ixteen years on the gridiron took their toll on Michael Keck’s brain. The former high school and college football player suffered countless blows to the head. More than 10 led to concussions. At least one rendered him unconscious.
In a game as violent as football, none of that would have been notable if it weren’t for what came next. Keck died in 2013 of a heart attack when he was just 25. His wife, Cassandra, recalls one of his last requests: “When I die, make sure you donate my brain to Boston University.”
That brain was described Monday as severely damaged by neuropathologist Dr. Ann McKee and her colleagues from Boston University. Their case report, in the journal JAMA Neurology, details one of the youngest individuals ever identified with the degenerative brain disease known as chronic traumatic encephalopathy, or CTE. Boston University, along with the Concussion Legacy Foundation, collaborates on a “brain bank,” located at the Bedford VA Medical Center, that lets athletes and military personnel donate their brains and spinal cords for examination after their deaths. The research center has diagnosed CTE in at least 87 former NFL players, as well as dozens of former high school and college football players.
Keck’s case was particularly intriguing because it was one of the first times BU researchers examined such a young brain and were able to compare its physical characteristics with the results of neuropsychological tests on the subject during his life, some of which showed impaired brain activity, said Todd Solomon, a clinical neuropsychologist at the university who participated in the research.
Dr. James Noble, a Columbia University neurologist who was invited to write an editorial to accompany the article, said he hopes this case will bring attention to amateur athletes who may be at risk for CTE even if they don’t play professionally.
[stat_brightcove id=”4664703562001″ credit=”Alex Hogan and Hyacinth Empinado/STAT” caption=”Concussions, or even more mild, repetitive head trauma, may lead to a degenerative brain disorder called Chronic Traumatic Encephalopathy.”]
“Those are the people we probably need to know a lot more about,” Noble said. “But we don’t.”
But Eric Nauman, a professor at Purdue a member of the Purdue Neurotrauma Group, said while the case provides more evidence of the danger of repeated impact to the head, “it is not really a new result.” Researchers should also be looking for cases of CTE in individuals without obvious symptoms, Nauman said.
Keck started playing football at age 6, impressed his coaches in high school, and played for a few years at college in Missouri. He spent one year on the bench, recovering from shoulder surgery, and then played for two years after that, his wife said.
Toward the end of his time on the field, he felt his brain slowing down and knew something was wrong. He saw himself in the stories of former NFL players like Junior Seau, who committed suicide and was diagnosed with CTE.
But Keck’s doctors didn’t believe him, Cassandra said. At one visit, his physicians offered to prescribe pain medications for severe headaches, she said. Another time, a neurologist didn’t even know what CTE was.
“No doctor ever talked to him about CTE,” Cassandra said. “It was something he had to look up himself.”
Six months after Keck died of cardiac arrest, Cassandra got back the results of tests on his brain. “It was one of the worst cases I’ve seen in a young individual,” McKee said. She is also the chief of neuropathology for the VA Boston Healthcare System.
Cassandra has shared her story in the press and gave permission for JAMA Neurology to release the case report — which comes 10 years after the publication of the first confirmed case of CTE in a professional football player — in part, she said, to raise awareness about the disease.
McKee said that future research will look at genetic components of the disorder and will try to better understand the relationship between head trauma and the development of CTE.