Tuesday, June 29, 2010

Chris Henry data sound football alarm

Is it possible that football is as dangerous to the brain as boxing? The results say yes

ESPN.com
by Johnette Howard
June 29, 2010

Dr. Bennet Omalu is a forensic neuropathologist by training. He grew up in Nigeria and admits that for years after arriving in the United States, he knew nothing about football. He used to be the assistant medical examiner for the city of Pittsburgh. And what Omalu first saw in 2002 while performing an autopsy on retired Steelers lineman Mike Webster, what he saw after he put some slides of Webster's brain under a microscope for a routine examination, eventually led to Omalu's being discredited by NFL officials for some controversial conclusions that the league wouldn't publicly embrace for another five years.

What if football is as dangerous to your brain as boxing?

Would that change the way you regard the long-term risks of the game, or the way you parent your kids?

Before Omalu studied the brains of Webster and a handful of other NFL players whose lives had met sudden ends, the NFL never really looked at itself that way. Omalu was the first person to contend those players had been afflicted with pugilistic dementia or "punch-drunk syndrome" -- a layman's term for a disease called chronic traumatic encephalopathy. CTE's only known cause is repeated blows to the head. Omalu says all of the first nine NFL players he examined posthumously showed the sort of brain damage that doctors usually only see in older patients suffering from Alzheimer's or dementia.

On Monday, Omalu and a colleague, Dr. Julian Bailes, found themselves back in the news as they presented the findings on their latest subject, Cincinnati Bengals wide receiver Chris Henry, who died at the age of 26 in December. Until Henry, no active NFL player had been diagnosed with CTE. And none with the diagnosis had been as young.

The diagnosis, for an athlete who played just five NFL seasons, was a surprise to Omalu and Bailes. The idea that Henry was playing with brain damage that can only be diagnosed using brain tissue samples (which can't be culled until a person dies) ramped up concerns over how quickly athletes start to suffer from CTE -- and why they do.

Researchers say concussions aren't the only danger. Even the accumulation of lesser blows to the head -- the sort of contact that's intrinsic in football -- could be enough to eventually cause serious long-term brain damage. The threshold could be far lower than anyone previously thought.

Danger to the Brain

Could football be as dangerous to the brain as boxing is? ESPN.com examines the findings that the late Chris Henry had degenerative brain damage caused by multiple hits to the head.

That's a confounding dilemma for people trying to make organized football safe. If that's possible.

"I am still a persona non grata to the NFL," Omalu said in a phone interview Monday after he and Bailes, his co-director at the Brain Injury Research Institute at West Virginia University, presented the Henry findings at a campus news conference.

"I wouldn't expect what we have found to be accepted happily. The first person to diagnose pugilistic dementia in boxers was also a forensic pathologist and that was in 1928. Here I was 80 years later, finding the same thing in football."

Still, you rarely find anyone screaming that football should be abolished, and few consider it as dangerous as boxing.

It's time that changed.

"I think people are in still denial," Omalu said, "because the public loves football so much."

Maybe the perception gap also exists because boxers are so explicitly up front about their intent to separate opponents from their senses. Fight fans aren't riven with guilt over the violence in the sport because they cling to the consoling idea that boxers make "informed" decisions about the risks, the same as cigarette smokers or Indy car drivers or skydivers do.

Football fans used to say the same thing.

But the Henry findings change all that. Football just became a bit harder to love unconditionally on Monday. The brain trauma caused by a lot of sports -- not just football -- just became a lot harder to rate for risks.

That's why Bailes, a former team physician for the Pittsburgh Steelers and current team doctor for the WVU football team, confessed that he was initially "sad" about Henry's diagnosis and struggled to find something positive because the red flags were so "profound."

Bailes noted Monday that as a wide receiver, Henry was usually far away from the play-after-play collisions in the trenches. He wasn't a kamikaze hitter.

Bailes said Henry had never even been diagnosed with a concussion during his college career at WVU or in his five NFL seasons with Cincinnati.

And, Bailes added, the usual tools that team doctors use, such as MRIs and CT scans, don't show the presence of CTE, anyway.

So again, how does an athlete assess the danger he or she faces?

More than ever, it's clear no one really knows.

Bailes says the Henry discovery may force us to rethink everything.

No wonder the Bengals' Andrew Whitworth, a teammate of Henry's last year, told the Cincinnati Enquirer on Monday, "It's kind of fearful. It's shocking that a guy you played with and didn't really play that long could be diagnosed [with CTE].""It's very emotional to hear -- it rattles me," the Seattle Seahawks' Sean Morey, a special-teams player, told The New York Times. "You have to ask how many are playing the game today that have this and don't even know about it."

