First soccer, rugby players diagnosed with CTE
The death of 36-year-old Pittsburgh Steelers offensive lineman Justin Strzelczyk put the link between playing football and CTE in the national spotlight. Strzelczyk was killed in 2004 in a car crash after a 40-mile high-speed chase with police in New York.
Evidence of CTE was found in the brain of football player Lew Carpenter after his death in 2010 at the age of 78.
Pro Football Hall of Famer Louis Creekmur, who played for the Detroit Lions from 1950 to 1959, suffered decades of cognitive decline before his death.
Linebacker John Grimsley of the Houston Oilers died of an accidental gunshot wound to the chest. Analysis of his brain tissue confirmed damage to the neurofibrillary tangles that had begun to affect his behavior and memory.
Chris Henry played five seasons for the the Cincinnati Bengals before dying at the age of 26. He died after falling from the bed of a moving pickup during a fight with his fiancée, ending a life plagued by behavioral problems. His young age prompted concern over how quickly athletes start to suffer from CTE.
Offensive lineman Terry Long of the Pittsburgh Steelers commited suicide by drinking antifreeze. Although the antifreeze caused swelling of the brain, football-related brain injuries were a contributing factor to his death.
Pro Football Hall of Famer John Mackey suffered from dementia for years before dying at the age of 69.
Ollie Matson played 14 NFL seasons starting in the 1950s and suffered from dementia until his death in 2011.
Andre Waters spent most of his 12 seasons with the Philadelphia Eagles before his suicide at age 44.
Tom McHale of the Tampa Bay Buccaneers, right, died in 2008 of an apparent drug overdose at the age of 45.
Junior Seau took his own life in 2012 at the age of 43. The question of CTE came up immediately after his death; scientists at the National Institutes of Health confirmed the diagnosis in January 2013.
Wrestler Chris Benoit was found dead at his suburban Atlanta home along with his wife, Nancy, and son in an apparent murder-suicide. Later testing found that the damage to his brain was similar to that of an elderly Alzheimer's patient.
Reggie Fleming, who played for six NHL teams, mainly in the 1960s, was the first hockey player to be diagnosed with CTE.
Hockey player Bob Probert was found to have CTE after suffering from heart failure at the age of 45.
Ryan Freel became the first MLB player to be diagnosed with CTE nearly a year after he committed suicide at age 36.
The disease that carves an insidious path through the brain seems to be doing the same through sports.
Chronic traumatic encephalopathy, the degenerative brain disease associated with concussions, has been identified in both a soccer and a rugby player, according to a review in the journal Acta Neuropathologica.
The brain tissue of people found to have CTE displays an abnormal build-up of tau -- a protein that, when it spills out of cells, can choke off, or disable, neural pathways controlling things like memory, judgment and fear. CTE can be diagnosed only after death.
According to Dr. Ann McKee, a neuropathologist who has examined dozens of brains found to have CTE, the brain of the soccer player -- Patrick Grange -- displayed diffuse disease.
"There was very severe degeneration of the frontal lobes with widespread tau pathology in the frontal, temporal and parietal lobes," McKee, director of neuropathology at the Bedford VA Medical Center, said in an e-mail. "He is one of the youngest players to have shown this much disease."
Grange played with the Chicago Fire Reserve MLS team and the Albuquerque Asylum semi-pro team, according to his obituary. He died in 2012 at 29 after being diagnosed with amyotrophic lateral sclerosis, a rare, incurable neurodegenerative disease. About 13% of the 103 CTE cases uncovered by McKee and colleagues also showed evidence of progressive motor neuron disease.
"(Grange) had no known genetic predisposition for ALS," said McKee, professor of neurology and pathology at the Boston University School of Medicine. "And no family members have been diagnosed with ALS."
An autopsy showed that Grange had Stage 2 CTE with motor neuron disease, according to a statement from Boston University.
His case is interesting because it raises questions about the relationship between heading the ball and CTE.
"The fact that Patrick Grange was a prolific header is important," Chris Nowinski, co-founder and executive director of the Sports Legacy Institute, said in an e-mail. "We need a larger discussion around at what age we introduce headers, and how we set limits to exposure once it is introduced."
Heading would seem to be innocuous compared with the brutal hits that can be dealt in a football or hockey game, but the damage, according to studies, can add up. Headers in soccer are associated with microstructural damage to brain tissue and memory problems; and an Italian study linked them with ALS.
Similarly, researchers found Australian rugby union player Barry "Tizza" Taylor died in 2013 of complications of severe CTE with dementia at age 77. Taylor played for 19 years in amateur and senior leagues before becoming a coach, according to Boston University.
"Cognitive problems, memory loss, attention difficulties and executive dysfunction were first noted in his mid-50s, followed by depression and anxiety, worsening explosivity and impulsivity," the statement said. By his mid-60s, the statement said, Taylor was "physically and verbally abusive" and "paranoid."