Aaron Hernandez's violent end: Was CTE to blame?

— -- Former New England Patriots tight end Aaron Hernandez’s April suicide marked the last chapter in a dramatic fall from superstardom into a life of violence and incarceration. Now, findings from an autopsy on his 27-year-old brain have some asking whether his football career – and specifically, the blows to the head he received on the field – could be at least partly to blame.

The findings, released Thursday, indicate chronic traumatic encephalopathy (CTE) – a condition that is the result of repeated head trauma. In recent years, research has uncovered evidence of a connection between CTE and certain contact sports, most notably professional football. A growing number of former NFL players and their families have come forward, describing the onset of psychiatric conditions and behavior changes believed to be linked to CTE.

But as to whether CTE was to blame in any way for Hernandez’s murder conviction, and later his suicide in prison, experts are split.

“The brain lesions noted on autopsy could be compatible with the psychiatric features, although the mechanism is unknown,” said Dr. Luca Giliberto of the Litwin-Zucker Research Center for Alzheimer's Disease and Memory Disorders at the Feinstein Institute for Medical Research in Manhasset, New York.

Even though the exact way CTE affects the likelihood of violent behavior is still a mystery, he believes a connection is, at least, possible.

“All data and evidence show that the risk is real,” Giliberto said. “We cannot hide our heads in the sand when we see these cases and say, ‘maybe not.’ If we keep hiding we will keep collecting more cases like Hernandez.”

Others, however, were more skeptical that enough evidence exists to blame violent behavior on CTE.

“Even though there has been speculation about behavioral changes due to CTE, no one has proven any correlation,” said Dr. Anthony G. Alessi, associate clinical professor of neurology and orthopedics at UConn Health. “This is where science breaks down and litigation comes into action.”

Indeed, most in the field agree that the research is only in its very early phases. The largest study so far on CTE in former NFL players, conducted at Boston University, involves the brains of just 111 such athletes. In all of these cases, the athletes themselves or their families volunteered the brains for study after these players had died. While the findings thus far have been revealing – 110 of the 111 brains studied showed evidence of CTE – they are not representative of all professional players in the sport. This means that researchers do not yet know how prevalent this condition is among all players on the professional level, much less among the millions of others who play or have played at the college and high school levels. Nor can these findings provide solid answers yet on the connection between CTE and behavior.

Where both Giliberto and Alessi agree is that sports in which head collisions are common definitely put players at risk of brain trauma and CTE. And they warn that the damage can start early.

“Around a six and half million young Americans are involved in some kind of youth sports associated with a high risk of collision damage to the brain,” Alessi said.

Of particular concern is repeated head trauma before the age of 13, while the brain is still maturing, he said. This can have dangerous future consequences, he noted.

Giliberto noted that entities like the NFL should also take steps to talk openly about the topic, as well as to step up and provide data needed to take advantage of the millions of dollars invested on research in this topic.

“The phenomenon of CTE has been there since times of gladiators,” Giliberto said. “It was just that we never looked at it and admitted that it existed.”