Press Releases
MEMBER OF NFL HALL OF FAME DIAGNOSED WITH DEGENERATIVE BRAIN DISEASE
All NFL and College Football Players Studied Post-Mortem Show Signs of CTE
(BOSTON) – The Center for the Study of Traumatic Encephalopathy (CSTE) at Boston University School of Medicine (BUSM) announced today that a recently deceased member of the NFL Hall of Fame suffered from the degenerative brain disease Chronic Traumatic Encephalopathy (CTE) when he died, becoming the 10th former NFL player diagnosed with the disease.
Last week, CSTE researchers announced CTE had been diagnosed post-mortem in a former college football player who died at 42, the first advanced case in a non-NFL football player. Most concerning, all 11 of the former NFL and college football players studied post-mortem at the CSTE have shown signs of CTE.
Lou Creekmur, former offensive lineman for the Detroit Lions and eight-time Pro Bowl player, was diagnosed with CTE by neuropathologist and CSTE co-director Ann McKee, MD. Creekmur played 10 seasons for the Detroit Lions, and was famous for breaking his nose 13 times while playing without a facemask. He died July 5, 2009 from complications of dementia following a 30-year decline that included cognitive and behavioral issues such as memory loss, lack of attention and organization skills, increasingly intensive angry and aggressive outbursts.
CTE can only be diagnosed by examining brain tissue post-mortem. Creekmur’s brain was studied by McKee who determined that he was suffering from CTE and not another cause of dementia such as Alzheimer’s disease. McKee said, “This is an important case because we are confident many CTE cases are misdiagnosed as Alzheimer’s disease. By examining his brain, I was able to confirm that there was absolutely no sign of Alzheimer’s disease or any other type of neurodegenerative disease except for severe CTE. This is the most advanced case of CTE I’ve seen in a football player; his brain changes were similar to those of profoundly affected professional boxers.”
President and CEO of the Alzheimer’s Association Mass./N.H. Chapter James Wessler stated, “This is a very important finding that could explain the underlying cause of dementia in countless individuals who have had histories of repetitive head trauma.”
The Creekmur case is also important in advancing discussion of what risk factors may play a role in causing CTE other than trauma. One hypothesis that has been put forward is that anabolic steroids could play a role in CTE. However, Creekmur played in the 1950s, a time that predates documented steroid use in the NFL, so the case proves CTE does occur in the absence of steroids.
Robert Stern, PhD, CSTE co-director, added, “The U.S. House Judiciary Committee is holding a hearing on the football head injury crisis on Oct. 28, and we feel that this evidence should be part of the discussion. The long-term consequences of brain trauma in sports are a tremendous public health problem. CTE is the only fully preventable cause of dementia. We need to make changes to the game of football, at all levels of play, which will decrease the risk of CTE to both pro and amateur athletes.”
Creekmur was a member the NFL’s Plan 88. The Plan was named for former NFL star John Mackey’s jersey number. Mackey, a Hall-of-Fame tight end for the Colts in the 1960s and 70s, suffers from severe dementia. The Plan was created by the NFL to provide financial support to families of former players who suffer from some form of dementia. Members of the Plan have been diagnosed with “dementia,” which refers to progressive memory and cognitive deficits significant enough to impair daily living. During life, it is not possible to determine the underlying disease that causes dementia. However, now that a Plan 88 member has been examined pathologically, CSTE scientists have proven it is possible to determine the cause of dementia, which in this case was repetitive trauma from football.
Creekmur’s wife of 33 years, Caroline Creekmur, had extensive discussions with her husband prior to death about his brain trauma history, and is confident he remembered “16 or 17” concussions, none that caused loss of consciousness or necessitated a hospital visit. He did not have any significant head trauma since retiring from the NFL.
There are approximately 100 former NFL players whose families are receiving support through Plan 88, including Ralph Wenzel, age 66, former lineman for the Pittsburgh Steelers and San Diego Chargers, who now resides in an assisted living facility with advanced dementia. Upon learning of Creekmur’s CTE diagnosis, Wenzel’s wife, Dr. Eleanor Perfetto, stated, “Sadly, these findings do not come as a surprise. For those of us who have watched our husbands deteriorate and lose their independence from progressive dementia, our hope is that this research will one day lead to changes in the game of football such that other players and their families will not have to experience the pain that we have experienced.”
CTE is characterized by the build-up of a toxic protein called tau in the form of neurofibrillary tangles (NFTs) and neuropil threads (NTs) throughout the brain. The abnormal protein initially impairs the normal functioning of the brain and eventually kills brain cells. Early on, CTE sufferers may display clinical symptoms such as memory impairment, emotional instability, erratic behavior, depression and problems with impulse control. However, CTE eventually progresses to full-blown dementia. Although similar to Alzheimer’s disease, CTE is an entirely distinct disease.
