September 23rd, 2017

Aaron Hernandez and CTE

This is sad, although it may offer Hernandez’s family mild comfort and some evidence that might help them win a lawsuit against the NFL:

Aaron Hernandez, the former NFL star who took his life while serving a murder sentence in prison, had chronic traumatic encephalopathy — commonly known as CTE — attorney Jose Baez said Thursday.

Baez cited study results compiled by the Boston University CTE Center, which examined Hernandez’s brain for the neurodegenerative brain disease.

Hernandez played for the New England Patriots from 2010 to 2012 after a standout collegiate career at the University of Florida.

According to a statement from BU, Hernandez’s brain was examined by Dr. Ann McKee, director of the CTE Center. The neurodegenerative brain disease has Alzheimer’s-like symptoms, including memory loss, confusion, aggression, rage and, at times, suicidal behavior. It is believed to result from repeated trauma to the head, which results in a buildup of the abnormal protein tau that clumps in the brain.
The disease is categorized in four degrees, with Stage 4 being the most severe. According to McKee’s analysis, Hernandez was found to have Stage 3 CTE, which is commonly associated with cognitive and memory loss, as well as behavioral changes and impaired judgment.

Perhaps Hernandez wouldn’t have gone so far as murder without this added push from his own brain. However, a caveat—a huge caveat—is that most people with CTE don’t commit murder and don’t kill themselves. There is no way to know how much effect his CTE had on Hernandez’s behavior, and to what extent it may have intensified the emotional reactions that led to his crimes.

I doubt that CTE alone would be considered enough to get him off the hook in the legal sense even if it had been diagnosed before his trial, and of course there was no way to have discovered it before his trial because it can only be diagnosed by autopsy. The legal system has to go on symptoms: does the person have dementia or a mental illness with hallucinations, for example, that might lead to a case of diminished responsibility?

There actually was a case in which CTE (undiagnosed, of course) was raised in a murder trial by a former wrestler—not for the crime itself, which had happened 32 years before the trial, when the accused was a young man—but in the context of deciding whether he was competent to stand trial:

His lawyers argued that decades of getting banged around in the ring had caused dementia, rendering him incapable of understanding what was happening. Frank M. Dattilio, a forensic psychologist hired by the defense, called Snuka a “shell of a man.”

Some think that the defense is taking advantage of the recent media coverage of sports-related CTE, or chronic traumatic encephalopathy. A degenerative brain condition caused by head injuries and concussions, it’s often associated with professional athletes from the football and hockey worlds who suffer blow after blow in play.

“I think they’re using it as a strategy, and the goal was to find him incompetent, which was successful,” says John O’Brien, a forensic psychiatrist and physician, who testified for the prosecution during Snuka’s competency hearing.

Snuka was found not competent* to stand trial. But it sounds as though he exhibited strong signs of dementia, and he died about a year later.

[* NOTE: A lot of people confuse competence to stand trial with the insanity defense. They are different. The latter defense is used in the body of a trial, and involves state of mind as an element of the crime. The former has to do with whether a trial will even take place if the person is found incompetent and therefore unable to stand trial—meaning that he or she lacks the requisite mental capacity or state of mind to understand the charges and/or to cooperate in his/her defense. It’s a tough standard to meet unless the defendant is really far gone.]

30 Responses to “Aaron Hernandez and CTE”

  1. Ymar Sakar Says:

    meaning that he or she lacks the requisite mental capacity or state of mind to understand the charges and/or to cooperate in his/her defense.

    Demoncrats still get their vote right?

  2. Griffin Says:

    One of the problems with this entire CTE issue is that as you said the only way to diagnose is in an autopsy and they have a huge issue where most of the brains they are examining are from people that have shown signs of some sort of impairment. So what seems unknown is how many regular everyday people like construction workers or military veterans or numerous other professions may also have this and we have never known. And then we don’t know if maybe many former football players have this yet show no signs or at least nothing out of the ordinary range of behaviors.

