Aaron Hernandez worst case of CTE for his age

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https://www.washingtonpost.com/spor...7cd204-c57b-11e7-afe9-4f60b5a6c4a0_story.html

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Ann McKee, Director of the Boston University CTE Center, and neuropathologist Victor Alvarez conduct the post-mortem study of the brain of former NFL player Aaron Hernandez. (Boston University School of Medicine/Boston University School of Medicine)
By Adam Kilgore November 9 at 3:50 PM

BOSTON — Aaron Hernandez suffered the most severe case of chronic traumatic encephalopathy ever discovered in a person his age, damage that would have significantly affected his decision-making, judgment and cognition, researchers at Boston University revealed at a medical conference Thursday.

Ann McKee, the head of BU’s CTE Center, which has studied the disease caused by repetitive brain trauma for more than a decade, called Hernandez’s brain “one of the most significant contributions to our work” because of the brain’s pristine condition and the rare opportunity to study the disease in a 27-year-old.

Hernandez, a former New England Patriots tight end, hanged himself with a bedsheet in April in a Massachusetts prison while serving a life sentence for the murder of Odin Lloyd in 2013.

In a diagnosis that linked one of football’s most notorious figures with the sport’s most significant health risk, doctors found Hernandez had Stage 3 CTE, which researchers had never seen in a brain younger than 46 years old, McKee said. The extent of that damage represents another signpost in football’s ongoing concussion crisis, which has seen professional players weigh early retirements and parents grapple with whether to allow their young sons to take up the sport. The findings released Thursday will only heighten those concerns.

Because the center has received few brains from people Hernandez’s age, McKee could not say whether his brain was representative of a 27-year-old who had played as much football. But she found the advanced stage of CTE alarming.

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[The NFL studied every concussion over two seasons. What happens next may be up to manufacturers.]

“In this age group, he’s clearly at the severe end of the spectrum,” McKee said. “There is a concern that we’re seeing accelerated disease in young athletes. Whether or not that’s because they’re playing more aggressively or if they’re starting at younger ages, we don’t know. But we are seeing ravages of this disease, in this specific example, of a young person.”

At Thursday’s conference, McKee flipped through slides comparing sections of Hernandez’s brain with a sample without CTE. Hernandez’s brain had dark spots associated with tau protein and shrunken, withered areas, compared to immaculate white of the sample. His brain had significant damage to the frontal lobe, which impacts a person’s ability to make decisions and moderate behavior. As some new slides appeared on the projectors, some physicians and conference attendees gasped.

“We can’t take the pathology and explain the behavior,” McKee said. “But we can say collectively, in our collective experience, that individuals with CTE, and CTE of this severity, have difficulty with impulse control, decision-making, inhibition of impulses for aggression, emotional volatility, rage behaviors. We know that collectively.”

McKee said Hernandez had a genetic marker that makes people vulnerable to certain brain diseases and could have contributed to how aggressively he developed CTE.

“We know that that’s a risk factor for neurogenerative disease,” McKee said. “Whether or not that contributed in this case is speculative. It may explain some of his susceptibility to this disease.”

The condition of Hernandez’s brain, pristine because of his age and the adept handling of medical examiners, could lead to future breakthroughs and better understanding of CTE. For example, researchers could better study the interaction of inflammation and tau pathology through the use of fluorescent stains. It gave researchers their best view yet of a marker associated with CTE.

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Normal 27-year-old's brain and Aaron Hernandez's brain. (Boston University School of Medicine/Boston University School of Medicine)
“We are able to understand this disease at the scientific level in a way that’s very rarely presented,” McKee said. “We’re very grateful to the family for making this donation. We’re hoping this will advance medical science in a very significant way. . . . This will really accelerate and advance our research going forward.”

BU researchers say they have discovered CTE in more than 100 former NFL players, a handful of whom have committed suicide. Medical examiners delivered Hernandez’s brain, weighing 1,573 grams, to BU’s labs in April. From the outside, it looked like a typical brain — no lesions, no bruises, no abnormalities. When researches sliced the brain into sections, they discovered startling damage.

Ventricles were dilated, in response to the brain shrinking. Researchers determined Hernandez had lost brain tissue. Membranes that were supposed to be firm had grown “thin and gelatinous,” McKee said. There were abnormal, large holes in parts of Hernandez’s brain.

The hippocampus, which plays a key role in memory, had shrunk.

The fornix, which also contributes to memory function, had atrophied.

The frontal lobe, which is responsible for problem-solving, judgment, impulse control and social behavior, had been pockmarked with tau protein.

The amygdala, which produces emotional regulation, emotional behavior, fear and anxiety, had been severely affected.

The temporal lobes, which process sights and sounds, showed significant damage.

Together, they were “very unusual findings in an individual of this age,” McKee said. “We’ve never seen this in our 468 brains, except in individuals some 20 years older.”

