I’ve written about football and brain health before but a brand new study by Dr. Daniel Daneshvar from Massachusetts General Hospital and Dr. Jesse Mez from Boston University was just published on the connection between repeated head injuries and CTE. The team collected data from 34 previous studies of helmet accelerometers used in youth, high school, and college football players.  These are not professionals, but our school age children.

“These results provide added evidence that repeated non-concussive head injuries are a major driver of CTE pathology rather than symptomatic concussions,” Dr. Jesse Mez

Chronic Traumatic Encephalopathy (CTE) is a progressive degenerative disease of the brain found in people with a history of repetitive brain trauma. This is often found in athletes participating in high-impact, contact sports such as football, hockey, boxing, and wrestling, but can also occur in military personnel who have been exposed to explosive blasts.

Here’s how it works:

1. Repetitive Brain Trauma: When an athlete plays a contact sport, they can receive frequent blows to the head. Even if these blows do not lead to immediate concussion or noticeable injury, the repetitive nature of the trauma can cause damage over time. This research concludes that “sub-concussive” hits — those that don’t cause full-blown concussions — may be the biggest factor.
2. Tau Protein Buildup: These injuries can lead to the abnormal buildup of a protein called Tau in the brain. Tau proteins help stabilize microtubules in the brain. However, when they become defective and fail to properly clear from brain tissue, they can clump together and form tangles. These tangles disrupt normal brain cell functioning and can lead to cell death. This is also implicated in Alzheimer’s disease.
3. Progressive Damage: Over time, this can lead to progressively worsening symptoms such as memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, and eventually, progressive dementia. This progression may begin months, years, or even decades after the last brain trauma or end of active athletic involvement.

This study analyzed data from 631 male brain donors who had previously played football.

On average, the brain donors had played about 12 years of football and died at age 60. About 28%, or 180 of them, didn’t have evidence of CTE in their brains, but 72% did. 163 had low-stage CTE, and 288 had high-stage CTE. As seen in previous studies, the number of reported concussions wasn’t associated with CTE incidence or severity.

However, the number of years playing football as well as several factors measured by the PEM were associated with CTE. Every additional year playing football was associated with 15% increased odds of a CTE diagnosis and, for those with CTE, 14% increased odds of severe CTE.

Every 1,000 additional estimated blows to the head conferred 21% increased odds of a CTE diagnosis, and 13% increased odds of developing severe CTE. Analyses that took into account the linear and rotational accelerations experienced during head blows were better at predicting CTE than models that only included the number of blows.

It’s important to note that not everyone who experiences repeated concussions or traumatic brain injuries will develop CTE. Factors such as genetics, the exact nature and number of head injuries, and other yet unknown factors likely play a role in determining who develops CTE.

There is no cure for CTE, and the diagnosis can only be definitively confirmed post-mortem via brain tissue analysis.

My personal take away is that, with so many opportunities for sports in school, why do we continue to risk our children’s brain health? 

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