An autopsy has revealed unusually severe brain disease in the frontal lobe of the former NFL player accused of fatally shooting six people in Rock Hill, South Carolina before killing himself.

The 20 years Phillip Adams spent playing football “definitely … gave rise” to a diagnosis of stage 2 chronic traumatic encephalopathy, said Dr. Ann McKee, who examined his brain, on Tuesday.

Authorities have said that on April 7, Phillip Adams killed Rock Hill physician Robert Lesslie; his wife, Barbara; two of their grandchildren, 9-year-old Adah Lesslie and 5-year-old Noah Lesslie; and two HVAC technicians working at the Lesslie home, James Lewis and Robert Shook, both 38.

Police later found Adams with a self-inflicted gunshot wound to the head.

The degenerative disease known as CTE is linked to head trauma and concussions that has been shown to cause a range of symptoms, including violent mood swings and memory loss.

“There were inklings that he was developing clear behavioural and cognitive issues,” McKee said. “I don’t think he snapped. It appeared to be a cumulative progressive impairment. He was getting increasingly paranoid, he was having increasing difficulties with his memory, and he was very likely having more and more impulsive behaviours. … It may not have been recognised, but I doubt that this was entirely out of the blue.”

McKee, who directs the CTE Center at Boston University, said that of 24 NFL players diagnosed with the disease after dying in their 20s and 30s, most had stage 2, like Adams. The disease has four stages, with stage 4 being the most severe and usually associated with dementia.

The second stage is associated with progressive cognitive and behavioural abnormalities such as aggression, impulsivity, explosivity, depression, paranoia, anxiety, poor executive function and memory loss, McKee said.

But Adams’ CTE diagnosis was different from the other young players because it was “unusually severe” in both frontal lobes, she said.

McKee compared Adams’ brain to that of Aaron Hernandez, the former football star also posthumously diagnosed with CTE after he hanged himself in prison at the age of 27 while serving a life sentence for a 2013 murder.

The Lesslie family said they appreciated the diagnosis.

“Even in the midst of crushing heartbreak, we are finding some comfort in the CTE results and the explanation they provide for the irrational behaviours pertaining to this tragedy,” their family statement said.

The Adams family said they were not surprised that he had the disease, but were shocked to learn how severe his condition was.

“After going through medical records from his football career, we do know that he was desperately seeking help from the NFL but was denied all claims due to his inability to remember things and to handle seemingly simple tasks, such as travelling hours away to see doctors and going through extensive evaluations,” their statement said.

CTE, which can only be diagnosed through an autopsy, has been found in former members of the military, football players, boxers and others who have been subjected to repeated head trauma. One recent study found signs of the debilitating disease in 110 of 111 NFL players whose brains were inspected.

Adams, 32, played in 78 NFL games for six teams over six seasons.

Adams’ sister had told USA Today that her brother’s “mental health degraded fast and terribly bad” in recent years and that the family noticed “extremely concerning” signs of mental illness, including an escalating temper and personal hygiene neglect.

Brain trauma in ex-NFL player who shot six
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