Football and the Effects on the Brain

Written by Randy Yan and Edited by Sorina Long

Each year in the United States, people of all ages participate in high contact sports such as football and boxing. And arising from these sports is a side effect like no other. From concussions to brain contusions, all of these types of traumatic brain injury can have potentially detrimental effects. Chronic traumatic encephalopathy, otherwise known as CTE, is one type of traumatic brain injury observed in documented cases that have occurred in athletes in high contact sports. 

CTE is a neurodegenerative disease, which means that the neurons in the brain are damaged or dying, leading to a decline in cognitive and locomotive function [1]. Repetitive brain trauma is the primary cause of a variety of conditions ranging from depression and suicidal behavior to even behavioral and personality changes [2]. These symptoms progress, resulting in more severe consequences such as loss of muscle movement and poor judgement. Symptoms affecting muscle movement and judgement then significantly worsen, leading to extreme cognitive impairment and even aggressive tendencies. Currently, the only way to analyze and diagnose this disease is by performing an autopsy on the brain to look for evidence of unique progressive deterioration of various parts of the human brain such as the cerebral hemispheres, medial temporal lobe, thalamus, mammillary bodies, and brainstem [3]. In one case, CTE was determined in a retired professional football player through an autopsy, revealing changes that were consistent with long-term repetitive concussive brain injury [4]. This CTE pathology is standard for most who are diagnosed with the disease. 

Because CTE can only be diagnosed postmortem, the Boston University School of Medicine has established a brain bank to dedicate greater efforts to studying the disease [5]. In a study of 202 deceased former American football players, ranging from all levels of play such as high school players and professional players, 87% were diagnosed neuropathologically with CTE, including 110 of 111 former National Football League (NFL) players [6]. It was concluded in that study that those who played in the NFL had more severe CTE pathology than others who did not play as much such as those who only played in high school teams—indicating a high correlation between severe CTE pathology and high levels of play. 

Despite the lack of treatment for CTE, researchers are determined to improve the understanding of CTE and eventually come up with treatments for the disease. Having strong protective gear should be a priority for those playing in high contact sports [7]. One should be aware of the impact force can have on the brain’s ability to function and exercise with caution in order to minimize these effects. Hopefully in the near future, CTE can be diagnosed during life so treatment can be determined and implemented before it is too late.

References: 

1. “What is Neurodegenerative Disease?” The EU Joint Programme – Neurodegenerative Disease Research. https://www.neurodegenerationresearch.eu/about/what/
2. Stern, R.A., Riley, D.O., Daneshvar, D.H., Nowinski, C.J., Cantu, R.C., McKee, A.C. (2011). Long-term consequences of repetitive brain trauma: chronic traumatic encephalopathy. American Academy of Physical Medicine and Rehabilitation, 3: S460-S467.
3. McKee, A.C., Cantu, R.C., Nowinski, C.J., Hedley-Whyte, E.T., Gavett, B.E., Budson, A.E., Santini, V.E., Lee, H.S., Kubilus, C.A., Stern, R.A. (2009). Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy After Repetitive Head Injury. Journal of Neuropathology & Experimental Neurology, 68: 709–735.
4. Omalu, B.I., DeKosky, S.T., Minster, R.L., Kamboh, M.I., Hamilton, R.L., Wecht, C.H. (2005). Chronic Traumatic Encephalopathy in a National Football League Player. Neurosurgery, 57: 128-134.
5. “VA-BU-CLF Brain Bank.” Boston University Research: CTE Center. http://www.bu.edu/cte/our-research/brain-bank/
6. Mez J., Daneshvar D.H., Kiernan P.T., et al. (2017). Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football. JAMA, 4: 360–370. 
7. Daneshvar, D.H., Baugh, C. M., Nowinski, C.J., McKee, A.C., Stern, R.A., & Cantu, R.C. (2011). Helmets and Mouth Guards: the role of personal equipment in preventing sport-related concussions. Clinics in sports medicine, 1: 145-163.