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The CSTE was created in 2008 as a collaborative venture between Boston University School of Medicine (BUSM) and Sports Legacy Institute (SLI). The mission of the CSTE is to conduct state-of-the-art research of Chronic Traumatic Encephalopathy, including its neuropathology and pathogenesis, the clinical presentation and course, the genetics and other risk factors for CTE, and ways of preventing and treating this cause of dementia.
Sports Legacy Institute is a 501(c)(3) nonprofit corporation founded in 2007 to solve the sports concussion crisis. SLI is dedicated to education, prevention, treatment, and research on the effects of concussions and other brain injuries in athletes and the military. SLI partnered with Boston University School of Medicine to form the Center for the Study of Traumatic Encephalopathy in 2008.
October 28, 2009: BUSM Center for the Study of Traumatic Encephalopathy CSTE
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FIRST FORMER COLLEGE FOOTBALL PLAYER DIAGNOSED WITH CTE
Former Brigham Young University Football Coach Died at 42
(BOSTON) – The Center for the Study of Traumatic Encephalopathy (CSTE) at Boston University School of Medicine (BUSM) announced today that a deceased former college football player who died at age 42 was already suffering from the degenerative brain disease, Chronic Traumatic Encephalopathy (CTE). This is the first time an advanced case of CTE has been discovered in a college football player that did not play professionally. It is also the first case diagnosed in a wide receiver. CTE has been diagnosed post-mortem in at least seven recently deceased former National Football League players, and early signs of the disease were recently found by CSTE researchers in an 18 year-old deceased football player.
CTE was diagnosed in Mike Borich, a Snow College and Western Illinois University player in the 1980s, by neuropathologist Ann McKee, MD, co-director of the CSTE. Borich went on to become an award-winning division I college football coach, and was named the Offensive Coordinator of the Year in 2001, while coaching at Brigham Young University under head coach Gary Crowton. Borich also coached for the NFL’s Chicago Bears in 1999-2000. He left coaching in 2003 struggling with overwhelming drug and alcohol addictions, ultimately dying from a drug overdose in February 2009. Other CTE sufferers, such as Tom McHale of the Tampa Bay Buccaneers, died with similar late-onset drug and alcohol problems. Borich was known to have approximately 10 concussions during his college football career with no subsequent concussions or head injuries since that time.
Robert Cantu, MD, a leading sports concussion expert and BUSM CSTE co-director and clinical professor of neurosurgery at BUSM said, “CTE is the only fully preventable cause of dementia. It is our hope that this evidence helps draw the focus of the CTE discussion to amateur athletes, where it belongs. Young men and women are voluntarily exposing themselves to repetitive brain trauma without full knowledge of the potential consequences, and the rules of the games are designed without an appreciation for the risks carried by the players.”
Joe Borich, Mike Borich’s father, donated his son’s brain tissue to the CSTE Brain Bank, a brain tissue repository for the study of CTE. By donating Mike’s brain, he hoped to enable athletes to play sports more safely. He also anticipated that the analysis might provide a window into Mike’s personality changes and increasingly self-destructive behavior. “Mike suffered greatly in his last few years. Through donating his brain to research I hope that his suffering will now have had meaning, and his legacy will be that in his death he helped to save others.”
Cantu and McKee and the other co-directors of the BUSM CSTE, Robert Stern, PhD, and Chris Nowinski, a former division I football player, published a paper that reported all CTE findings in athletes in the July issue of the Journal of Neuropathology and Experimental Neurology (2009, vol.68¸ pp. 709-735). McKee also recently presented these findings to the NFL Mild Traumatic Brain Injury Committee and NFL Players Association.
Stern added, “The US House Judiciary Committee is holding a hearing on the NFL head injury crisis next week. This evidence should be part of the discussion. Brain trauma in sports is a public health problem, not just an NFL problem.”
Borich was not part of the CSTE Brain Donation Registry when he died. The CSTE Brain Donation Registry has now enrolled over 175 athletes in the C.O.N.T.A.C.T. research program (Consent to Offer Neural Tissue of Athletes with Concussive Trauma). These athletes will be interviewed annually by phone throughout their lives and, upon death, their brain tissue will be examined by the CSTE. This prospective approach with allow the researchers to examine the relationship between clinical symptoms and pathology for the first time.