The physical damage inside Hernandez’s brain provides another layer to the catastrophic and tragic downfall of Hernandez, a gifted player who caught a touchdown pass from Tom Brady in the 2012 Super Bowl.

Hernandez grew up a football star in Connecticut and fell in with a rough crowd at age 15, after his father died unexpectedly during a routine operation. He starred at the University of Florida even as off-field trouble, in the form of drugs and violence, dogged him. The problems caused some teams to remove him from consideration in the NFL draft, and he lasted until the Patriots plucked him in the fourth round.

Hernandez formed a dominating tandem with fellow 2010 draftee Rob Gronkowski and convinced the Patriots he had straightened out his life. The Patriots signed him to a seven-year, $40 million contract after the 2012 season. Months later, in the summer of 2013, Lloyd was murdered, his body found in a gravelly field a mile away from Hernandez’s mansion in North Attleboro.

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Hernandez’s estate filed a federal lawsuit against the Patriots in September, alleging the Patriots knew hits to the head could lead to brain damage and failed to protect him.

A jury convicted Hernandez of the killing in 2015. Hernandez hanged himself in his cell just four days after a jury had acquitted him of the murders of Daniel de Abreu and Safiro Furtado, two strangers whom the state argued Hernandez killed in 2012 after an altercation at a Boston club.

Thursday’s news conference coincided with the release of an NFL study consisting of video reviews of the 459 known concussions that occurred over the 2015 and 2016 seasons, from preseason games through the playoffs.

The NFL has attempted to make the sport safer for its players through rule changes, policies designed to remove concussed players and technological advances. But brain trauma occurs when a football player’s brain accelerates or decelerates after it hits another player or the turf, bashing the sides of the head, an action no helmet can prevent.

“It happens inside the skull,” McKee said. “It’s an intrinsic component of football.”
 

Mackeyser

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If the NFL doesn't embrace CBD research that may allow for the healing of the brain... This sport may not be a thing years from now.
 

Angry Ram

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If the NFL doesn't embrace CBD research that may allow for the healing of the brain... This sport may not be a thing years from now.

You know what, I thought about this very subject sitting in Houston traffic.

On one hand you got people wanting the NFL to be safer, which they by eliminating the one play where these things happen most violently...kickoffs. Plus all the launching rules and helmet-to-helmet hits, can't lead with the crown, etc.

Then you got people whining and bitching about all the rule changes saying it helps the offense, it's becoming flag football, etc etc.

Can't have it both ways.
 

LesBaker

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I call bullshit on this for the time being.

He was lucid and clear thinking as he killed two times.
 

BatteringRambo

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Well then there must be overwhelming evidence in correlation to other individuals that commit murder.. homicides and other malicious acts that reach morbid etc. I'm not going into detail here or a soap box stand just throwing that out there. My education and knowledge in those extremely sophisticated - detailed and time oriented fields of expertise do not apply to me (in reference to investigating and research by experts) .
 

fearsomefour

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The worst case in people that had their brain examined because they committed murder?
It's kind of silly really.
The problem is the ol corrilation vs causation argument. For every Hernandez there are thousands of ex players whom were out of the game in their early mid twenties, late twenties, thirties that have not had these issues.
That does not mean CTE isent a real thing.
I think CTE is more likely to affect the amateur game where players are not paid.
The NFL, a multi billion dollar a year industry, will have a large hand in forming any CTE policy that comes down the road.
At the end of the day, going forward, I think this will be filed under professional risk.
 

Mackeyser

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I call bullcrap on this for the time being.

He was lucid and clear thinking as he killed two times.

The science says otherwise.

I mean, they have slices of his brain SHOWING the damage. And it's not microscopic, it's entirely visible with the naked eye.

Prior to this, neuroscientists didn't even think damage of this level was POSSIBLE in someone younger than 40 and ZERO times has anyone with this level of damage been shown before the age of 46.

I thought the scientists did a fine job explaining that the damage didn't "make him do it", but eliminated the barriers neurologically that impede the rest of us like impulse control and violent outbursts.

Sometimes people with CTE harm others, other times they harm themselves. Often, it's both.

I don't make excuses for Aaron Hernandez. He was guilty and deserved to be in jail.

The CTE explains WHY he did what he did. It doesn't absolve him of responsibility (although with other medical diagnoses, that's exactly what happens).
 

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Neither the players and their union nor the owners will do anything more than what they're already doing. Fans piss and moan about rules put in place to protect players from hits to the head. Players get fined for hits to the head then appeal them knowing they broke rules that keep them safe as much as their fellow players. It's a big finger pointing joke.
 

Mackeyser

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Well then there must be overwhelming evidence in correlation to other individuals that commit murder.. homicides and other malicious acts that reach morbid etc. I'm not going into detail here or a soap box stand just throwing that out there. My education and knowledge in those extremely sophisticated - detailed and time oriented fields of expertise do not apply to me (in reference to investigating and research by experts) .

