Posted on: July 11, 2011 3:39 pm

Was former Irish DE Duranko's ALS really ALS?

Posted by Adam Jacobi

As reported yesterday, former Notre Dame star lineman Pete Duranko passed away on Friday after a long battle with amyotrophic lateral sclerosis (ALS), or Lou Gehrig's disease. Duranko was a starter on Notre Dame's dominant 1966 defensive line, part of a team that won the national title while allowing 38 points. That would be 38 points for the entire season. 

As the Denver Post noted, Duranko was an ardent supporter of efforts to combat ALS, and he was a national spokesman and fundraiser for the ALS Association, fighting the disease that would eventually claim his life. 

It's my genuine hope that Duranko and his family continue that selfless spirit even after his death. In this instance, that would mean donating his brain to the researchers studying former football players' brains for chronic traumatic encephalopathy (CTE) -- the degenerative brain condition that frequently affects those players after (and in some disturbing situations, during) their careers. 

Now, obviously, ALS and CTE are two different diseases, and I'm clearly no doctor, but it's important to note that there have been multiple athletes who were diagnosed with ALS, but were discovered to have brain injuries instead. Here's how the New York Times described it last year in a fascinating story about whether Lou Gehrig himself actually suffered from his eponymous disease:

A peer-reviewed paper to be published Wednesday in a leading journal of neuropathology, however, suggests that the demise of athletes like Gehrig and soldiers given a diagnosis of amyotrophic lateral sclerosis, commonly known as Lou Gehrig’s disease, might have been catalyzed by injuries only now becoming understood: concussions and other brain trauma.

Doctors at the Veterans Affairs Medical Center in Bedford, Mass., and the Boston University School of Medicine, the primary researchers of brain damage among deceased National Football League players, said that markings in the spinal cords of two players and one boxer who also received a diagnosis of A.L.S. indicated that those men did not have A.L.S. They had a different fatal disease, doctors said, caused by concussionlike trauma, that erodes the central nervous system in similar ways.

This research doesn't prove anything about Duranko's disease, of course. If we assumed that every former football player diagnosed with ALS really had CTE, then we'd also be deterining that football players can't get ALS, and that would be ridiculous. But with ALS, we're talking about something that's normally a very rare diesease, and among football players, CTE is distressingly common. Thus, from the strict standpoint of probability, it seems more likely that Duranko's disease is CTE manifesting itself in symptoms similar to ALS, rather than ALS itself.

It's also important to note that the "usual" symptoms of CTE -- depression, loss of memory, substance abuse, and otherwise erratic behavior -- don't seem to be prevalent in Duranko's account of his late life. Duranko reported more problems with opening coffee creamers than with basic cognitive function, so we hardly have a "textbook" case of CTE here. But not all former players with CTE exhibit those symptoms; many football players that have been diagnosed with CTE by Boston University researchers died from unrelated causes, so as with all diseases affecting something as wonderfully complex as the brain, there's no easy, widely applicable diagnosis available here.

So if Boston's researchers don't do anything with Duranko from here on out, then this conversation's basically a non-starter, and he will have died as a proud soldier in the fight against A.L.S. But that's in and of itself fine. Determining where Duranko's eventually fatal brain disease came from probably wouldn't have made much of a difference in his life, and so long as his symptoms were consistent with ALS, his efforts to combat ALS were hugely worthwhile for every other family affected by the disease (or, if the case may be, CTE).

And since Duranko worked so hard to help better the lives of those who would be diagnosed with ALS after him, it would be nice to know that he would similarly benefit those in future generations who choose to follow his path into football and, hopefully, put together a career as long and storied as his. If that means informing them that a football career that lasts for 15 years from high school to the NFL can potentially afflict someone with a brain disease that's basically ALS, then that's what needs to happen. If Duranko didn't have CTE and was simply felled by the extreme misfortune of ALS, well, that's clearly important information too. But let's keep informing the current and future football players of America either way. They deserve it.

Posted on: October 19, 2010 11:11 am

Did a concussion lead to Chris Rainey's arrest?

