What is CTE & how can it be diagnosed?
As rugby’s legal case grows, CTE remains one of the most serious and least visible long-term risks linked to repeated head trauma.
All eight rugby players who first came forward in the landmark legal case led by former England World Cup winner Steve Thompson were diagnosed by neurologists at King’s College London with early-onset dementia and probable chronic traumatic encephalopathy, or CTE.
CTE is the disease discovered in former American football player Mike Webster by Dr Bennet Omalu, and it later became widely known through the film Concussion. Former NFL players also brought a class action against the league and reached a settlement worth about $1bn.
The condition is associated with repeated head trauma, including numerous smaller blows or rapid brain movements often described as sub-concussive impacts, and it has been linked with symptoms such as memory loss, depression, and progressive dementia.
“There’s clearly a problem. We don’t know the magnitude of the problem, but as long as we insist that there is no problem, we’ll never get to the bottom of it.”
Dr Ann McKee
One of the most difficult realities is that CTE can only be definitively diagnosed after death through examination of the brain, although researchers are working toward methods that may improve diagnosis during life.
Jeff Astle is one of the most prominent football examples in the UK. A re-examination of his brain found that he had died from CTE, adding to wider concern about repeated heading and long-term neurological disease in football.
That challenge is what makes sub-concussive trauma so difficult in live sport: the impacts may not be obvious on the pitch, and they may not be picked up in post-match assessment either. The damage risk can build silently over time.
Dr Ann McKee of Boston University has been one of the leading neurologists in CTE research and a key figure in pushing sport to take repetitive head trauma more seriously, even while parts of the sporting world continue to argue that more evidence is needed before stronger intervention.
“We’re just denying it and prolonging it and making sure that as many rugby players as possible get CTE.”
Dr Ann McKee
