display
Aaron Hernandez was just 27 years old and sentenced to life in prison for murder when he committed suicide in a prison cell in 2017.
Experts from Boston University then carefully examined the former football player's brain and found it to be badly damaged, diagnosis CTE.
Chronic traumatic encephalopathy (CTE) is a rare, progressive neurodegenerative disease, triggered by repeated - even mild - head trauma.
That is, by knocks and bumps in the head or by falling with the head on the ground.
It doesn't have to be a concussion.
Sports such as boxing, American football, ice hockey and soccer are therefore particularly in focus.
It can also affect soldiers and war refugees with explosion trauma and victims of domestic violence.
On Thursday evening, the ZDF series “Der Bergdoktor” focused on the disease.
From Sunday to Monday, the consequences of CTE research may be seen at the Super Bowl.
A duel between the generations - and a referee for the first time
One quarterback is already a legend, the other wants to become one: The duel Tom Brady (43) against Patrick Mahomes (25) is also a duel of the generations.
And: Sarah Thomas is the first referee in the Super Bowl.
Source: WELT / Steffen Schwarzkopf
The repeated cranial trauma leads to "increasing destruction of nerve cells and an abnormal accumulation of tau protein, as also occurs in Alzheimer's and other neurodegenerative diseases," according to the German Alzheimer's Society.
The tau protein is located in the nerve cells.
If nerves are broken, it is - to put it simply - released.
Depression, aggression, memory and language disorders
display
The symptoms (changes in cognitive abilities, abnormal behavior and mood) often only appear years or decades after the end of a career - as in the fictitious case of a former boxer at the “Bergdoktor”.
As in many known cases from the NFL.
This is also why the story of Aaron Hernandez caused a stir.
The neuropathologist Dr.
Ann McKee was able to examine Aaron Hernandez's brain after the death and presents the results here
Source: Boston Globe via Getty Images / Boston Globe
CTE has a cluster of symptoms, but not everyone develops the same symptoms.
It usually begins with impaired concentration and memory, headaches, dizziness and disorientation.
Then aggression, mood swings up to depression, language difficulties.
Later on, symptoms similar to Parkinson's can occur.
Visual disturbances.
And more.
"CTE is divided into four phases," says neuropsychologist Daniela Golz, co-chair of the Society for Sports Neuropsychology, founded in 2015.
“But who actually goes through all four, with whom the disease might stop after stage one - that is still unclear.
Just as you don't know exactly which risk factors you have to bring with you in order to develop CTE at all. ”After all, not everyone who has suffered multiple blows or bumps to the head will later develop CTE.
Incidentally, the disease can only be clearly identified by examining the brain after death.
The diagnosis in the living based on clinical criteria is not 100 percent.
Hollywood film "Shattering Truth" clears up
display
For a long time, CTE was known as Boxer's Syndrome.
Then in 2005 Bennet Omalu published the first evidence of CTE in a deceased football player (Mike Webster).
As a result, other US studies that looked at the brains of deceased footballers and found CTE there caused a sensation - carried out primarily by the CTE Center at Boston University and the Boston Healthcare System with neuropathologist Ann McKee.
Dr.
Bennet Omalu, here in 2016, brought crucial insights into CTE research
Source: Getty Images / Pete Marovich
“CTE has experienced a significant acceleration in public perception in recent years, above all as a result of developments in the USA and first there.
Because the US national sport is a collision sport, they are in some ways ahead of us, ”says Golz.
"The film 'Shattering Truth' also gave the subject a wide publicity, especially in the USA." The Hollywood film was released there at the end of 2015, with Will Smith in the leading role as Bennet Omalu.
Dr.
Ann C. McKee (r.) And an assistant examine the brain of a deceased former NFL professional
Source: Boston Globe via Getty Images / Boston Globe
The NFL has long since responded.
Helmet-on-helmet tackles are forbidden, but there are still collisions and falls on the ground and thus blows / bumps to the head.
To protect the players there is therefore the so-called Concussion Protocol.
In a nutshell: game observers who are specially deployed for this purpose intervene if head injuries are suspected, the professional is removed, subjected to a test immediately and, if necessary, not allowed back on the field.
display
The player must then undergo further examinations.
