CTE in Football

Overview of Chronic Traumatic Encephalopathy (CTE) in Football Players

Background Information

  • Study Focus: The impact of repeated traumatic brain injuries in football players, specifically the occurrence of CTE.

  • Publisher: Science News, July 25, 2017, by Aimee Cunningham.

  • Context: The significance of understanding the health implications of playing football, especially concerning brain health.

Prevalence of CTE in Former Football Players

  • Study Sample: A total of 202 deceased former football players.

  • Findings:

    • 177 out of 202 (approximately 87.6%) were diagnosed with CTE.

    • In detail:

    • Among 111 NFL players, 110 (an overwhelming 99%) were diagnosed with CTE.

    • Among 14 high school players, 3 showed signs of CTE.

    • Among 53 college players, 48 exhibited signs of the disease.

    • Autopsy Method: The diagnoses were based on autopsy examinations of the brain and interviews with family and friends regarding players' health experiences.

Implications of Findings

  • Causation vs. Correlation: While the findings highlight a strong association between playing football and developing CTE, it does not suggest that all football players will develop the disease. Motivation for donation of brains for research typically stems from observable symptoms in deceased players.

  • Expert Commentary:

    • Gil Rabinovici, neurologist at the University of California, San Francisco, expressed concern about the safety of playing football, emphasizing the need for ongoing investigation into the risks of developing neurological symptoms.

Understanding Chronic Traumatic Encephalopathy (CTE)

  • Definition: CTE is a degenerative brain disease characterized by clumps of the protein tau forming in the brain.

  • Diagnosis: CTE can only be diagnosed post-mortem through brain autopsies.

  • Progression: The disease's progression is classified by the severity of tau clumping:

    • Mild to Severe CTE

    • In milder cases, tau is localized; as it progresses to severe, tau is more widely distributed throughout the brain.

  • Visualization:

    • Diagnostic Imagery: Clumps of tau appear darker in pathological images, illustrating the extent of the disease.

Symptoms and Behavioral Issues Associated with CTE

  • Common Psychiatric Symptoms:

    • Behavioral Issues: Impulsivity, anxiety, and depression were reported regardless of CTE severity.

    • Cognitive Symptoms: Memory loss was also frequently observed among diagnosed cases.

    • Dementia: Notably, dementia was more prevalent in cases classified as severe.

  • Research Observations:

    • Jesse Mez from Boston University noted similar reported symptoms across various severity levels, raising questions about possible underlying mechanisms like inflammation or unnoticed brain regions.

Research Gaps and Future Directions

  • Current Limitations: The inability to diagnose CTE during a person’s life creates a significant barrier to understanding its true prevalence, particularly in professional and amateur leagues.

  • Recommendations for Future Research: Focus is crucial on prevention of concussions and head impacts in contact sports to mitigate risks associated with CTE.

Citations and References

  • Mez, J. et al. (2017). Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football. JAMA. Vol 318, July 25, 2017, p. 360. doi:10.1001/jama.2017.8334

  • Rabinovici, G. (2017). Advances and gaps in understanding chronic traumatic encephalopathy. JAMA. Vol 318, July 25, 2017, p. 338. doi:10.1001/jama.2017.9353.