Chronic traumatic encephalopathy (CTE) has become a hot-button topic in both the medical and sports communities as the link between the permanent brain disease and repeated head impacts gradually becomes more clear.
In recent years, studies have made it increasingly evident that repeated concussions or severe head impacts can lead to the development of CTE. CTE is marked by severe memory problems, emotional issues, mood swings, depression, anxiety, and a number of other serious health issues.
Despite this, CTE remains notoriously difficult to research. While researchers believe they may have identified biomarkers that could potentially identify CTE in living individuals, the only accepted way to currently diagnose the disease is through an autopsy after death.
To even be tested for CTE, a person has to suspect they may have the brain disease and willingly have their brain examined after their passing.
This presents two unique issues. The first is the overall lack of samples.
Of the countless athletes whose lives may have been affected by CTE, only a few hundred have had their brains submitted for research and examination. The number is gradually increasing, thanks to a wave of living athletes agreeing to submit their brains to brain banks like those operated by the Concussion Legacy Foundation and Boston University.
The second issue is more complex. Because a person is only likely to submit their brain for testing if they suspect they may be living with CTE, a disproportionately large number of the brains eventually come up positive for the disease. That means it is practically impossible to accurately assess how widespread CTE is in organizations like the NFL.
Combined, these two issues present an impenetrable barrier to fully understanding CTE that will exist for years to come – until brain banks have a larger and more diverse collection of brains to research or an objective test for CTE in the living is confirmed to be accurate.
Indeed, football players seem keenly aware of the responsibility they have to join the group of athletes donating their brains for research.
“[…] We need better data. I think it is the responsibility of every person who cares about the game of football to welcome as much research as possible to be done to ensure that future generations are fully aware of all the risks associated with this game,” says Cross. “So with that in mind, I recently pledged to donate my brain to CTE research.”
Cross is one of a small number of athletes with no discernable signs of CTE who are still making the hard decision to submit their brain to autopsy and research after their death. Rather than hoping to provide answers to their family and loved ones, he hopes to help provide answers to the athletics world as a whole.
“If we’re going to truly come to an understanding of what playing football does to a brain, we must study a full range of individuals,” he explains. “That means studying the brains of players like Junior Seau, who had very well-documented struggles, and myself, someone who has been fortunate to continue to function at a pretty high level nearly 30 years after retiring from the game.”
Athletes like Cross are essential to properly researching and understanding CTE. Without them, researchers can only see one side of the metaphorical coin.
Even if an objective test for CTE in the living becomes available, donated brains like those from Cross will still be the only way to deeply research the factors that determine if an athlete develops CTE and how fully the disease effects the brain.
Perhaps even more importantly in the short-term, athletes like Cross are helping to destigmatize CTE.
“For the last decade or so, CTE has been treated by players like the 800-pound gorilla in the room. To acknowledge it would mean owning up to the fact that they’re scared of it — or that they may already be suffering some of the side effects. That’s something that football players simply aren’t wired to do,” Cross says. “It’s against our nature. But I’m hopeful that we’re reaching a point where we can move past that.”