Warning sign on youth football head trauma

Player had hint of brain disease

Chris Nowinski of Boston University is recruiting former professional football players to donate their brains for study. (Chris O'Meara/Associated Press)

In a discovery that is bound to reverberate through the nation's youth football community, clinical researchers reported yesterday that the brain of a recently deceased 18-year-old high school football player showed the earliest signs of an incurable debilitating disease caused by the kind of repetitive head trauma he experienced on the field.

The discovery could provide new clues as to how much of a threat concussions are to athletes, including players from Pop Warner to the National Football League and those engaged in other contact sports, according to researchers at Boston University School of Medicine's Center for the Study of Traumatic Encephalopathy. No scientist had previously documented the degenerative brain disease in a football player younger than 36.

"The findings are very shocking because we never thought anybody that young could already be started down the path to this disease," said Dr. Robert Cantu, a clinical professor of neurosurgery at BU Medical Center and a co-director of the brain study institute. "It should send a powerful mes sage to people at every level of football that they need to care about this issue and treat concussions with respect."

Dartmouth High School football coach Rick White believes more precautions will be taken when a player has a concussion. "The time a player takes off, the time they're allowed to come back, has changed dramatically over the years," said White. "As this research keeps coming out, you're going to see kids have to sit out longer. Some of these injuries could be season-ending, and even career-ending.

"It's definitely a scary thing. You don't want to be sending a kid back out onto the field with what could be a permanent injury. Hopefully the technology of helmets can catch up and they can make a helmet that can prevent this kind of thing."

In the same study, postmortem exams of brains of seven former NFL players who died between ages 36 and 50 confirmed that six of the men suffered from the disease, chronic traumatic encephalopathy (CTE), the BU team said in a news conference near the site of Super Bowl XLIII in Tampa. The researchers said the disease is caused by multiple head injuries and afflicts individuals similarly to early-onset Alzheimer's.

Only one brain that neurologists have reported analyzing since they began testing for CTE in recent years did not show conclusive evidence of damage caused by the disease, the study team said.

The BU researchers also released their findings on the sixth player to be diagnosed with CTE, Tom McHale, who played nine seasons with Tampa Bay, Philadelphia, and Miami, and died last year of an accidental drug overdose at 45. The abnormalities in McHale's brain were distinctly similar to those found in the damaged brains of the other NFL football players, said Dr. Ann McKee, a neurologist who is director of BU's brain bank and co-director of the study center.

McKee said she has conducted postmortem exams of thousands of brains.

"I have never seen this disease in the general population, only in these athletes," she said. "It's a crisis, and anyone who doesn't recognize the severity of the problem is in tremendous denial."

The 18-year-old high school student, whose identity was withheld at his family's request, had suffered numerous concussions playing football and other contact sports, his parents told researchers. Though his brain showed only the earliest stages of the disease, the findings were "absolutely alarming," McKee said, because they confirmed that the disease can permanently damage an athlete's brain at a significantly earlier age than researchers imagined.

The student had been playing contact sports within weeks of his accidental death, the researchers said. They declined to discuss how he died, other than to say it did not involve head trauma or violence.

"This should be a wake-up call, especially to parents, coaches, and league administrators," said Chris Nowinski, a former Harvard football player and professional wrestler who is co-director of the BU center and author of the book "Head Games: Football's Concussion Crisis." "We're exposing more than 1 million kids to early-onset brain damage and we don't know yet how to prevent it."

Had the teenager lived, neurologists said, he eventually would have developed early-onset dementia that would have advanced unabated until his death.

In McHale's case, researchers informed his wife, Lisa, that their postmortem exam showed extensive damage to his brain from CTE. They said the disease likely aggravated his attempt to overcome his addiction to painkillers. McHale also left three sons, ages 14, 11, and 9.

"We lost an absolutely amazing person," Lisa McHale said. "That's not going to change for us, but it would be a blessing if Tom's case helps to raise awareness about the disease and advances the research into it. That would go a long way in giving some meaning to his death."

