE that maybe might offer some hope?

NOWINSKI: Yeah. Webster was the first American football player diagnosed with CTE, but we've known about it for almost 100 years, starting with boxers.

MARTÍNEZ: We had terms before, punch drunk, right? Also shell shocked...

NOWINSKI: Yeah.

MARTÍNEZ: ...For soldiers. I mean, we had these terms before, but I guess we didn't know exactly what to call it medically.

NOWINSKI: Right. We didn't even have the tests we use now to diagnose CTE. So we couldn't visualize tau protein, which is the hallmark of CTE, until the late 1970s. The reality is, we also now are finding that this is pretty widespread among people who had really long careers. We let this disease linger far too long, just assuming it was in boxers and now we realize it's in football players, ice hockey players, rugby players, military veterans who are exposed to blast injuries or blast overpressure. We've studied more than 400 NFL players and more than 90% have had it. We just published that 18 of 19 NHL players have had it, and we contrast that with the fact that only a minority of those who played through high school have had it. But I think the number out there is much bigger than people realize.

MARTÍNEZ: Tamura mentioned the NFL in his note. Considering the NFL's dubious past about downplaying the effects of football on the brain, where does the league stand today on concussions and CTE?

NOWINSKI: You know, the reality is, you know, I started this work almost 20 years ago when I was with the WWE. My colleague, Chris Benoit, who had confided in me that he was concerned about all his concussions, changed dramatically over a period of months and ended up killing his wife, his 7-year-old son, and himself. Aaron Hernandez killed two people. Philip Adams, former NFL player at 32, killed six strangers and had CTE. All of them had CTE. So we know this is happening and it's going to keep happening until we learn how to cure this disease. And so the important thing is that this is a very sad day for everybody, especially the victims and their families. And hopefully, we can make something good come of this, which is a reminder to everybody that this has been happening for a long time, and we're going to have to change if we want different outcomes.

MARTÍNEZ: Given the shooter's request to have his brain studied, is that what will happen? I mean, is that request alone enough?

NOWINSKI: I suspect it is. The New York Medical Examiner's office is among the most sophisticated in the world, and they have neuropathologists who are familiar with CTE. And so I suspect that they will study him for CTE and every other possible brain disorder that could cause this sort of behavior and psychiatric symptoms.

MARTÍNEZ: Chris Nowinski is a neuroscientist and CEO of the Concussion Legacy Foundation. Chris, thank you.

NOWINSKI: Thank you. Transcript provided by NPR, Copyright NPR.

NPR transcripts are created on a rush deadline by an NPR contractor. This text may not be in its final form and may be updated or revised in the future. Accuracy and availability may vary. The authoritative record of NPR’s programming is the audio record.

A Martínez
A Martínez is one of the hosts of Morning Edition and Up First. He came to NPR in 2021 and is based out of NPR West.