Like many of the other former football players found to have CTE after their deaths, Henry had behavioral problems that Omalu and Bailes strongly suspect were at least partly a result of the disease, which Bailes said is linked to depression, substance abuse, erratic behavior and even suicide.

Webster, the former Steelers center, was sleeping in train stations and sometimes at odds with his family just before he died. Lineman Terry Long, the second NFL player Omalu studied, committed suicide by drinking antifreeze in 2005. Former Philadelphia Eagles safety Andre Waters shot himself after inconsolably telling a family member he needed to get help. Henry was arrested five times early in his NFL career for incidents ranging from assault to marijuana possession to drunken driving. He died December after either jumping or falling out of the back of a moving pickup truck being driven by his fiancée in Charlotte, N.C., as they were having an argument.

"It was a big shock when I first learned [Chris was playing football with brain damage]," Henry's mother, Carolyn Henry Glaspy, told reporters on Monday after watching Omalu and Bailes present their findings about her son.

And now?

Glaspy sighed and said, "Some things make so much sense."

Monday, June 28, 2010

WVU doctors: Chris Henry had chronic brain injury

Associated Press
June 28, 2010

MORGANTOWN, W.Va. — Cincinnati Bengals receiver Chris Henry suffered from a chronic brain injury that may have influenced his mental state and behavior before he died last winter, West Virginia University researchers said Monday.

The doctors had done a microscopic tissue analysis of Henry's brain that showed he suffered from chronic traumatic encephalopathy.

Neurosurgeon Julian Bailes and California medical examiner Bennet Omalu, co-directors of the Brain Injury Research Institute at WVU, announced their findings alongside Henry's mother, Carolyn Henry Glaspy, who called it a "big shock" because she knew nothing about her 26-year-old son's underlying condition or the disease.

Henry died in December, a day after he came out of the back of a pickup truck his fiancee was driving near their home in Charlotte, N.C. It's unclear whether Henry jumped or fell. Toxicology tests found no alcohol in his system, and an autopsy concluded he died of numerous head injuries, including a fractured skull and brain hemorrhaging.

But Bailes, team doctor for the Mountaineers and a former Pittsburgh Steelers physician, said it's easy to distinguish those acute traumatic injuries from the underlying condition he and Omalu found when staining tiny slices of Henry's brain.

Bailes and fellow researchers believe chronic traumatic encephalopathy, or CTE, is caused by multiple head impacts, regardless of whether those blows result in a concussion diagnosis. A number of studies, including one commissioned by the NFL, have found that retired professional football players may have a higher rate than normal of Alzheimer's disease and other memory problems.

What's interesting, Bailes said, is that Henry was only 26, and neither NFL nor WVU records show he was diagnosed with a concussion during his playing career.

But it doesn't take a collision with another player for brain trauma to occur.

"The brain floats freely in your skull," Omalu said. "If you're moving very quickly and suddenly stop, the brain bounces."

And over time, with repetition, that causes big problems.

CTE carries specific neurobehavioral symptoms, Bailes said — typically, failure at personal and business relationships, use of drugs and alcohol, depression and suicide.

"Chris Henry did not have that entire spectrum and we don't know if there's a cause and effect here," Bailes said. "It certainly raises the question and raises our curiosity. We're just here to report our findings. That may be for others to decipher."

Henry's personal struggles were well documented.

Although he was a vital part of the Bengals' offense as a rookie, he ended that season with an arrest for marijuana possession. After a playoff loss to Pittsburgh, he was arrested on a gun charge in Florida.

Henry was suspended for half a season in 2007 as the league cracked down on personal conduct.

When he was arrested a fifth time, a judge called Henry "a one-man crime wave" and the Bengals released him.

But Henry got a second chance and played 12 games in the 2008 season.

Teammates said they'd noticed a change his demeanor, and at the start of the 2009 season, he described himself as "blessed" and said he was turning his life around.

Glaspy gave Bailes permission to examine her son's brain in detail.

"I was a little scared," she said. "It was something new to me. I'm still trying to educate myself as to what it means. Some of it makes sense with some of the behavioral patterns in Chris — just like mood swings and the headaches.

"Hopefully I can share whatever they share with me with other parents and help the NFL deal with the matter of being hit in the head and concussions and to educate ourselves as mothers and fathers when we send our kids out there on the field."

Omalu first came across CTE, a condition often seen in boxers, after studying the brain of Pittsburgh Steelers Hall of Fame lineman Mike Webster. Webster died in 2002 of a heart attack at age 50. He had suffered brain damage that left him unable to work following his career.