McHale was a successful restaurateur in Tampa when his life began to spiral out of control in 2005, 10 years after his last season in the NFL. His wife said he fought with "everything he had in him" to overcome his opiate addiction, including twice entering rehab facilities and undergoing outpatient treatment until his death. But even when he was in recovery from the addiction, which at times turned him into a "monster," she said, his behavior was unlike any she had previously witnessed.

A confirmed feature of CTE is that many years generally pass after a football player leaves the sport before the disease begins affecting his personality and behavior.

"The man who died in 2008 was very, very different from the guy I married," Lisa McHale said. "It was like he was a shell of his former self."

BU researchers said McHale's addiction played no role in his developing the brain trauma disease. Rather, they said, the CTE may have contributed to his addiction by affecting areas of his brain that control certain behavioral impulses.

"We have not yet been able to connect the dots between the brain damage related to CTE and a greater susceptibility to addiction, but we believe that's the case," Cantu said.

Regardless of a possible connection, McHale's CTE would have progressively damaged his brain and his ability to function normally, the neurologists said.

"That means I was never going to get Tom back, and the poor guy was never going to be his former self despite how hard he was trying," Lisa McHale said.

McHale said the brain center's findings convinced her that CTE contributed to her husband's death, though she has accepted the official finding of an accidental drug overdose.

"I'm not interested in changing anybody's mind about how Tom died," she said. "But I'm speaking out because we know so little about CTE and the damage it can do."

She said she already knows enough that she is reluctant to allow her two youngest sons to continue playing Pop Warner football.

"I'm very uncomfortable with it," she said. "I'm kind of hoping they decide on their own that it's not their sport."

Researchers said they cannot estimate CTE's prevalence among football players, though some athletes appear to be more susceptible than others, indicating there may be a genetic link. Because the research remains in its early stages, scientists also have yet to determine how many blows to the head or how severe the hits must be to cause CTE. McHale, for instance, was not known to have suffered a concussion playing football, though he absorbed thousands of blows to his helmet.

Scientists also are exploring whether players are more susceptible to developing CTE at a particular age. They expect to discover the answers only through extensive research on the brains of deceased players.

To that end, retired NFL players have enlisted their colleagues to donate their brains to the BU study. With Nowinski serving as the chief recruiter, the initial list of 12 prospective donors has expanded. Researchers announced a new group of donors, including Hall of Famer Joe DeLamielleure, Dan Pastorini, Ken Gray, Harry Jacobs, Mel Owens, and Chad Levitt. Retired Patriot Ted Johnson was the first former NFL player to say he would volunteer his brain to the center.

"It's unfair to the players, their wives, and their children that they have to pay such a price for playing a game they love," said DeLamielleure, 57, who played in the NFL with Buffalo and Cleveland from 1973-85 and was renowned as O.J. Simpson's key blocker with the Bills. "It's wrong. This needs to be fixed, and I'm going to do everything I can to bring awareness to it."

Unlike DeLamielleure, who has not experienced symptoms of CTE, former NFL player Brent Boyd said he suffers from post-concussion disability. Boyd, 51, played six seasons as an offensive lineman for the Minnesota Vikings in the 1980s.

"I know the indignities caused every day by mild traumatic brain damage," said Boyd, who was among a group of retired NFL players that has criticized the league's pension plan as inadequate and believes the league's union does not do enough to help retired players in need.

Boyd recently sent a letter to 2,000 retired NFL players imploring them to donate their brains to the study after their deaths.

"As NFL retirees, we already have given all we can of our bodies and brains, while alive at least," he wrote. "Here is one [more] chance to give something to the sport of football, not to the league owners or union, but to Pop Warner, high school, college, and future NFL players."

Barbara Matson of the Globe Staff contributed to this report; Bob Hohler can be reached at hohler@globe.com.