CTE, first reported in 1928 and originally referred to as “dementia pugilistica” because it was believed to only affect boxers, is a progressive neurodegenerative disease caused by repetitive trauma to the brain. The use of the terms Traumatic Encephalopathy and CTE were first used in the 1960s.
The disease is characterized by the build-up of a toxic protein called tau in the form of neurofibrillary tangles (NFTs) and neuropil threads (NTs) throughout the brain. The abnormal protein initially impairs the normal functioning of the brain and eventually kills brain cells. Early on, CTE sufferers may display clinical symptoms such as memory impairment, emotional instability, erratic behavior, depression and problems with impulse control. However, CTE eventually progresses to full-blown dementia. Although similar to Alzheimer’s disease, CTE is an entirely distinct disease.
***********************************************************************************************************
The CSTE was created in 2008 as a collaborative venture between Boston University School of Medicine (BUSM) and Sports Legacy Institute (SLI). The mission of the CSTE is to conduct state-of-the-art research of Chronic Traumatic Encephalopathy, including its neuropathology and pathogenesis, the clinical presentation and course, the genetics and other risk factors for CTE, and ways of preventing and treating this cause of dementia.
Sports Legacy Institute is a 501(c)(3) nonprofit corporation founded in 2007 to solve the sports concussion crisis. SLI is dedicated to education, prevention, treatment, and research on the effects of concussions and other brain injuries in athletes and the military. SLI partnered with Boston University School of Medicine to form the Center for the Study of Traumatic Encephalopathy in 2008.
October 22, 2009: BUSM Center for the Study of Traumatic Encephalopathy CSTE
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CENTER FOR THE STUDY OF TRAUMATIC ENCEPHALOPATHY ANNOUNCES NEW FINDINGS LINKING FOOTBALL AND PROGRESSIVE BRAIN DAMAGE
Four 88 Plan Members Will Donate Brains Upon Death
Leading medical experts at the Center for the Study of Traumatic Encephalopathy (CSTE) at Boston University School of Medicine (BUSM) reported today that nine-year NFL veteran, former Tampa Bay Buccaneer Tom McHale was suffering from chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by head trauma, when he died in 2008 at the age of 45. In addition, the CSTE has discovered early evidence of CTE in the youngest case to date, a recently deceased 18-year-old boy who suffered multiple concussions in high school football.
McHale, a Cornell University graduate, former restaurateur, husband and father of three boys, is the sixth former NFL player to be diagnosed post-mortem with CTE since 2002. CTE, a progressive neurodegenerative disease caused by repetitive trauma to the brain, is characterized by the build-up of a toxic protein called tau in the form of neurofibrillary tangles (NFTs) and neuropil threads (NTs) throughout the brain. The abnormal protein initially impairs the normal functioning of the brain and eventually kills brain cells. Early on, CTE sufferers may display clinical symptoms such as memory impairment, emotional instability, erratic behavior, depression and problems with impulse control. However, CTE eventually progresses to full-blown dementia. McHale died due to a drug overdose after a multi-year battle with addiction. Expert consensus is that drug abuse of any kind would never cause the neuropathological findings of CTE seen in McHale.
The other former NFL players diagnosed with CTE are former Pittsburgh Steelers Mike Webster, Terry Long and Justin Strzelczyk, along with Andre Waters and John Grimsley. Waters and Long committed suicide. Grimsley, an avid and experienced gunsman, died in 2008 from a self-inflicted gunshot wound that the medical examiner ruled as accidental. All six NFL CTE sufferers died by the age of 50. Damien Nash, who died in 2007 at the age of 24, is the only former NFL player to be examined neuropathologically and not have CTE. Chris Nowinski, co-founder of the non-profit Sports Legacy Institute (SLI), explained, “This means that six of six deceased former NFL players between the ages of 25 and 50 have had severe brain damage that, if they had lived, would have developed into debilitating dementia.”
According to Ann McKee, MD, CSTE co-director and a leading neuropathologist who specializes in degenerative brain diseases, “CTE has been described for approximately 80 years. Initially referred to as dementia pugilistica because of the boxers that were originally studied, CTE is now being seen in other athletes. Although the neuropathological findings of CTE are, in some ways, similar to those we see in Alzheimer’s disease, they represent a distinct disease with a distinct cause, namely repetitive head trauma.” McKee conducted the neuropathological analysis on the brains of both Grimsley and McHale. Her findings of significant CTE in their brains were independently confirmed by E. Tessa Hedley-Whyte, MD, professor of pathology at Harvard Medical School and a neuropathologist at Massachusetts General Hospital.