    This whole thing is not as cut and dry as some in the media want it to be.

  3. Frog Says:

    It strikes me as odd that CTE symptoms should be limited to cognitive, memory and emotional alterations. Why not be associated also with seizures, coordination dysfunction, motor deficits, for example?
    I have not done any homework on CTE, am simply responding to Neo’s essay. But “encephalos” means “brain” (from the Greek ‘en’ (in) ‘cephalos’ (head), not selected parts thereof unless so designated, and brain injury can take many forms based on the loci of injuries, as is implied in the title of Chronic Traumatic Encephalopathy.
    In contrast, see for example PML, virus-caused: Symptoms of PML include mental deterioration, vision loss, speech disturbances, ataxia (inability to coordinate movements), paralysis, and coma. In rare cases, seizures may occur. Because lesions and nerve damage can occur anywhere in the brain, the initial symptoms may be different among people with the disease.
    PML means Progressive, Multi-focal Leukoencephalopathy. Leuko refers to the white outer layer of the brain, the Cortex, as opposed to the deeper inner gray (Subcortical) portion. Thus PML is a more descriptive characterization than is CTE, which seems associated with frontal white matter lesions only, as opposed to, for example, lateral lesions, which would injure motor or tactile sensory functions.
    So perhaps CTE should be called a Frontal Encephalopathy, with its putative cause eliminated from the definition. PML is not called VPML (viral PML), after all, because the cause was not until recently identified. Note the putative; duodenal ulcers were said for decades to be caused by stress or drinking, treated with ‘bland diets’, etc., until Australians discovered the bacterial cause.
    Trauma may well not be the only cause for CTE! It may also be out there in the general population without antecedent documented crashing of helmeted heads.

  4. Paul in Boston Says:

    My late mother had Alzheimers from age 80 until she passed away at 92. When my father passed on we brought her here to Boston to live in the “memory” unit of an assisted living home. Early on in her late eighties and early nineties, when she could still get around on her own using a walker, she would occasionally fall and hit her head. Protocol required that she be taken to the ER where she could checked out for injury and brain trauma. The xrays of her head that the doctors showed me were of a shriveled brain due to Alzheimers. This clearly had been going on a long time. The scans of CTE damage sure look the same to me. What makes anyone sure that the damage is due to head trauma and not some other insidious disease like Alzheimer’s?

    The CTE coverage sure looks to me like another hysteria whipped up by the press as an attack on football and little if anything to do with what could just as well be a real disease that affects younger people.

  5. huxley Says:

    Aaron Hernandez was only 27 years-old.

    Maybe there is a brain disease which affects younger people like senility but so far we don’t know about it.

    Meanwhile there are all these hard contact sports veterans with brain damage and it’s not that surprising.

    I don’t want to lay off murder charges on the NFL etc. and I’m willing to wait for more research, but if I had a son interested in football, boxing or rugby, I would discourage him.

  6. huxley Says:

    My best friend, who was a serious wrestler in high school and a serious body builder later, expects football and boxing fade away like bull fighting as people become more aware of the prices exacted for the spectacles.

    He’s conservative too.

  7. Frog Says:

    huxley:
    C’mon! He was serving life in prison, and…
    “A lawyer for Aaron Hernandez said Thursday that the former NFL player — who committed suicide in prison — had suffered from a “severe” case of the degenerative brain disease CTE.”
    A lawyer for the decedent. Sniffing for a lawsuit. Or an excuse.

    Kindly give my previous remarks here on this subject some thought.

  8. neo-neocon Says:

    Paul in Boston:

    Alzheimer’s cannot be definitively diagnosed by CAT scans of the brain or MRIs of the brain, although it can be suggested as a diagnosis by such scans:

    CT and MRI scans, which reveal the anatomic structure of the brain, are used to rule out such problems as tumor, hemorrhage, stroke, and hydrocephalus, which can masquerade as Alzheimer’s disease. These scans can also show the loss of brain mass associated with Alzheimer’s disease and other dementias. In Alzheimer’s disease, the region of the brain known as the hippocampus may be disproportionately atrophied.

