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Could Post-Concussion Symptoms Have Driven Junior Seau to his Death?

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EXPERT CONTACT :

John J. Leddy, MD, director and Barry S. Willer, PhD, research director

University at Buffalo Concussion Clinic
University at Buffalo School Medicine and Biomedical Sciences
Leddy: 716-204-3200
Willer:  716-304-6585
leddy@buffalo.edu
bswiller@buffalo.edu

John J. Leddy, MD, associate professor and director of the University at Buffalo Concussion Clinic and Barry S. Willer, PhD, professor and the clinic’s research director consider the possibility that former NFL player, Junior Seau, who was found dead on May 2, may have been suffering from concussion-related depression.

What was your response when you first heard about Seau’s death?

The pattern of behavior, including the domestic violence incident just a month or so ago and the violent end to his life, is reminiscent of other former players struggling with chronic traumatic encephalopathy (CTE). He may have shot himself in the chest so his brain would be preserved and examined for CTE. Junior Seau made a choice to end his life rather than expose his family and friends to his untethered anger. Our response is one of sorrow for him and his family.  We wonder how many other former players are living with the consequences of CTE.
 
How significant is Seau’s long football career in terms of possible exposure to concussion?
 
Junior Seau was one of the best linebackers to play the game of football. The position he played is considered very high risk for repeated sub-concussive blows and therefore at high risk for CTE. Sub-concussive blows are at a force lower than that which cause observable concussion, but sufficient to cause temporary disruption of brain function.  Repeated sub-concussive blows create damage much greater than one concussive blow.
 
What would you hope to learn from an examination of Seau’s brain if that takes place?
 
We assume that examination of Junior Seau's brain will take place at Boston University (BU) and we expect they will find evidence of CTE. We are currently in discussion with the research team at BU to develop a research protocol to determine CTE in those still living with the disease. This requires advance magnetic resonance imaging and we are developing a pilot study to look at former Bills and former Sabres. In addition to BU researchers, we are collaborating with local researchers in neurology, neurosurgery, orthopedics and the UB School of Public Health. We have some local funding for initiation of the study from the Robert Rich family foundation, the Sabres Foundation, Ralph Wilson fund, and PUCCS (Program for Understanding Childhood Concussion and Stroke).
Related Topics:

concussion, CTE, head injury, Leddy, NFL, seau, suicide, Willer

'There's No Such Thing As a Minor Concussion,' UB Doctor Says

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EXPERT CONTACT :

Dr. John J. Leddy

Associate Professor of Clinical Orthopaedics and Director of the UB Concussion Management Clinic

University at Buffalo School of Medicine and Biomedical Sciences

leddy@buffalo.edu

With the NFL and NHL seasons well under way, Leddy discusses the progress that doctors, teams and athletes have made in understanding concussions and recognizing the seriousness of the injuries. With colleague Barry Willer, Leddy has developed an exercise-based test that helps doctors understand when it’s safe for an athlete to return to play. Athletes treated at Leddy’s concussion management clinic include Toronto Maple Leafs center Tim Connolly, formerly of the Buffalo Sabres.

On the need to take concussions seriously:
 
“There’s no such thing as a minor concussion, and the problem is that once you have one or two, you’re more likely to have a third, fourth or a fifth, and then you are at risk for sustaining cumulative and permanent damage over time. The brain is a unique organ. You only have one, and you need it for almost everything else. Clearly, the animal and human research shows that if somebody goes back before they’re fully recovered, they’re going to fare much worse and often will have a second, more significant, injury.”
 
On the progress that doctors, teams and the public have made in recognizing that concussions are serious:
 
“When I was playing high school sports, people went into play after concussions. Nobody realized that they were dangerous. They thought you got your “bell rung,” and then you got over it and that was it.”
 
“It’s really gotten press in the last two or three years at the NFL level and NHL level. And then when you have very prominent athletes like Sidney Crosby and Eric Lindros—they get a lot of publicity and it starts to get public attention. I think with all the publicity about concussions in professional athletes over the past year, scholastic athletes and team physicians are certainly taking concussion more seriously now.”
 
On the method Leddy and Willer have developed to test whether athletes are ready to return to play:
 
“We use a standardized treadmill exercise test to establish the exercise tolerance of patients with post-concussion symptoms lasting more than three weeks. In the test, patients exercise on a treadmill with gradually increasing intensity until they can exercise to full capacity without worsening symptoms.”
 
“The test replicates the physiology of what athletes have to do during sport. It helps us determine when an athlete is physiologically recovered from concussion and is safe to return to play. It is our experience that this program speeds recovery in those with abnormal physiology, especially in athletes.”
 
"The test also assists in the differential diagnosis of ongoing symptoms—physiologic post-concussion syndrome versus cervical injury versus migraine headaches, for example. Patients with physiologic post-concussion syndrome are given a specific exercise prescription based upon the treadmill results to safely perform at home on a daily basis. When we rule out physiologic post-concussion syndrome with the treadmill test, we are able to direct specific therapy to the underlying problem, such as a cervical issue or a migraine headache."

Related Stories:
The Right Call: Pioneering Research at UB Concussion Management Clinic Helps Football Player Make Tough Choice

Related Topics:

concussions, NFL, NHL, post-concussion syndrome

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