NZ neuros publish first findings of CTE in ex-League player

Neuroscientists have published a report of chronic traumatic encephalopathy in a former top-flight New Zealand rugby league player.

The 2021 death was – chronologically – the first case of a Kiwi ex-pro Rugby League player to have been diagnosed with the disease. Billy Guyton, a NZ rugby union player, died in May 2023 and was confirmed with the disease in March this year.

The identity of the rugby league player is only described in the paper as a 79-year-old male who had represented New Zealand internationally before retiring from the game in the 1970s.

At 64, the player was diagnosed with Parkinson’s disease and exhibited a range of neurological and cognitive symptoms in later life. Analysis of his brain found Lewy body (clump of abnormal protein buildup in brain cells) disease “consistent with Parkinson’s”. It also found neurofibrillary tangles – masses of tau protein, which are telltale signs for a diagnosis of chronic traumatic encephalopathy (CTE).

“The person did have a complex neuropathology, they had evidence of Parkinson’s type changes which the person had experienced in life and also some dementia type changes,” says Maurice Curtis, a professor in biomedical science who is co-director of NZ’s The Neurological Foundation Human Brain Bank.

“This is not uncommon because he was an older gentleman and many people once they get over the age of 60 or 70 get a diagnosis of Alzheimer’s or Parkinson’s disease.”

CTE has been a subject of greater public scrutiny in recent years with postmortem identification of the disease in high-profile athletes and the emergence of in-life diagnoses of traumatic encephalopathy syndrome (TES) based on a collection of symptoms and personal history.

“We know that repetitive head injuries actually predispose people to Parkinson’s disease, to Alzheimer’s disease, but the one pathology that is characteristic and only seen in repetitive head injury cases is the chronic traumatic encephalopathy,” Curtis says.

“The family had thought about the fact that there was such a significant sporting history and thought maybe it’s just Parkinson’s disease or dementia based on age and other risk factors.

“But one of the big risk factors here was the sporting history. And so they donated the brain on that basis that they thought maybe it’ll just help Parkinson’s disease.”

Diagnosing CTE when a person is alive is particularly difficult, with other neurological diseases such as Alzheimer’s and Parkinson’s having the potential to mask the other disorder. Only analysis of microscopically thin layers of brain tissue for signs of tau provides scientists a definitive example. TES offers clinicians a pathway to diagnosing likely CTE, which Curtis says can be helpful when applied “conservatively”.

While Australia is seeing an increased awareness around head injury and appropriate management of concussion in sport at all levels, he feels the discussion is still in its infancy in New Zealand. Like Australia though, current and former athletes are continuing to reach out with an interest in donating their brains after death.

“The number of people that have played a lot of sport that that say, ‘Hey, I think I’m, I’m a sitting duck for this’ … is pretty high,” Curtis says. “We’ve had about 40 people sign up for brain donation that have got a significant sporting history.”

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