Shane Tamura is suspected of shooting four people in Midtown Manhattan, where the NFL offices are. A note he left references the NFL and CTE.

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.

“CTE is linked to repetitive brain trauma and has a distinct pathology that can only be diagnosed at autopsy,” says Dr. Ross Zafonte, a principal investigator of the Football Players Health Study at Harvard University and executive vice dean at the University of Missouri.