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Is Roethlisberger's brain trauma at fault for recent behavior?

| Sunday, April 25, 2010

On Nov. 22, the helmeted head of Steelers quarterback Ben Roethlisberger met the knee of onrushing Kansas City Chiefs linebacker Derrick Johnson.

The quarterback with two Super Bowl rings wobbled off the field and sat out the next game. Less than four months later, he stood accused of raping a Georgia student in a Milledgeville nightclub, and quiet questions began: Six years in the National Football League, 242 sacks, four serious head traumas -- three on the field and one from a nearly fatal 2006 motorcycle crash -- and two sexual assault allegations after boozy evenings in Nevada and Georgia.

On Wednesday, NFL Commissioner Roger Goodell ordered Roethlisberger, 28, to undergo a battery of medical tests, part of a conditional punishment plan that could bench him for up to six games and cost him about $2.8 million.

Medical experts consulted by the Pittsburgh Tribune-Review refused to diagnose the root causes of Roethlisberger's pattern of self-destructive behavior. But frontal lobe brain trauma has long been known to affect mood, judgment, interpersonal relations, foresight and the inhibition that keeps most others from displaying inappropriate social behavior -- what's called "executive function" by neurologists and psychiatrists.

People who suffer repeated head injuries often exhibit signs of aggression, childishness, impaired self-control, inappropriate sexual activity and alcohol abuse, according to the National Institutes of Health.

"Ben Roethlisberger is a guy with a lot of concussions," said famed forensic pathologist Cyril Wecht. "It would be a very wise decision, a very appropriate one, for the NFL to test him for damage related to them. That's being very fair to Ben.

"It's conceivable to think that there is a possibility that those concussions have led to some behavioral issues. The question I pose is simple: Can someone with several chronic or repetitive head injuries later display behavior that is socially undesirable• It's certainly possible, but we won't know that unless there is a proper evaluation, then work-up and treatment plan. It would be medically negligent not to include these sorts of tests as a part of this disciplinary process."

Wecht doesn't want to excuse Big Ben's boorish behavior, only to ask the NFL to strongly consider the causes of it, including underlying brain trauma. The former Allegheny County coroner was so concerned with the issue that he convened a March 12 and 13 pow-wow of leading concussion experts at Duquesne University -- a conference he provocatively titled "Is Football Bad for the Brain?"

NFL spokesman Greg Aiello said a formal clinical evaluation is standard for any player arrested, charged or otherwise appearing to engage in mischief, but the medical results won't be released to the public.

"We do not disclose any other details relating to a specific individual," Aiello said. "Yes, medical professionals perform the evaluation. Yes, we have access to the findings and recommendations."

Roethlisberger's spokesman, agent Ryan Tollner, did not return telephone calls seeking comment.

Traumatic brain injury long has been a key concern of the NFL Players Association. In October, the union formed a special committee to study the diagnosis, treatment and prevention of brain injuries. Former Steelers wide receiver Sean Morey co-chairs it with Virginia's Dr. Thom Mayer, the union's medical director.

"Until we examine a lot of people like Ben Roethlisberger and study the histories of brain injury and relate them to exhibited behavior, we won't be able to answer the essential questions that need to be answered," Mayer said. "There's so much more we need to know."

That's why the NFL last week donated $1 million to Boston University to study chronic traumatic encephalopathy. Known simply as "CTE" or "punchdrunk syndrome," it's a degenerative brain condition that affects cognition and player conduct, eventually leading to dementia. Post-mortem examinations of the brains of Steelers Terry Long, Justin Strzelczyk and Hall of Fame center Mike Webster found evidence of the syndrome.

Strzelczyk died in a fiery 2004 explosion after ramming his vehicle into a truck filled with acid while trying to evade pursuing police cruisers. His marriage had ended in divorce, and he was dogged by rumors of drug use and depression.

Long committed suicide by drinking antifreeze in 2006, having previously suffered from broken relationships and facing federal charges of defrauding lenders and accusations that he burned down a chicken-processing plant.

Webster experienced dementia, sleep problems, memory loss and a broken marriage before succumbing to a heart attack in 2002.

"With Mike Webster, you had all the signs -- a failed business and marriage. He had become homeless. He was suicidal, depressed. This is typical of chronic traumatic encephalopathy," said West Virginia University neurosurgeon Julian Bailes and Iron Mike's physician.

Bailes refuses to weigh in on Roethlisberger but encourages more research into repetitive concussions and sub-concussive blows to the head and how they affect behavior.

"We've looked at 23 brains through autopsy now," said Bailes, who serves on the union's brain trauma committee. The syndrome "seems to manifest by affecting the emotional circuitry of the brain, and we need to look more into that."

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