Playing Tackle Football in Childhood Linked to Early Onset of Cognitive Impairment

Highlights:

Neurodegenerative diseases such as chronic traumatic encephalopathy (CTE) and Alzheimer’s disease are characterized by cognitive impairment and emotional symptoms.
Cognitive impairment refers to loss of memory, understanding, thinking and decision making skills and depending on severity, may seriously impact activities of daily living.
Cognitive and emotional symptoms occurred earlier in athletes (diagnosed with chronic traumatic encephalopathy (CTE) and other brain diseases) who began playing tackle football earlier in childhood.

Starting to play tackle football below 12 years of age may be associated with a quicker onset of cognitive impairment, mood and behavioral changes, according to a study conducted by a research team at VA Boston Healthcare System (VABHS) and Boston University (BU) School of Medicine. The findings of the study appear online in the journal Annals of Neurology.

Chronic Traumatic Encephalopathy
Chronic traumatic encephalopathy is a concussion related brain disease in people suffering from repeated traumatic brain injuries.

‘Repeated head impacts in tackle football or other contact sports during childhood may have long-term consequences due to injury to developing brain.’

Details of Study

This project included 246 deceased football players who enlisted in the UNITE (Understanding Neurologic Injury and Traumatic Encephalopathy) study and who had donated their brains for neuropathological examination and research purposes to the VA-BU-CLF (Concussion Legacy Foundation) Brain Bank.

Information was gathered by conducting telephone interviews with family members and/or friends to find out the presence/absence, and age of onset, of cognitive, behavior and mood symptoms. To reduce bias, the interviewers were not aware of the neuropathological findings and the neuropathologists did not know the histories of the persons whose brains they were analyzing.

Of the 246 participants, 211 were diagnosed with CTE with many of them also having evidence of other brain diseases, such as Alzheimer's.
35 athletes had no evidence of CTE, though several had evidence of other brain diseases.
Among the 211 with CTE, 7 played high school football, 64 played college level football, 2 played semi-professional, and 138 played at the professional level.

"Youth exposure to repetitive head impacts in tackle football may reduce one's resiliency to brain diseases later in life, including, but not limited to CTE," said corresponding author Ann McKee, MD, chief of Neuropathology at Boston VA Healthcare System, and Director of BU's CTE Center. "It makes common sense that children, whose brains are rapidly developing, should not be hitting their heads hundreds of times per season."

Interestingly, although age of first exposure to tackle football was associated with early onset of cognitive and emotional problems, there was no relation to the severity of the disease whether CTE, Alzheimer’s or other brain pathology.
Also, symptom onset was not limited to those diagnosed with CTE and was noted in those players without CTE as well, who had cognitive or behavioral and mood changes that may have been related to other diseases.

"Younger age of first exposure to tackle football appears to increase vulnerability to the effects of CTE and other brain diseases or conditions. That is, it influences when cognitive, behavioral, and mood symptoms begin. It is comparable to research showing that children exposed to neurotoxins (e.g., lead) during critical periods of neurodevelopment can have earlier onset and more severe long-term neurological effects. While participation in sports has important health and social benefits, it is important to consider contact and collision sports separately and balance those benefits against potential later life neurological risks," said Michael Alosco, PhD, an assistant professor of Neurology at BU School of Medicine and an investigator at the BU Alzheimer's Disease Center and the BU CTE Center.

Extending Previous Research

The current study follows previous research that linked youth tackle football with severe later-life cognitive, behavioral and mood disturbances in living former amateur and professional tackle football players, as well as alterations in brain structures (determined by MRI scans) in former NFL players.

What is Chronic Traumatic Encephalopathy (CTE)?

Chronic traumatic encephalopathy (CTE) is a progressive degenerative condition affecting the brain of people who have suffered repeated traumatic brain injuries and concussions, such as players who take part in contact sports, like tackle football, boxers, members of the military and others. It was originally believed to exist mainly among boxers, and was termed dementia pugilistica.

Symptoms include memory loss, impaired thinking and judgment, behavioral disturbances such as aggression, depression and gradual onset of dementia.

Currently diagnosis is made only on autopsy examination following death. However several ongoing studies including a recent UCLA study appear to show promise in finding a screening test to identify persons at increased risk and to enable making appropriate and timely interventions.

Conclusion

Although this study validates the hypothesis that there may be long-term consequences associated with experiencing repeated hits to the head during childhood, the study team emphasize that it is unclear whether their findings can translate to the broader tackle football population. More research, especially prospective longitudinal studies, is necessary to gain more insight into the association between youth football and later in life consequences.

Reference:

What Is CTE? - (http://www.protectthebrain.org/Brain-Injury-Research/What-is-CTE-.aspx)

Source-Medindia