Overview
Dr. McKean discusses her mission to research and prevent chronic traumatic encephalopathy (CTE), its causes, progression, and impact, particularly in contact sports. She highlights the scientific, personal, and societal challenges of raising awareness, the importance of education and prevention, and offers advice for parents, sports organizations, and individuals.
Dr. McKean’s Mission and Background
- Mission began after identifying CTE in football players’ brains, shifting her focus from Alzheimer’s to traumatic brain injury.
- Early cases included men as young as 45, and even an 18-year-old, highlighting the disease’s early onset.
- She advocates for eradicating CTE and supporting affected families.
Understanding CTE
- CTE stands for chronic traumatic encephalopathy, a progressive, neurodegenerative brain disease caused by repetitive brain trauma.
- Initially presents as small abnormalities, expanding over time even after the trauma stops.
- Risk factors include not only football but also soccer, ice hockey, rugby, boxing, MMA, military service, and domestic violence.
- Disease progression is both exposure and age-dependent.
Research and Findings
- McKean’s work includes dissecting and analyzing nearly 10,000 brains in a specialized neuropathology lab.
- CTE is strongly associated with repetitive subconcussive hits, not just concussions.
- Studies revealed up to 95% of NFL players and 90% of college players studied had CTE.
- In a study of athletes under 30, 41% had early CTE, revealing significant risk in youth sports.
CTE Symptoms and Case Studies
- Early symptoms: depression, emotional instability, impulsivity, poor judgment, aggression, memory and cognitive issues.
- Symptoms often dismissed or misattributed, deepening affected individuals’ struggles.
- Highlighted cases: Wyatt Bramwell, Owen Thomas, Aaron Hernandez, and Jeff Astle, who showed severe early onset and behavioral changes.
Scientific and Societal Challenges
- Initial resistance from sports organizations like the NFL and public skepticism delayed acceptance.
- Dr. McKean experienced efforts to discredit her findings, but persisted through scientific evidence and advocacy for families.
- NFL settlements compensated earlier cases of CTE but excluded later diagnoses.
Stages and Mechanisms of CTE
- CTE staging ranges from minor to severe brain involvement, with tau protein accumulation as a marker.
- Disease can progress with aging, even after exposure stops, possibly due to ongoing inflammation and vascular injury.
- Helmets protect against skull fractures but not the internal movement causing CTE.
Prevention and Recommendations
- Advocate for reducing head impacts in youth and delaying full-contact exposure.
- Suggests rule changes (e.g., removing heading in soccer, limiting full contact, monitoring athletes).
- Education for parents, coaches, and players about risks is vital.
- Monitoring for cognitive/mood changes and regular assessment recommended.
Alzheimer’s Disease and Brain Health
- Dementia is a general term; Alzheimer’s is the most common form.
- Risk reduction includes social/mental engagement, cardiovascular health, fitness, and adequate sleep.
- Inflammation and vascular health are key contributors to neurodegeneration.
Advice for Parents and Decision Makers
- Encourage non-contact or lower-risk sports for children when possible.
- Delay high-risk exposure until physical development supports resilience.
- Team and league leaders should lead in limiting head impacts, especially non-concussive ones.
- Promote brain donation for research advancement.
Recommendations / Advice
- Prioritize brain health through lifestyle choices and education.
- Seek medical attention for persistent mood or cognitive changes in athletes.
- Consider brain donation as a legacy contributing to future scientific understanding.