    CTE also cannot be diagnosed by scans while alive. The diagnosis is done by autopsy:

    . A diagnosis requires evidence of degeneration of brain tissue and deposits of tau and other proteins in the brain that can be seen only upon inspection after death (autopsy).

    So there is some atrophy of the brain that shows up in scans in both illnesses (as well as in other brain degenerative syndromes), but neither Alzheimer’s nor CTE can be definitively diagnosed by brain scan. However, on autopsy, a suspected diagnosis can be confirmed in both illnesses by the findings of the autopsy.

    The autopsy findings in each illness are different:

    Subjects with CTE had tangles of tau proteins in their brains that were similar to those seen in later-stage Alzheimer’s patients. However, these tangles occurred in a very different pattern. While the tangles in Alzheimer’s patients are scattered throughout the brain, those in the athletes exhibited a “skip phenomenon:” The tangles occurred in some areas of the cerebral cortex but were absent in others within the same lobe. In addition, the brains of the athletes did not show the classic neuritic amyloid plaques or the widespread cerebral atrophy characteristic of Alzheimer’s disease. Finally, the subjects diagnosed with CTE ranged from 18 to 52 years old, whereas Alzheimer’s disease typically does not occur until after age 60.

  9. huxley Says:

    Frog: I read what you said. As far as I’m concerned, you went off into the weeds, and I’m not sure you absorbed what I wrote.

    I was speaking more generally than the Hernandez case.

  10. Frog Says:

    huxley : neuroanatomy is not “in the weeds”.
    It is better to speak generally when one knows about what one is speaking.

    Neo: that the tau shows up in autopsies of 18 to 52 year olds implies a non-traumatic cause. A history of a concussion or two does not make a case for CTE, diagnosable only by brain biopsy while alive or autopsy when dead.

    The issue of lesions’ locations must be addressed, as I tried to earlier indicate.

    See also this: ” Random effects models were used to pool overall and sport-specific concussion incidence rates per 1000 athlete exposures (AEs). The overall risk of concussion was estimated at 0.23 (95% CI 0.19 to 0.28). The three sports with the highest incidence rates were rugby, hockey and American football at 4.18, 1.20 and 0.53, respectively. Lowest incidence rates per 1000 AEs occurred in volleyball, baseball and cheerleading at 0.03, 0.06 and 0.07, respectively. Quality of the included studies varied, with the majority of studies not reporting age and gender-specific incidence rates or an operational definition for concussion.
    “Conclusions There are striking differences in the rates of incident youth concussion across 12 sports. This systematic review and meta-analysis can serve as the current sport-specific baseline risk of concussion among youth athletes.”
    (From the British J of Sports Medicine, 2015)

    So helmeted American football is associated with much fewer concussions than rugby or hockey.

    In sum, the etiology of CTE may be something OTHER THAN trauma. Is the incidence of CTE compatible with the incidence of concussions? If there are thousands of concussions and only a few cases, usually decades later, of CTE, causality is in doubt.

  11. Mike K Says:

    The CTE coverage sure looks to me like another hysteria whipped up by the press as an attack on football and little if anything to do with what could just as well be a real disease that affects younger people.

    I am suspicious, too, but there does seem to be something going on. I think it may be an effect of the physical giants now playing at the elite college and professional level. Somebody once said the way to eliminate the head trauma is to do away with the helmet. A lot of this stuff may be impact and acceleration-deceleration. Think about the energy delivered by a 305 pound player running at full speed.

  12. neo-neocon Says:

    Frog:

    We don’t know if there are only a few cases of CTE or many, because the vast majority of people are never autopsied.

    From what I’ve read about CTE, it’s not just a history of concussion that is the purported cause. It’s either many smaller concussions or a few (certainly more than one) more severe ones.

