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DR. RIAZ DISCUSSES CHRONIC TRAUMATIC ENCEPHALOPATHY, RAY EASTERLING, AND JUNIOR SEAU

By Jaboner Jackson 8 a.m. | When news of Junior Seau's presumed suicide came across the wire yesterday, speculation immediately turned to the effects that playing professional football for over a dozen years may have had on his health. Specifically, questions surrounding the effects of head trauma on his final frame of mind surfaced. I discussed Seau's death with our team medical expert, Hassan A. Riaz, MD, MBA, to understand the role that head traumas may have played in not only Seau's death but that of Ray Easterling, another former NFL player who committed suicide by shooting himself last month, as well.

Doc, when I told you that Junior Seau died yesterday, you immediately brought up Ray Easterling. Who is Ray Easterling and why is he relevant to Seau's death?

First of all, I want to extend my condolences to the family of Junior and Ray. I was definitely a fan of Seau and watched his career at USC and with the Chargers for years. I also understand the role that Ray played in advancing football while playing in the 1970's. My thoughts are with the families of both of them.

Now in terms of Ray Easterling, he played football mostly in the 1970's. He had been suffering from dementia for about twenty years and had had depression right after his playing days. Dementia refers to a loss of mental ability. There are various kinds of dementia, one of which is Alzheimer type dementia. Easterling had started to show signs of Alzheimer type dementia at a very early age. Easterling's family suspected that repeated concussions and head traumas were responsible for this early onset dementia and mood disturbances. For this reason, Easterling had filed suit against the NFL over its handling of concussions. But Easterling killed himself last month before the suit could be resolved.

At first glance, there appear to be some similarities between Seau and Easterling. Does this concern you? And what does the medical research say about head traumas and early death?

Yes, the conditions of Seau and Easterling definitely concern me. We are starting to better understand the effects of repetitive head traumas on the mental and physical well beings of athletes. Specifically, we have now begun to recognize a medical condition called Chronic Traumatic Encephalopathy (CTE). Chronic Traumatic Encephalopathy leads to dementia-like symptoms, cognitive impairment, and mood disturbances such as depression. The concerning part about CTE is that it can develop after even a single traumatic brain injury. So it can develop even after a single pronounced concussion.

Chronic Traumatic Encephalopathy sounds like a dangerous condition. What does current research show about CTE?

CTE has been extensively studied in boxing. Retired boxers develop dementia at a higher rate and a younger age than does the general population. And autopsies of athletes in boxing and other sports have shown that brains resemble those of Alzheimer Disease. This means that CTE mirrors Alzheimer dementia. Except the dementia in athletes is happening a couple of decades earlier and more frequent than it should. And since CTE is only diagnosed definitively by pathology--meaning autopsy--it's been a hard diagnosis to make. But we're starting to have more and more athletes donating their bodies to science to help us understand this difficult neurodegenerative process.

This can't be good for the NFL. What does CTE exactly mean for the future of the NFL?

Make no doubt about it--the NFL and Roger Goodell are becoming advocates of player safety because of the huge health and litigation implications of Chronic Traumatic Encephalopathy. The NHL is also starting to field litigation regarding CTE. As is our U.S. Military. I am not exaggerating when I say that CTE has the potential to change forever the nature of contact sports. Even a single concussion on the playing field is too much. It's important to remember that these players are conducting a job. Accordingly, employers--such as the NFL--have legal responsibilities to ensure player safety.

Was Seau suffering from CTE?

Again, CTE is diagnosed definitively via pathology. So an autopsy would have to be conducted to know this for sure. But it's very likely that Seau was having significant effects of brain trauma on his health. Depression is common after brain trauma. And deep depression is more common with multiple brain traumas. It's important to remember that people do not just suddenly kill themselves. They have mood disorders most of the time that cause them to commit suicide. They have chronic major depression.  And chronic major depression is linked to multiple traumatic brain injuries.

What's the bottom line on head traumas in sports, Doc?

We're still learning about the effects of traumatic brain injuries in athletes. But what we've already learned doesn't look good. For any of our high school athletes out there, always take any head trauma seriously. Always go and see your doctor. You're not getting paid to play football. Take care of your health first and foremost.

ABOUT DR. RIAZ:  Hassan A. Riaz, MD, MBA is President of Mercy Medical Center outside of Long Beach, CA.  He went to medical school at the Keck School of Medicine of the University of Southern California and did his postgraduate training at Harbor-UCLA Medical Center.  You may contact him at drriaz@footballphds.com and his assistant will try to get him to respond.

 

drriaz@footballphds.com

jaboner@footballphds.com

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