Due to the growing strength of these findings linking brain trauma on the football field to CTE, a number of living former NFL players have recently agreed to join three-time Super Bowl champion Ted Johnson and seven other former NFL players to donate their brains to Boston University School of Medicine upon death. The new donors include three members of the NFL’s 88 Plan, joining Ralph Wenzel, another 88 Plan donor.
The 88 Plan was named after former NFL star John Mackey’s jersey number. Mackey, a Hall of Fame tight end for the Colts in the 1960s and 70s, suffers from severe dementia. The plan was created by the NFL to provide families of former players who suffer from some form of dementia with money to support their care. Members of the Plan, by definition, have been diagnosed with “dementia,” which refers to progressive memory and cognitive deficits significant enough to impair daily living. During life, it is not possible to determine the underlying disease which causes dementia. Following death, CSTE doctors will be able verify with certainty whether or not 88 Plan members’ dementia was caused by trauma sustained in sports like football (i.e., CTE) or by other causes of dementia, such as Alzheimer’s disease. Eleanor Perfetto, PhD, wife of retired NFL player and 88 Plan member, Ralph Wenzel, who served as offensive lineman for the Chargers and Steelers, 1966-73, said, “My husband suffered numerous concussions and other head traumas while playing football and is now exhibiting significant dementia, is living in a locked assisted living facility, and is unable to feed himself or even recall his days playing football. Something needs to be done to prevent this type of tragedy from occurring to other players and their families.”
CSTE is a collaboration between SLI and BUSM. SLI was founded by former Harvard football player and WWE pro wrestler Chris Nowinski, and neurosurgeon and concussion expert Robert Cantu, MD, chief of Neurosurgery and director of Sports Medicine at Emerson Hospital in Concord, Mass, and clinical professor Neurosurgery at BUSM. The work at BUSM is being led by McKee, an associate professor of Neurology and Pathology, director of the Neuropathology Core of the BU Alzheimer’s Disease Center, and the director of the brain banks of the Framingham Heart Study and the Bedford VA Medical Center, and Robert Stern, PhD, associate professor of Neurology and co-director of the BUSM Alzheimer’s Disease Clinical and Research Program. The CSTE received initial funding for their research from BUSM and subsequently received a $100,000 grant from the National Institute on Aging to support their work. This past week, the group of researchers learned that they received a $250,000 grant from the National Operating Committee on Standards for Athletic Equipment (NOCSAE).
Co-Director of the CSTE, Stern, said, “CTE is the only fully preventable cause of dementia. By studying large numbers of athletes throughout their lives, as well as examining brain tissue through our expanding CSTE brain bank, we will be able to determine the specific risk factors for CTE. This, in turn, will foster education and allow meaningful guidelines to be implemented at all levels of athletic participation, from youth, to college, to pro. In the mean time, however, we already know that return to play too soon after a concussion can have devastating results.”
The discovery of the initial stages of CTE in an 18-year-old should move the discussion of football’s concussion crisis toward youth football. The identity of the 18-year-old will not be revealed at the family’s request. According to Cantu who wrote the first return-to-play guidelines, “Our efforts to educate athletes, coaches, and parents on the need to identify and rest concussions have only been moderately successful because people have been willing to look the other way when a child suffers a concussion. I hope the discovery of CTE in a child creates the urgency this issue needs. It is morally and ethically wrong to allow our children to voluntarily suffer this kind of brain trauma without taking the simple educational steps needed to protect them.”
Lisa McHale, widow of Tom McHale, said, “What’s even more disturbing to me, and the reason I am here, is that Tom is not alone. His is now the sixth confirmed case of CTE among former professional football players. Bearing in mind that only six former players, over the age of 25, have been tested for CTE, I find these results to be not only incredibly significant, but profoundly disturbing. And I just can’t conceive of anyone thinking otherwise. I have 9 and 11-year-old boys who are just beginning to play Pop Warner football. In light of Tom’s situation and the findings on the high school football player with the initial evidence of CTE, I now question their involvement in a sport that had been so important in our lives.”
NFL players who have recently chosen to join the CSTE brain donation registry include Hall of Famers Joe DeLamielleure and Willie Wood, an 88 Plan member. They are joined by Ken Gray, Brent Boyd, Dan Pastorini, Mel Owens, and Chad Levitt, as well as 88 Plan members Wayne Hawkins and Willie Daniel. SLI president and CSTE co-director Nowinski said, “We appreciate the growing support among former NFL players and their choice to give back to past, current, and future generations of athletes. I hope this research serves as a wake-up call that radical change is needed in football to protect the millions of children playing the game.”
January 27, 2009: BUSM Center for the Study of Traumatic Encephalopathy CSTE
