One of the world’s foremost neurologists has paid tribute to the former middleweight champion Paul Pender for the role he has played in advancing knowledge about brain trauma and the disease it causes.

Dr Ann McKee, who works out of Boston University, has played a key role in studying CTE [chronic traumatic encephalopathy] and its relationship with contact sports, and Dr McKee, in 2018, was ranked in TIME magazine’s list of their 100 most influential people in the world.

Pender, from Brookline, Massachusetts, retired in 1962 with a record of 40-6-2 (20 KOs), and had boxed the likes of Terry Downes, Carmen Basilio, Ralph “Tiger” Jones, Ernie Durando and Gene Fullmer.

On The Diary of a CEO podcast hosted by Steven Bartlett, Dr McKee, head trauma neurologist at BU, recalled seeing CTE in a brain for the first time, and revealed that it was Pender’s. 

“I was studying Alzheimer’s Disease – I’d been looking at Alzheimer’s Disease brains and we had a man that came into the bank in 2003 who was named Paul Pender,” explained McKee. “He was a boxer – a famous boxer in the Boston area, and he twice fought ‘Sugar’ Ray Robinson for the world title.

“So he [Pender’s brain] came in with the diagnosis of Alzheimer’s Disease into our Alzheimer’s bank and everybody thought it was Alzheimer’s Disease because he retired from boxing about 40 years before he died and everyone felt, ‘Well, if this was related to boxing it would have shown up earlier’.

“When I looked at that brain, it was very obvious right from the minute I looked at it that it wasn’t Alzheimer’s Disease, because Alzheimer’s has beta amyloid plaques – you have to have them to make the diagnosis. This guy had no beta amyloid plaques, but what he did have was this protein called tau and using our stains, it stains brown, and this tau was all over his brain and in the most peculiar regions.

“It was circling around small blood vessels; it was clustered at the crevasses of the brain; it was involving nuclei in the brain that are not involved in Alzheimer’s; it was in the cerebellum. It was the most curious disease.”

The brain bank in Boston, which Dr McKee is in charge of, has gone on to examine the brains of football players, soccer stars, combat sports athletes, hockey players and far more in trying to learn more about CTE. McKee has since studied thousands of other brains.

“I scientifically became extremely interested in finding out more about how boxing could promote this kind of neurodegeneration,” Dr McKee continued. “And then it was five years later that I had the opportunity to look at an American footballer’s brain, so I looked at the first case, [NFL linebacker] John Grimsley, 45 when he died, and I couldn’t believe my eyes – that a 45-year-old man could have this amount of tau in his brain; could have this amount of degeneration. It just doesn’t happen this early. Neurodegenerative diseases are generally diseases of ageing, so 70s, 80s – unless you have a genetic component it comes on in your 50s – but 45 is extraordinarily early and I couldn’t let go of it. It was monumentally interesting from a scientific point of view that an exposure to trauma could cause this kind of brain damage.” 

Tau protein can only be discovered during autopsies – samples are viewed on slides under microscopes – meaning that CTE cannot be diagnosed in living people. 

Dr McKee famously faced a wall of denial from the NFL but still battles to help sports become safer environments for their participants. More than 20 years on from Pender, she is also still trying to do what she can to help families who are struggling for answers.

“I realized very quickly that if I didn’t speak out for these families who were experiencing this tragedy, this devastation, the death of a loved one who had changed before their eyes, nobody else was,” she said.

Last week, October 24, Brazilian heavyweight Adilson Rodriguez passed away, and he had CTE, which was formerly known as punch drunk syndrome and dementia puglisitica. He was 66.