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Those who have been following recent concussion-related lawsuits against the NFL and Pop Warner will be familiar with CTE, or chronic traumatic encephalopathy, a neurological disease discovered in 99 percent of NFL players' brains donated to an MIT study. The frustrating thing -- for players, their families, and scientists alike -- has been the fact that CTE could only be diagnosed posthumously, after a patient had passed away or, as in many cases, committed suicide.
However, researchers now believe they have a method for identifying CTE in living patients, which could have enormous health and legal consequences.
The Tau of CTE
While scientists believe they know what causes CTE -- repeated trauma to the brain from constant impacts with other players and the turf -- until now, an autopsy was needed to definitively diagnose the disease. So Dr. Bennet Omalu developed a brain scan he hoped would identify indicators of CTE in living patients.
One theory was that CTE was correlated with high levels of tau protein, also linked to Alzheimer's. And so-called [F-18]FDDNP-PET imaging can allegedly identify tau proteins, which make distinctive patterns in the brain, in living subjects. Omalu told CNN tau has a "specific topographic signature," that can be detected using [F-18]FDDNP-PET imaging.
Omalu tested at least a dozen former NFL players with this imaging system beginning in 2012, but only one of those tested has passed away since. According to Omalu's study, published this month in Neurosurgery, a scan found elevated level of tau protein in Fred McNeill's brain while he was still alive and suffering from the common symptoms of CTE, and a detailed brain-tissue analysis following his death in 2014 confirmed the CTE diagnosis. McNeill was a linebacker for the Minnesota Vikings for 12 seasons from 1974 to 1985.
CTE testing and diagnosis remains in its infancy, and even Dr. Omalu admits, "Future studies are warranted to determine whether differential and selective [F-18]FDDNP-PET may be useful in establishing a diagnosis of CTE in at-risk patients." But the physical, psychological, and, yes, legal and financial ramifications could be huge.
Of course diagnosing CTE as early as possible could mean finding more effective means of care and treatment. But finding out exactly when a person develops CTE can be crucial to determining legal liability for brain injuries, if any. If, for instance, a football player did not show high levels of tau protein during high school, but did upon graduation from college, that could absolve both the high school and the NFL from liability. Early diagnoses of CTE could also allow players to make more informed decisions about their playing future.
Correlation doesn't equal causation, and one result doesn't make a scientific fact. But catching CTE early, before a former player is dead, could be the next step in concussion lawsuits.