    I do think that the study of this phenomenon is really in its infancy.

  13. J.J. Says:

    The advent of better helmets in the 1970s changed the game. Prior to that tackling and blocking was always done with the shoulder with the head was on either side of the player being tackled/blocked. The new helmets allowed the players to use the helmet as a battering ram. Leading with the head became the maneuver of choice as it was effective in bringing down players and delivered a punishing blow. This has led, as the players become faster and larger, to many concussions during games. And, apparently, to long term brain damage.

    One way to improve the safety of the game is to go back to the old style of blocking and tackling. The rules are being changed to discourage leading with the head, but it will take twenty years for the changes to be implemented in full because too many players and coaches are believers in leading with the head.

  14. Mike K Says:

    The players are just too big. I don;t know how to change that. If a black kid is 7 feet tall he goes to basketball. Otherwise football and gets to be 300 pounds.

  15. miklos000rosza Says:

    I agree with Mike K that the players are just too big. I’ve been surprised no one’s been paralyzed (since Darold Stingley) or killed there on the field.

  16. Frog Says:

    Neo-
    CTE is ‘Chronic’ (v. Acute) ‘Traumatic’ (v. Non-traumatic) Encephalopathy.

    The first is merely temporally specific. Traumatic indicates a specific cause. That case should not yet be deemed settled science, as you have yourself indicated in your own query about how many cases are out there in the general population.

    We could call it Professional Sports Encephalopathy at this point. We could also postulate a possible genetic proclivity, since most (~ 75%) of NFL players, and probably most college football players, are now black, as opposed to 50 years ago, and thus now enjoy greater visibility than if they were merely members of the general population.

    See how tenuous this all is?

  17. groundhog Says:

    Facts may not be all in — but I don’t see much up side on ramming your head repeatedly into anything with a great deal of force.

    Just call me an ignorant layman, but that’s what I’m going with for now.

  18. Paul in Boston Says:

    Neo @ 11:34 pm yesterday. Interesting isn’t it, death and autopsy are required for a genuine diagnosis for both diseases.

    Why is there no discussion of boxers in all this? A boxer routinely gets hit in the head mutiple times during a fight and can experience multiple small and large concussions in fifteen rounds. I’ve never heard of an increased incidence of suicide among them. The head blows certainly take their toll, just look at videos of Ali and Joe Fraser late in life. The old boxers tend to have what looks like Parkinson’s with all the associated tremors.

    I’m sticking with my initial assumption of a hysteria ginned up to attack pro football.

  19. groundhog Says:

    It would be interesting to know which direction each hit to the head came from.

    Don’t boxers mostly take hits to the front? Football players might have hard hits from different angles.

    Might also explain why some have avoided these conditions and others haven’t.

  20. Dave Says:

    I am all for banning professional boxing and football altogether, taking away the greatest opportunities of upward mobility for the black men in the name of protecting them, perfectly in line with most of the other liberal policies – destroying the livelihood of black men in the name of doing them good.

  21. miklos000rosza Says:

    These days boxing is dominated much more by Mexican, other Latin, as well as Eastern European fighters — and this is also the primary audience now for the sport.

  22. Mr. Frank Says:

    Many years ago (75?) boxing was popular with the general population. Some schools had boxing teams as did many branches of the military. Young boys got boxing gloves for Christmas, and the Golden Gloves was a prestigious competition.

    When the damage to fighters became clear and blacks dominated the sport and more people became middle class, parents would not let their kids box. This is now happening with football as youth participation declines and TV ratings slip.

    The NFL sees this coming and has been running ads about the positive effects of football. The recent flap over the National Anthem comes at a bad time for the NFL.

    The growth of Major League Soccer and the American investments in the English soccer league teams may also be part of the football decline.

  23. Lee Says:

    He was 27 when he died. He was 23 when he was arrested. He was 17 when he was first beating people up and shooting at them. I think he played two seasons, maybe three with the NFL. He played three seasons with Florida in college, but as a freshman, and typical of most freshmen, he mostly warmed the bench..

