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
- 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
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.
‘Repeated head impacts in tackle football or other contact sports during childhood may have long-term consequences due to injury to developing brain.’
- 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.
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
"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.
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
What is Chronic Traumatic Encephalopathy (CTE)?
Chronic traumatic encephalopathy
is a progressive degenerative condition affecting the brain of
people who have suffered repeated traumatic brain injuries
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.
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.
- What Is CTE? - (http://www.protectthebrain.org/Brain-Injury-Research/What-is-CTE-.aspx)