Posted by Tom Fornelli

It seems that 2010 is becoming the year of the concussion in football.  As we all learn more about what concussions are and the long term effects they have on those who suffer them, the world of football has begun to take the injury a lot more serious than it had in the past.  Just look at the NFL this weekend, as two big hits in two seperate games have the league wondering if it should start suspending players who make head-to-head contact while tackling.

While the long term effects of concussions like chronic traumatic encephalopathy -- CTE -- have included depression and suicide, what about the short term effects?  There's no question that a concussion could lead to some dramatic behavior changes in a victim, like perhaps that person suddenly decides he wants to text an ex-girlfriend that it's "time to die."  That's what some are wondering in the case of suspended Florida receiver, Chris Rainey, who suffered a concussion only a few days before his arrest.

Even the victim in the Rainey case thinks his concussion had something to do with the events of that night.
Since the arrest, the victim has maintained that Rainey's threatening behavior that night was out of character. According to state attorney's records, the victim told police Rainey "has been acting strangely since receiving a head injury in a game played on 9/11/10."

The Gators played USF on that day, and coach Urban Meyer told reporters two days later that Rainey had a concussion.

"He got dinged pretty good," Meyer said on Sept. 13.
When reviewing the text messages between Rainey and the victim that led to the infamous "time to die" message, the victim pointed to Rainey's concussion that very night.
Text messages exchanged between Rainey and the victim that night indicate she thought Rainey's concussion was affecting his behavior. "U want to act a fool so im gonna act a fool too and im here," Rainey texted the victim.

She responded, "I'm not opening the door. It will do no good. Go back home and cool off. U have a concussion chris. Ur acting ridiculous."

Now the question is, is the concussion an excuse or a reason?  It's not easy to answer, but Dr. Robert Cantu of the Sports Legacy Institute says that injuring the brain, which a concussion does, changes behavior and can cause people to act bizarrely.  Of course, Cantu also says that bizarre behavior changes don't normally include "irrational or emotional behavoir, or loss of impulse control."

Which there's no question Rainey displayed on that night.  Though whether it was love or a concussion, we'll likely never know.
Posted on: September 13, 2010 9:57 pm

Former Penn captain who killed self had C.T.E.

Posted by Adam Jacobi

Earlier today, we questioned the sanity of allowing Houston QB Case Keenum to return to action for the Cougars after sustaining a concussion during play on the previous Friday. And while we can try to conjure as many different synonyms for "reckless" as possible to describe the situation, it's really not as likely to resonate as an argument without a tangible example of the dangers involved. 

Unfortunately, new details about those exact dangers emerged just today, as the New York Times reported that Penn student Owen Thomas, the former lineman and captain of the Quakers who hanged himself at the age of 21, was found to be suffering from the same type of degenerative brain disease that has recently been associated with long football careers. The disease, Chronic Traumatic Encephalopathy (or C.T.E.), can cause a host of serious mental problems in those afflicted with it, including substance abuse, suicidal depression, and symptoms similar to Alzheimer's and Lou Gehrig's Disease. Most notably, it was also found in an autopsy of Chris Henry, the former Cincinnati Bengals and West Virginia Mountaineers wide receiver who died after falling out of his fiancee's truck in a bizarre incident last year.

The most harrowing aspect of the revelations about Henry and Thomas is that neither man was ever diagnosed with a concussion, and neither had an extensive football career past middle school. Henry played one of the least contact-intensive positions in the sport, and while Thomas was on the other end of that spectrum, he was also only a 21-year-old junior when he began the mental collapse that ended in his apartment months later.

Worse, as of last year, 20 deceased football players had been tested for CTE--some who had exhibited no symptoms whatsoever--upon autopsy. 19 tested positive. Thus, considering Thomas' history in the sport and his subsequent quick descent into suicidal depression, it would have been far more surprising if the 21-year-old Thomas hadn't had CTE. That should be frightening for every single fan of the sport of football--and even moreso for parents of young football players.

And yet Houston coach Kevin Sumlin won't give Keenum a week off after Keenum's concussion. Just something to think about.

The views expressed in this blog are solely those of the author and do not reflect the views of CBS Sports or CBSSports.com