    If he had developed such a bad case of CTE, it’s because someone had been bashing his head well before he started playing for the NFL. Maybe he had the crap beat out of him as a kid. As much as I have grown to hate the NFL, I don’t think they’re the evil ones here.

  24. J.J. Says:

    Mr. Frank: “The growth of Major League Soccer and the American investments in the English soccer league teams may also be part of the football decline.”

    Two completely different populations that watch the sports. Football is a blue collar sport. The Seattle Seahawks fans are mostly Trump type voters. The Seattle Sounders fans are typical Seattle progressives. The difference in the crowds as seen on TV is shocking to the eye.

    The NFL needs to get the politics out of the game and recognize that it is entertainment, not a social justice organization. I’d rather watch grass grow than watch soccer. Gotta have me some football in the fall.

  25. Dave Says:

    Soccer is the ultimate liberal sport because it is fair, according to them. they make scoring so difficult that the goal differential in a match between the best team in the world and an average team is usually 1 or 2 goals. What is the point of a sport if they better team doesn’t always mean, yes luck and chance should be part of the game but its influences should be minimal. what is the point for buying expensive players if buying expensive players doesn’t automatically translate to win against weak teams? However to liberals creating a sport which rich teams buying expensive players can only give them a moderate advantage is fair to them. Liberals have a really weird sense of justice and fairness.

  26. Frog Says:

    Seems a peculiar way to settle the so-frequent ties at the end of 90-minute soccer games: a five-kick penalty shootout, which just takes 5 minutes, tops.
    The games themselves are boring, but that is to be expected when one limits four-extremity humans to the use of two lower extremities only.

  27. Lee Says:

    Just to compare: Junior Seau played nineteen seasons in the NFL. If three years of NFL play led to Stage 3 CTE, there world be a heck of a lot more players in deep trouble. John Mackey played ten years. Most of the players diagnosed post-mortem played ten years plus.

    It looks like a handful of young people have been diagnosed with CTE. Which makes me wonder if there is some illness going on — or if they were battered most of their lives. Shaken as babies, abused as kids, then got into contact sports in high school. But I seriously doubt three years of NFL play led to Aaron Hernandez beating the crap out of someone when he was still three or four years away from playing for the NFL.

  28. Dave Says:

    soccer is boring because it is not allowed to have any sort of rule changes to update the game after certain flaws of the game have been exploited. A much better way to settle a tied game should be a point system like boxing which each team gets a certain points rewarded for gaining a certain advantage on the field (shot on goal, corner kick…) in a defined set of categories and if a game goes to tie the team accumulated the most points wins. They wouldn’t even considered because it is deemed too Americanized. Why even go through the whole match? Why not just have the penalty right from the beginning when like most of the matches after semi-final in the world cup result in ties anyway.

  29. Ymar Sakar Says:

    Soccer can easily break ties or close scores, by having the aces of both teams do a 1v1 to see who can control the ball better.

    That tests skill and also team judgment. And it might be more interesting for the audience, since they only have to pay attention to two people. And it doesn’t end with the ball in the goal, they can have half the court to deal with.

  30. Ymar Sakar Says:

    The method of the esport or perhaps just sports in Asia, tend to revolve around both individual skill contests and team cooperation contests.

    So there might be a 3v3 or 5v5 arena, like a team deathmatch. But there are also duels, like on a ladder system. And another round robin 5v5 system, similar to chess tournaments, or where your strongest player can be played until he loses the match, and then your second strongest player goes up.

    A mixture of solo dueling 1v1s, round robin 1v3 sequences or 5 pairs of 1v1s, and a team match, is generally more balanced for competition and audience preferences.

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Previously a lifelong Democrat, born in New York and living in New England, surrounded by liberals on all sides, I've found myself slowly but surely leaving the fold and becoming that dread thing: a neocon.
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