The dispute became far more consequential as former players developed memory loss, depression, anxiety, headaches, sleep problems, dementia, and other neurological symptoms after retirement. Boston University researchers reported in September 2014 that 76 of 79 examined brains from former NFL players showed signs of CTE, a degenerative disease associated with repeated brain trauma and abnormal tau-protein accumulation. By January 2017, the reported total had risen to 90 of 94, and a landmark 2017 study in the Journal of the American Medical Association found CTE pathology in 110 of 111 donated former NFL brains. Later research reported that the odds of CTE approximately doubled for every additional 2.6 years of football participation. These figures came from donated-brain samples and therefore do not establish the prevalence of CTE among all football players, but they intensified accusations that the sport and its medical structures had minimized the lifelong danger of repetitive head impacts. The controversy produced lawsuits by more than 2,000 former players, congressional scrutiny, objections to the proposed NFL concussion settlement, and major changes to return-to-play rules. In October 2009, Commissioner Roger Goodell and NFL concussion officials were questioned by Congress; after pressure from lawmakers and the NFL Players Association, the league expanded its concussion policy and began barring players who had been knocked unconscious from returning to the same game or practice. The long-running conflict helped turn concussion reporting, independent medical evaluation, baseline neurological testing, sideline spotters, and helmet technology into permanent parts of professional football’s safety system.
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