Apples and oranges.

There's the issue of nature vs nurture. Some people are genetically predisposed to embracing violence. Others, even if very much NOT predisposed to violence are raised in violence especially abuse.

There IS a correlation between child abuse, usually physical, but also extreme emotional and/or sexual abuse, and committing violence later in life up to and including murder.

It is a bit early to try and establish correlation with neurotrauma, including CTE.

I suspect that any correlation would be tenuous at best, but that's an educated guess on my part and nothing more.
 

LesBaker

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The science says otherwise.

I mean, they have slices of his brain SHOWING the damage. And it's not microscopic, it's entirely visible with the naked eye.

Prior to this, neuroscientists didn't even think damage of this level was POSSIBLE in someone younger than 40 and ZERO times has anyone with this level of damage been shown before the age of 46.

I thought the scientists did a fine job explaining that the damage didn't "make him do it", but eliminated the barriers neurologically that impede the rest of us like impulse control and violent outbursts.

Sometimes people with CTE harm others, other times they harm themselves. Often, it's both.

I don't make excuses for Aaron Hernandez. He was guilty and deserved to be in jail.

The CTE explains WHY he did what he did. It doesn't absolve him of responsibility (although with other medical diagnoses, that's exactly what happens).

I don't agree that is is WHY he did what he did because advanced CTE doesn't make you a murderer.

Also just because someone has CTE doesn't mean they have symptoms. For instance he had no problems finding his way to anywhere while he was driving. He wasn't getting confused in his own house. He had NONE of the symptoms.

He was just a POS and a killer. He did it twice, planned it and carried it out two times.
 

Pancake

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How do they know how far advanced it was at the actual time of the murders? And just because he has CTE it is not automatically the reason why he committed murder. Science has no way of knowing what kind of morals people have. Maybe he was evil to begin with.
 

fearsomefour

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The science says otherwise.

I mean, they have slices of his brain SHOWING the damage. And it's not microscopic, it's entirely visible with the naked eye.

Prior to this, neuroscientists didn't even think damage of this level was POSSIBLE in someone younger than 40 and ZERO times has anyone with this level of damage been shown before the age of 46.

I thought the scientists did a fine job explaining that the damage didn't "make him do it", but eliminated the barriers neurologically that impede the rest of us like impulse control and violent outbursts.

Sometimes people with CTE harm others, other times they harm themselves. Often, it's both.

I don't make excuses for Aaron Hernandez. He was guilty and deserved to be in jail.

The CTE explains WHY he did what he did. It doesn't absolve him of responsibility (although with other medical diagnoses, that's exactly what happens).
I call nonsense.
"Sometimes people with CTE harm others, other times they harm themselves".....and often they harm no one.
"The CTE explain WHY he did what he did. It doesn't absolve him of responsibility"....Yeah, it would actually.
I think you are making big leaps in terms of cause and affect (affect....effect??).
 

Mackeyser

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I don't agree that is is WHY he did what he did because advanced CTE doesn't make you a murderer.

Also just because someone has CTE doesn't mean they have symptoms. For instance he had no problems finding his way to anywhere while he was driving. He wasn't getting confused in his own house. He had NONE of the symptoms.

He was just a POS and a killer. He did it twice, planned it and carried it out two times.

I'm sorry, bud, but you misunderstand how CTE applies when you say this.

Firstly, CTE DOES have pronounced symptoms. The problem is that there's no definitive way to diagnose CTE without actually slicing up the brain. As brain scans get better, they may be able to in the future, but not at this time.

For example, you're confusing the symptoms of Alzheimer's with CTE. They are very different brain maladies.

Was Aaron Hernandez a bad person. Yeah, seems so.

The point of the science is to say that it's scientifically reasonable to say that some people have bad/evil tendencies and we naturally have gates to stop that. In AH's case, his gates were torn down. What we don't know is what does that mean?

Does it mean the person will tend to go through the torn down gates?
Does it mean the person will want to go through the torn down gates?
Does it mean the person won't recognize where the gates used to be?

Science can't answer those questions, yet, which is why no one is saying that "the CTE made him do it".

That would be an irresponsible statement unsupported by the science.
 

Mackeyser

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I call nonsense.
"Sometimes people with CTE harm others, other times they harm themselves".....and often they harm no one.
"The CTE explain WHY he did what he did. It doesn't absolve him of responsibility"....Yeah, it would actually.
I think you are making big leaps in terms of cause and affect (affect....effect??).

Right. That was my whole statement. The CTE doesn't absolve him on responsibility. I finished that statement parenthetically by stating "although, with other medical diagnoses, that's exactly what happens."

The reason it doesn't (and who knows? it may in the future) is that neuroscience doesn't understand CTE fully, yet.

