Tamura killed four and badly wounded another before shooting himself in the chest.In the note, Tamura claimed to have CTE—chronic traumatic encephalopathy, a brain injury condition due to repetitive trauma to the brain—and that he wanted researchers to study his brain.

CTE cannot be diagnosed until the patient has died and their brain examined. But doctors said there are symptoms such as changes in cognition, mood and behavior. The American Brain Foundation said they can include difficulty thinking, short- and/or long-term memory loss, depression, anxiety, paranoia, headaches and suicidal thoughts or behavior.

The former football player who fatally shot four people and himself in Midtown Manhattan claimed to have a poorly understood brain disease, putting a renewed focus on the link between head injuries in sports and irreversible brain damage.