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Ramifications of a Scientific Breakthrough


Chronic Traumatic Encephalopathy, or CTE, is a neurodegenerative disease found in people who have suffered multiple head injuries. It is commonly associated with athletes who have participated in contact sports on a regular basis over a long period of time. Because of its presence in a large number of NFL athletes, CTE has become part of a national dialogue about the risks of playing certain sports.

Like other neurodegenerative diseases such as Alzheimer’s and Parkinson’s, CTE cannot be definitively diagnosed until after a person dies. A deceased person’s brain is examined for the presence of abnormal clumps of the tau protein in a pattern unique to CTE.

A little over one week ago, Dr. Ann McKee of Boston University’s CTE Center identified a protein found in brain tissue and cerebrospinal fluid. Levels of this protein are high in brain samples and spinal fluid of people with diagnosed CTE, and the level of the protein increased with the number of repetitive head impacts the person had sustained during their lifetime. The difference in Dr. McKee’s test is that it can be performed on living people; a sample of spinal fluid could potentially reveal the presence of CTE in living people with suspected brain trauma.


Aaron Hernandez, a star football player in high school, college and the NFL, hanged himself in his prison cell in April of this year. He was serving a life sentence for the murder of his friend, Odin Lloyd. An examination of Hernandez’s brain revealed Stage 3 CTE; he was only 27 years old. His family has filed a $20 million dollar lawsuit against the NFL and the New England Patriots.

If CTE had been diagnosed in Hernandez while he were alive, it is possible—even likely—that he would have received a clinical treatment plan that addressed his erratic, impulsive, and violent behavior. Furthermore, evidence of his advanced CTE could have provided a legal defense to his criminal behavior: Hernandez could have asserted an insanity defense along the lines of a “mental defect” that prevented him from conforming his behavior to the requirements of the law, per the Massachusetts statute. CTE clearly impairs impulse control.


Recent studies have shown that young children in particular are vulnerable to changes in the brain from contact sports. A study by Dr. Christopher Whitlow at Wake Forest School of Medicine in 2016 found that even when boys 8-13 years old had not suffered any concussions, their brains showed changes after only one season of football. If older players—e.g. high school athletes—could be diagnosed with CTE, the talent pool for college football and the NFL could potentially be drained.

But ramifications of definitively diagnosing a neurodegenerative brain disease in the living go well beyond sports. As noted above in the case of Aaron Hernandez, a diagnosis could potentially be used as a legal defense to a wide variety of violent crimes. Does CTE cause athletes to act out against not just themselves, with substance abuse and suicides that have been well documented, but against others with acts of domestic violence, assault, and even homicide?

Arguing either side of the issue is controversial. Athletes who have suffered repeated head trauma do not necessarily want to concede that their sport and livelihood makes them prone to acts of violence; those that do believe their impulsivity, aggression and acts of violence are due to brain trauma face backlash from those that think they are using their sport as an excuse for their behavior.

If brain trauma and CTE become more conclusively linked with violent and criminal behavior, then society will have to grapple with its endorsement of sports which not only involve but promote repeated head trauma. Football, hockey, soccer—all of these enormously popular and profitable sports rely on tackles, fights and passes that involve hits to the head that the public still wants to see. Just last week, President Trump commented that the new NFL rules meant to protect players were “ruining the game,” supposedly because players were not hitting as hard and therefore the entertainment value was decreased.


Dr. McKee’s test to diagnose CTE in living people is still not available. But the increased knowledge of what repeated hits to the head do to the brain is available. Armed with that knowledge, parents can make informed decisions about what sports they feel are safe and when their children should start playing them. Recent studies show that the younger a child starts to play contact sports, the more vulnerable their brain is to damaging changes resulting from hits to the head. Other studies show that perhaps taking time off in between contact sports rather than playing them year round can allow a brain to recover from repeated hits. Physical activity and the chance to develop leadership and social skills are important to youth growth, so the physical risks must be balanced with these positive aspects of sports. Recognizing the signs of brain trauma so that quick and effective treatment is sought is crucial. Parents and athletes should be aware and informed, and athletes should never play if there is any suspicion of head trauma.

If someone is exhibiting signs of “disinhibition,” i.e. they are engaging in violent behavior, they are abusing alcohol or drugs, they are experiencing a breakdown of their intimate relationships, or a combination of these, they may be suffering from a traumatic brain injury or a neurodegenerative brain disease. If the person is or was an athlete, this scenario is particularly likely. Getting this person into treatment to prevent (further) violent behavior is crucial.


If you or someone you know has been injured by the violent behavior of someone, contact Dave Thomas at The Thomas Law Firm for a free consultation regarding your legal rights.

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