TORONTO - Testing on the brains of four former CFL players who all died within the last year shows two of them suffered from CTE, or chronic traumatic encephalopathy, a neurological disease that's been linked to repeated concussions.
Bobby Kuntz, who played for the Toronto Argonauts and Hamilton Tiger-Cats, and Jay Roberts, an Ottawa Rough Rider, both had a history of repeated blows to the head during their professional football careers and both their brains showed the hallmarks of CTE, researchers say.
However, the brains of former Winnipeg Blue Bomber Peter Ribbins, who died in December of Parkinson’s disease, and former Montreal Alouette Tony Proudfoot, who died this year of Lou Gehrig’s disease, did not display signs of CTE.
Neurosurgeon Dr. Charles Tator, part of the Canadian Sports Concussion Project at the Krembil Neuroscience Centre in Toronto, said results of testing on the four donated brains has raised more questions about CTE than answers.
"What we've been led to believe by other work is that this condition happens to everybody who has repeated concussions," Tator said Tuesday.
"So our finding is quite different from that and it actually adds to the importance of doing further research into this, because only two of the four professional football players — all of whom had multiple concussions — were found (to have) this degenerative condition.
"And we don't know why that is so."
CTE, which leaves a distinct pattern of protein deposits in the brain, can cause memory impairment, emotional instability, erratic behaviour, depression and poor impulse control. The condition also may eventually progress to dementia.
Kuntz died in February after a long battle with Parkinson’s disease and diffuse Lewy body disease, a condition that overlaps with Parkinson’s and Alzheimer’s; Roberts, who died last October, had dementia and lung cancer.
“While both of these men appeared to have pathological signs of CTE, they also suffered from other serious neurological- and vascular-related diseases,” said neuropathologist Dr. Lili-Naz Hazrati, who performed the brain testing.
"Right now we have more questions than answers about the relationship between repeated concussions and late brain degeneration," she said. "For example, we are still trying to understand why these two players acquired CTE and the other two did not.”
Mary Kuntz donated her late husband's brain to the concussion project in the hopes of getting a decisive answer about what had caused his symptoms, which started to become evident about 15 years ago.
"I'd always had it in my mind," she said Tuesday from her Kitchener, Ont., home. "Whenever we went to see a new specialist — and we kept getting referred to one new specialist after the other because they couldn't pinpoint what was the matter with him — I would always ask: 'Could concussions have something to do with this problem?'
"And they'd say it could have, but they didn't then know the extent."
While she's surprised that only two of the four players studied showed signs of CTE, Kuntz said there was relief in finally learning what was behind her husband's deteriorating cognitive health.
"It's a bit of closure for us because all of my children were wondering if this was hereditary."
Jed Roberts said his father Jay Roberts had numerous concussions, though they were undocumented. He and his sisters began noticing early signs of their father’s memory decline when he started repeating stories.
It was his father's idea to donate his brain, he said from Edmonton. "I think he knew probably better than we did that there was something wrong and he wanted somebody to go in there and take a look at it."
Jed Roberts played 13 years with the Edmonton Eskimos and suffered his share of concussions, though far fewer than his dad. Knowing that not all players with repeated concussions develop CTE is encouraging news both for him and possibly for his two-year-old son, he said.
"Until this came out this morning, I was really waging a war in my head about whether or not to let my son play," Roberts said. "It gives me some encouragement and some hope that if we can make the necessary changes, which I think we are in the sport of football, it doesn't have to be the kind of thing where a player is risking his life."
Angus Reid, the B.C. Lions centre who has played more than 160 CFL games, conceded there is a danger associated with choosing football as a career.
"I'm still playing football," Reid said. "I think if I was concerned for the safety of my entire body, brain included, I probably wouldn't play this sport. Let's be honest. There is going to be damage done to you on some level.
"Problems with the body are not a new thing. The discussions on concussion has become the new one ... There is a responsibility to constantly be improving technology to protect the body, but in the end, people collide into each other every day for a livelihood (and) there are going to be problems."
Hazrati said there is obviously a link between concussion and CTE, but the study of the four players' brains is too small to determine how the two are connected — and why two of the players did not develop the disorder.
"It raises the question: are there protective factors in these two players who did not have CTE? But also it raises the questions as to whether concussions can lead to other kinds of neurodegenerative diseases."
Tator said researchers wonder if the frequency of head trauma plays a role — if a player has, for instance, five concussions in a given season as opposed to one or two. Genetic predisposition might also contribute to CTE, as may some other underlying medical or neurological disorders, he added.
"And what we found, in fact, in these players is that virtually all of them did have additional serious medical conditions. So it's going to be a long time before we have all the answers to this very complex condition."
Solving the puzzle will require more research by the Toronto group and similar teams worldwide, said Tator, who hopes players experiencing neurological symptoms and their families will consider brain donations in the future.
And it is not just footballers who are in jeopardy of CTE or other possible long-term consequences of repeated knocks to the head — concussions can occur in virtually any sport, but especially in other high-contact games like hockey, soccer and rugby.
"It's really important to get to the bottom of this," Tator said. "It's really important for future generations."