We see that the brain is SIGNIFICANTLY damaged. What neuroscientists don't know is if or to what degree does damage lead to causality.

Is brain damage a factor only pertaining to degree? Meaning that it's not a factor of IF a person does something, but IF they do that it will be exaggerated?

Is brain damage a factor in causation? Does a diminished frontal lobe, for example, lead to inevitable violence?

Neuroscience doesn't know that in the same way they better understand Alzheimer's or Cerebral Palsy.

So, we don't know cause and effect, yet. We don't know how CTE affects behavior, whether there's a causative effect or CTE simply becomes a factor in aberrational behavior.

As researchers discover more, we'll better understand.
 

fearsomefour

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Right. That was my whole statement. The CTE doesn't absolve him on responsibility. I finished that statement parenthetically by stating "although, with other medical diagnoses, that's exactly what happens."

The reason it doesn't (and who knows? it may in the future) is that neuroscience doesn't understand CTE fully, yet.

We see that the brain is SIGNIFICANTLY damaged. What neuroscientists don't know is if or to what degree does damage lead to causality.

Is brain damage a factor only pertaining to degree? Meaning that it's not a factor of IF a person does something, but IF they do that it will be exaggerated?

Is brain damage a factor in causation? Does a diminished frontal lobe, for example, lead to inevitable violence?

Neuroscience doesn't know that in the same way they better understand Alzheimer's or Cerebral Palsy.

So, we don't know cause and effect, yet. We don't know how CTE affects behavior, whether there's a causative effect or CTE simply becomes a factor in aberrational behavior.

As researchers discover more, we'll better understand.
Right.
So, we don't know much.
Jumping to a bunch of conclusions is not going to happen when billions of dollars are being made.
We shall see.
 

Mackeyser

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Well, it's not like we don't know anything.

We know that concussive and especially sub-concussive impacts (like what linemen sustain on every single play) are what CAUSE CTE.

That much we know.

What we don't know is if CTE is a cause, trigger or factor in aberrational behavior like violence including emotional, physical and/or self-harm. There's obviously a LOT more to know, but most fans and the public in general at least at first really only want to know that much.

And I'm not jumping to any conclusions, simply trying to clarify.

As someone with a brain injury whose chronic pain and many past seizures has the potential to yield similar results to CTE, let's just say that I've got a ton of skin in this, especially in understanding what the science can tell us.

Early returns are that CBD compounds can actually HEAL damaged portions of the brain. Normally, that doesn't happen and actually, opiates inhibit that response, thus exacerbating the problem.

Once a person has a brain injury, there are tons of questions to be answered by science as we go forward like I've mentioned.

As for the billions of dollars, I feel fully confident the owners would light their players on fire if they thought they could land a more lucrative TV contract, but that's a different topic. I don't think the owners or the NFL care one ratshit about the health of the players beyond what the public forces them to do in order to keep making money.

Personally, I don't think the owner's antipathy to humanity and/or their players should in any way guide the rest of us human beings.

But that's my personal take.
 

LesBaker

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Firstly, CTE DOES have pronounced symptoms.

Of course it does but AH wasn't exhibiting any of them.

Was Aaron Hernandez a bad person. Yeah, seems so.

He was a violent punk before he got to college, while he was in college and when he got out.

Aaron Hernandez suffered the most severe case of chronic traumatic encephalopathy ever discovered in a person his age, damage that would have significantly affected his decision-making, judgment and cognition, researchers at Boston University revealed at a medical conference Thursday.

The article opens with this line. I think it's a bit of sensationalism. How many 27 year old's with CTE have they seen? Likely not a single one that ever played football for 12 or so years when you add up HS, college and the NFL.
 

Mackeyser

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Well, that's sorta the point, idn't it?

We don't know when AH started displaying symptoms but based on the DEGREE of damage, it follows that he didn't sustain it all in the pros, or even college.

Moreover, they did mention that he was genetically predisposed to have an exacerbated reaction to concussive and sub-concussive impacts that cause CTE. So while some kids can play all the way through the pros and have zero signs, those who are predisposed to enhanced damage may only play HS ball and end up with relatively severe CTE. That's the hypothesis that seems to require examination. AH's brain seems to be exhibit one. We'll see what the ultimate conclusion is.

I mean, we could end up at the point where kids have to take a DNA test to see if they flag for the genetic marker. If they do, no football and no head contact sports be it martial arts or even soccer or hockey. They are beginning to explore CTE in both soccer and hockey now. Anyone who's headed a hard kicked ball KNOWS it rings the bell, even if struck properly.

Lastly, the point of the statement is that while the sample size is small, it's large enough to draw some finite conclusions. Those conclusions include that AH's level of CTE at his age was thought nearly IMPOSSIBLE.

His brain is redefining the parameters for CTE in several ways.