A Victorian coroner has recommended AFL players be encouraged to donate their brains to science to further researchers’ understanding of the brain disease CTE.
Victorian Coroner Paresa Spanos made the recommendation after investigating the death of AFL great Danny Frawley, who died at 56 in a car crash in September 2019.
A post-mortem examination found Mr Frawley was suffering from “low-stage” CTE – chronic traumatic encephalopathy – which has been linked to repeated blows to the head.
Ms Spanos found that CTE was a “potential contributor” to the depression that Mr Frawley suffered before his death.
During his career, he sustained about 20 concussions, and was admitted to hospital five or six times for treatment, the coroner said.
Ms Spanos found that in the period immediately before his death, Mr Frawley’s anxiety and depression had been exacerbated by “personal and professional stressors”.
However, she said the available evidence did not indicate which of those stressors caused or contributed to his death.
The St Kilda Hall of Fame player, coach, and commentator had been open about his mental health issues, but it is not known how many of his problems were linked to CTE.
The disease can be diagnosed only by an autopsy, so it was impossible to tell how much and when it potentially started changing Mr Frawley’s personality or emotions, the coroner said.
Ms Spanos said there was a lack of knowledge about CTE in Australia and internationally, and more research was needed to determine how the disease contributed to brain dysfunction.
For that reason, she advised the AFL and the AFL Players Association to “actively encourage” players – and their legal representatives after their death – to donate their brains to the Australian Sports Brain Bank to further the community’s understanding of the condition.
She also recommended changes to coronial processes carried out by the Victorian State Coroner and the director of the Victorian Institute of Forensic Medicine.
Those included the early identification of a history of either major or minor repetitive head trauma, and to ensure that brain samples were examined and retained to determine if CTE was present.
Former AFL legends diagnosed
Mr Frawley was the second prominent AFL player to be diagnosed with CTE, after Graham “Polly” Farmer, who was found to be suffering from the condition after his death in 2019 at the age of 84.
In January, the ASSB also confirmed former Richmond player Shane Tuck had been suffering severe CTE when he died at the age of 38 in July 2020.
Mr Tuck’s death came as a shock, not only because of his age, but because he had concealed the extent of his mental health issues.
The presence of the disease in the brains of former players has forced the AFL to act, and in January the league introduced new rules governing concussion.
From this year, players who receive a blow to the head are required to be sidelined for a minimum of 12 days.
Previously, they had only to sit out of the game for six days.
At the time, AFL general counsel Andrew Dillon called the new rules “the most stringent concussion protocols in Australian sport”.
A recent five-year study by Monash University of AFL players showed elevated levels of the protein Neurofilament light (NfL) in their brains for at least two weeks after being concussed.
Elevated levels of NfL indicate damaged brain cells.
The study’s author, Stuart McDonald, said the university’s research into other sports showed elevated levels of NfL were still prevalent one month after a concussion, indicting many sportspeople were risking further damage by returning to the game too soon.
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