Before it can be used again, there are certain regulations.
Glasgow study causes a stir in football
According to the current status, can it be that a previous Alzheimer's diagnosis was or is more of a CTE with today's knowledge?
"There are overlaps, but also differences between Alzheimer's and CTE," says Golz.
“But yes, it is entirely possible that a previous Alzheimer's diagnosis was actually a CTE.
Whereby it must be said that Alzheimer's symptoms are very typical with word-finding, orientation and memory disorders.
Experts who specialize in dementia can say relatively clearly whether it is Alzheimer's. ”In the past, a CTE was more likely to go under or was diagnosed as another disease, today research has more attention to it.
"I think", adds Golz, "that when many neurologists hear that their patient comes from a contact or even collision sport, they are now more prudent than they would have been five or ten years ago."
EM final 2014: team doctor Dr.
Hans-Wilhelm Müller-Wohlfahrt takes care of Christoph Kramer
Source: pa / Augenklick / Ra / Photo RAUCHENSTEINER
In this country too, doctors, psychologists and scientists are now explicitly dealing with the topic.
For example, the Federal Institute for Sport Science (BISp) has committed itself to research into minor head and brain injuries in sport.
“Research on CTE has accelerated in Germany in recent years and has attracted media interest.
This in turn gave it a further boost, ”says Golz.
“I also have the impression that the subject of head injuries in general and CTE in particular is being seen more and more in sports associations.
I also don't think that it was ignoring CTE beforehand, but something that - to put it casually - was not on our screen.
We see clear developments in Germany and Europe, also in football, which also harbors potential dangers. ”Developments through new rules and tests on the one hand, and studies on the other.
A research project funded by the BISp, led by Claus Reinsberger from the University of Paderborn, has been investigating the question of whether and to what extent headers can affect the brain and health of soccer players in competitions or training.
Research is also being carried out at the German Sport University Cologne.
Scientists from the University of Glasgow and Hampden Sports, for example, found in a study published in 2019 that professional footballers were three and a half times more likely to die of neurodegenerative diseases than other adults.
However, a causal relationship between this finding and headballs or collisions has not been proven.
The DFB is also driving research forward, and together with the DFL and the statutory accident insurance VBG, it has commissioned research into the long-term effects of professional sport on the health of former soccer players: the NAKO Health Study (NAKO) has been measuring health status over a period of three years since 2020 by ex-professionals.
The question about the headers
Football has also started to react to the problem of head injuries in practice, so the DFB in the professional area has been asking players to investigate brain damage and CTE since summer 2019.
In Great Britain, among others, headers are banned in training for children up to the age of twelve.
This is not the case in Germany.
Headers are part of football, but should the little ones train them?
Source: Getty Images / Image Source / Kinzie Riehm
“The DFB is pursuing the strategy of thoroughly examining it beforehand in order to then make a decision based on real evidence.
They just approach things differently, want clearer information first, "says Golz and adds, with a view to studies by Inga Katharina Koerte, among others:" Certainly, headballs should be treated with caution in childhood.
There are clues that we are now investigating so that we can then say whether we need to restructure.
We shouldn't think: Oh, that always went well - and just carry on as before. "
display
A 2017 study by Koerte concluded that young footballers performed worse than other athletes on cognitive tests.
“In the case of young footballers, it is not about extreme phenomena like dementia or suicide,” says Koerte of the German Alzheimer's Society, “it is more about lost potential, poor school grades or problems in contact with others.
These consequences are perhaps less tangible, but they are nevertheless important for the happiness of individuals. ”Koerte is also coordinating a European study that focuses on footballers aged 14 to 15 in performance centers.
One possible reason for personal consequences
Thinking further, the research on head injuries and CTE may lead individuals to conclude that certain sports are better not to practice certain sports.
Or stop doing it.
In the NFL, a few young players did.
In the end, it's all about creating awareness.
It is about the fact that athletes, coaches, associations and parents are aware of the risk of head injuries and their possible long-term consequences.
“If you want to avoid repeated concussions, boxing is certainly not advisable.
But the athletes are also aware of that, ”says Golz.
“And boxing in particular is not badly positioned when it comes to diagnostics.
They know about the dangers. "