http://www.nytimes.com/2014/09/24/sports/soccer/soccer-star-bellini-is-found-to-have-had-brain-trauma.html 2014-09-23 16:42:06 Soccer Star Bellini Is Found to Have Had Brain Trauma The advanced case of C.T.E. in Bellini, a Brazilian who died in March, indicated again to researchers that the brain disease is not connected only to boxers and American football players. === Bellini, the Brazilian soccer star who won the 1958 World Cup and was honored with a statue outside the Estádio do Maracanã in Rio de Janeiro, has been found to have had the degenerative brain disease linked to dozens of boxers and American football players when he died in March at age 83. At the time, his death was attributed to complications related to Alzheimer’s disease. But researchers now say he had an advanced case of chronic traumatic encephalopathy, or C.T.E., which is caused by repeated blows to the head and has symptoms similar to those of Alzheimer’s. C.T.E. can be diagnosed only posthumously, and few brains of former soccer players have been examined. Bellini is the second known case, according to Dr. Ann McKee, a neuropathologist at Boston University and the Bedford Veterans Administration Medical Center, who was brought in to assist in examining Bellini’s brain. McKee was also involved in a finding earlier this year when researchers C.T.E. in the brain of McKee said in an interview that she was aware of a third former soccer player who had C.T.E. but was not yet authorized to publicly identify the person. As C.T.E. began to gain widespread attention about six years ago, it was often thought of as an American problem. After all, many of the early cases of the disease, for which there is no known cure, were connected to boxers and American football players. But more recently, evidence is mounting that those at risk for developing C.T.E. include soccer players. McKee said that although it is too early to say whether head balls in soccer were the cause of C.T.E., it is becoming apparent that its players are at risk of long-term brain trauma. “I think there’s been a perception that the nonhelmeted sports are somehow less likely or less prone to these kinds of diseases,” she said. “There was also a time when people said C.T.E. was only an American problem. I think we are learning that, in both cases, those things aren’t true and this is a problem that is going to be seen around the world.” Dr. Lea T. Grinberg, a neuropathologist specializing in brain aging who has been affiliated with the University of São Paulo and is currently an assistant professor at the University of California, San Francisco, led the study of Bellini’s brain and presented her analysis recently at the International Congress of Neuropathology in Brazil. In her remarks, Grinberg raised concerns about the risks presented in soccer (including those that come with heading the ball). “The Brazilian almost learns to walk and play football at the same time, so you need to learn more about it,” Grinberg said, according to a report in Globo. “Do we need to concern ourselves with weekend recreational players? And do children, who have a more fragile neck, have more risk? We do not have those answers yet.” McKee was asked to assist in analyzing Bellini’s brain and noted that while outward symptoms of C.T.E. are similar to those related to Alzheimer’s, the initial diagnosis of was incorrect; the brain exam showed there was no evidence of Alzheimer’s at all. Rather, Bellini had what McKee described as Grade 4 C.T.E. In Bellini’s case, there were multiple symptoms present. A halfback who was Brazil’s captain when it won its first World Cup, Bellini first began to struggle with memory loss nearly 20 years ago, his wife, Giselda, told Globo, recalling an instance when he failed to bring home items from a shopping list. The problems worsened, she said, in 2006. Once, she told the paper, Bellini hired a taxi and asked the driver to take him to the home base of Corinthians, a São Paulo soccer team he had played for decades earlier because he believed he needed to go to training. McKee said she was told that Bellini was not known to have had any nonsoccer head injuries in his life.