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Health

Sporting codes should implement CTE policies, neuropathologist says after analysing Paul Green's brain

The neuropathologist who discovered high amounts of chronic traumatic encephalopathy (CTE) in the donated brain of late rugby league player and coach Paul Green says major sporting codes should develop CTE minimisation policies.

Associate Professor Michael Buckland said moves by sporting codes to better manage concussion were welcome, but more could be done.

"I'm very pleased to see it is on their radar and they are taking head impacts seriously," Dr Buckland told ABC Radio Brisbane.

"I think a lot more needs to be done. I think alongside any concussion policy there needs to be a specific CTE minimisation policy, and that policy should be based on two fundamental principles.

"The first one is reducing a person's cumulative lifetime exposure to repeated head impacts, and the second principle would be delaying the age of onset of first exposure to repeated head impacts."

Dr Buckland said ideally he would prefer to see children playing non-contact versions of sports until they reach high school.

Most major sporting codes now have dedicated concussion protocols preventing players from returning to the field after a serious hit to the head, until they have been medically cleared.

Donation of Green's brain to have lasting impact

CTE can be missed entirely if a person is asymptomatic, or it can mimic other progressive brain diseases such as Alzheimer's.

It can lead to difficulties thinking and planning, trigger emotional changes, and cause memory problems.

Green played for five rugby league clubs and had a highly successful coaching career before his death, playing through the era of hard knocks and quick recoveries.

He was 49 when he died in August, and a post-mortem scan of his brain revealed significant evidence of CTE.

"I was certainly surprised at how much pathology there was, it was very easy to see," Professor Buckland said.

"Certainly in the frontal cortex of a 49-year-old man I would not expect to see any pathology, but in Paul's case there was quite a lot."

Other former professional athletes diagnosed post-mortem with CTE include late Richmond footballer Shane Tuck, and former Geelong footballer Polly Farmer.

Green's wife Amanda on Saturday said the findings of CTE in Green's brain had given the family some closure over his death.

At present, CTE is only diagnosed after death, with no tests yet available to confirm if a living person has it.

Dr Buckland said the family's brave decision to donate Green's brain would have a significant impact on the research into diagnosing CTE and ways to protect future generations from the disease.

"This is the only neurodegenerative disease I know of that is almost entirely preventable, and the way you prevent it is by reducing your exposure to repeated head impacts over your lifetime," he said.

"The other thing is by really dissecting what's unique about these lesions in the brain tissue, you can then start to develop ways to diagnose it during life.

"We can find molecules that are unique to CTE and then we can go and look for those molecules in the blood and develop a blood test."

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