Bailes said he and Omalu have now analyzed the brains of 27 modern athletes, and the majority showed evidence of CTE. But it's found in only a small number of players, he said.

"I think football is a great sport, and we want to make it safer," Bailes said, "but we have to continue to move forward with changes made recently and take the head impacts out of the sport as much as possible."

Former Bengal Henry Found to Have Had Brain Damage

June 28, 2010

Former Bengal Henry Found to Have Had Brain Damage

By ALAN SCHWARZ

Chris Henry, the Cincinnati Bengals receiver who died during a domestic dispute last December, has been identified by experts as the first player to have died with trauma-induced brain damage while still active in the N.F.L.

Dr. Julian Bailes and Dr. Bennet Omalu of the Brain Injury Research Institute at West Virginia University announced on Monday that Henry, 26, had developed chronic traumatic encephalopathy, the progressive brain disease whose recent discovery in some retired N.F.L. players has raised questions of football’s long-term safety risks.

The 22nd professional football player to be given a diagnosis of C.T.E., Henry is the first to have died with the disease while active after 2007, when prior C.T.E. findings prompted the N.F.L. to begin strengthening rules regarding concussion management. The fact that he developed the condition by his mid-20s — the youngest previous C.T.E. case was the lineman Justin Strzelczyk, 36, who had been retired from the Pittsburgh Steelers for five years before his death in 2004 — raises questions of how many current N.F.L. players might have the condition without knowing it.

“As we got the results, my emotion was sad — it’s so profound,” said Bailes, the chairman of the department of neurosurgery at West Virginia and a former team physician for the Steelers. “I was surprised in a way because of his age and because he was not known as a concussion sufferer or a big hitter. Is there some lower threshold when you become at risk for this disease? I’m struggling to see if something can come out positive out of this.”

In a statement, a co-chairman of the league’s head, neck and spine medical committee, Dr. Hunt Batjer, said: “Our committee has and will continue to address all issues relative to head injuries in current players.”

A message for the union spokesman George Atallah was not returned.

Caused exclusively by brain trauma, C.T.E. cannot be diagnosed in a living person; only microscopic examinations of brain tissue can identify the protein deposits and other abnormalities that mark the disease. So active players who might react to the Henry finding by seeking a test before continuing their careers must make do with unknowns.

“It’s very emotional to hear — it rattles me,” said Sean Morey, a special-teams player now with the Seattle Seahawks, who is a co-chairman of the union’s brain-injury committee. “The fact that this has been found that guys played against last year, an active player, I think it’s sobering. You have to ask yourself how many are playing the game today that have this and don’t even know about it.”

Like many of the other players found to have had C.T.E. after their deaths, Henry had behavioral problems in his final years that might have been at least partly a result of the disease, which is linked to depression, poor decision-making and substance abuse.

He was arrested five times in a 28-month stretch for incidents involving assault, driving under the influence of alcohol and marijuana possession. The league suspended him several times for violating its personal-conduct policy.

Henry caught 12 passes for 236 yards in the Bengals’ first eight games last season before he broke his arm and was put on injured reserve.

Henry died in Charlotte, N.C., on Dec. 17 after falling out or jumping out of the back of a pickup truck driven by his fiancée, Loleini Tonga. The head injuries that killed Henry were not related to the C.T.E. finding because the proteins and other changes that mark C.T.E. develop only over time, Bailes said.

Bailes said that he had not found evidence in news reports that Henry had sustained any diagnosed concussions during his N.F.L. career, and that he would soon make a request for related information from the Bengals. Bailes said he did know that Henry had not reported any concussions during his two seasons at West Virginia, because Bailes also serves as a Mountaineers team physician and had access to those records.

Bailes said he planned to speak with Henry’s family members to learn if he had sustained any notable hits or head injuries at Belle Chasse High School just outside New Orleans.

“I don’t want to imply that this is an N.F.L.-only phenomenon,” said Bailes, who wondered if problems are set up “while the brain is young and vulnerable, and it sustains an injury.”

He added: “Players spend 17 years banging heads in the pros on every play and you think it’s exposure based. Now with Chris Henry being so young, we have to rethink that.”

Near the end of last season, the N.F.L. strengthened several rules regarding concussion management, including the requirement that players with brain injuries not return to the same game or practice, and that they be cleared by independent experts, rather than team doctors. The three leaders of the league’s concussion committee resigned and were replaced by two neurosurgeons who vowed to chart a new course for research.

The N.F.L. is working with the union and the Centers for Disease Control and Prevention on an information brochure on concussions that is worded far more strongly than the one given to the players since 2007.

“We have to educate the players,” Morey said. “The players have to have the ability to have informed consent.”