Free e-book: Concussions, CTE and Football

From the Introduction:

When You Watch Your Next Football Game...

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From high school to college to professional levels, football dominates American sports and exposes millions to head traumas on practically every play.

It is a paradox of wide proportions. From opening day in September to the Super Bowl in February, the National Football League (NFL) dominates American sports and wins television ratings far beyond any other program--sports or otherwise.

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Increasingly, though, discussions of football (and other sports) include the medical terms concussion and chronic traumatic encephalopathy (CTE), a long-term degenerative and incurable brain disease. Although military personnel and others are vulnerable to the disease, the highest risk is among athletes involved in contact sports in which hits to the head are considered “part of the game.”

Ten years ago, few would have predicted that the movie “Concussion” starring Will Smith would be made. Fewer would have predicted that brain injuries would one day dominate the sports headlines. When former NFL star Junior Seau committed suicide in May 2012, the media focused almost entirely on whether the thousands of head blows he endured during his 19-year career as a middle linebacker were a contributing factor.

More than 3,000 former NFL players sued the league for allegedly misleading them about the risks of brain injury. The players and the league settled for more than $1 billion in damages. New policies and studies aimed at protecting the brains of athletes seem to be announced every week. But it’s not just professional athletes who are the focus of attention. No fewer than 40 states have passed laws requiring athletes in schools and recreational programs to schedule a doctor’s appointment when a concussion is suspected.

A progressive, degenerative brain disease, CTE can present itself  in athletes and others with a history of repetitive brain trauma months, years, or even decades after injury. Memory loss, confusion, depression, aggression, impaired judgment or impulse control, and, eventually, progressive dementia may result.

With this increasing awareness about the dangers of concussion, parents face tough choices about which sports their children should be allowed to play. Some of the more

New rules have since been designed to lessen brain trauma; but with every new horror story that emerges on the sports pages, parents worry even more.

dangerous sports for the brain, such as football, soccer, ice hockey, and lacrosse, are also the most popular. Although everyone agrees that brain trauma may have lasting and debilitating effects, and science continues to make slow progress toward understanding the disease, we cannot yet entirely quantify those effects. As a result, parents and even medical professionals are left to search their hearts and scour Web sites for answers. But a decade’s worth of research has made one thing clear: We need to find better ways to protect the brains of athletes.

Difficult to Measure

Concussions suffer from a perception problem. On the surface, they might not seem to have a lasting, serious impact. (In fact, sports programs and commentators continue to celebrate the most impactful “hits,” using euphemisms such as “getting your bell rung.”) They are an invisible injury: There is no blood, there are no displaced bones, and the patient rarely complains. Even when an athlete is knocked unconscious and observers react with panic, the concern quickly fades. Ninety-nine percent of concussed athletes wake up in seconds or minutes and then seem fine. When symptoms persist beyond the day of injury, in the vast majority of cases they dissipate within a month. The injury seems as if it is gone forever, leaving no scars or overt indication that it ever happened.

Children at Risk

Most brain trauma in the industrialized world occurs in children playing sports. Since participation is voluntary, and the rules of recreational sports are malleable, it seems reasonable to make every effort to reform each individual sport....

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Playing football before age 12 could have long-term health effects

Date:

September 19, 2017

:

Playing American football before the age of 12 may have long-term consequences for players' mood and behavior, according to a study involving 214 professional and amateur football players. Source: BioMed Central.

Football players who started playing before age 12 had more than twice the odds for clinical impairment in executive function (including analyzing, planning, and organizing tasks), regulating their behavior, and apathy, compared to players who started playing at age 12 or later.

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Researchers at Boston University School of Medicine, USA found that football players who started playing before age 12 had more than twice the odds for clinical impairment in executive function (including analyzing, planning, and organizing tasks), regulating their behavior, and apathy, compared to players who started playing at age 12 or later. They also had more than three times the odds for depression. The effects appear to apply to players of all ages and levels of education, no matter how long they had played for (duration) and whether they were professional or amateur players (level of play).

Dr Robert Stern, the corresponding author of the study said: "Overall, our study provides further evidence that playing American football before age 12, and being hit in the head repeatedly through tackle football during a critical time of brain development, is associated with later-life problems with mood and behavior."

This is the first study to show a relationship between age of first exposure to football and clinical dysfunction in a sample that included both professionals and amateurs who played only through high school or college. Previous research had only examined small samples of professional football players.

In order to investigate age of first exposure to American football and possible associations with long-term clinical implications, the authors scored self-reported measures of executive function, depression, behavioral regulation, and apathy that had been obtained by online questionnaire from 214 former American football players, who were 51 years on average at the time of the study. Cognitive function was assessed using a standardized, objective test administered over the telephone. All players took part in the Longitudinal Examination to Gather Evidence of Neurodegenerative Disease (LEGEND) study which investigates the long- and short-term consequences of exposure to repeated head impacts in athletes.

The researchers were surprised to find no association between age of first exposure and cognitive function (such as reasoning, memory, and attention) but they note that this may have had to do with how they gathered their data.

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Dr Stern said: "Cognition was measured using a brief test that was administered over the telephone, rather than a more thorough, in-person neuropsychological examination, such as that used in previous research."

The authors also caution that the findings cannot be generalized beyond to female players or other contact sports. Because this is a cross-sectional observational study, it does not allow for conclusions about cause and effect.

Dr Stern said: "It is important to note that participation in youth sports can have many benefits, including the development of leadership skills, social skills, and work ethic, not to mention the tremendous health benefits. The goal is to make sure that children can take advantage of all of the benefits of sports participation without the risk of long-term brain injury or disease. More research on this topic is needed before any recommendations on policy or rule changes can be made."

Dr Stern added: "However, other research suggests that incurring repeated head impacts can lead to long-term consequences, and we should be doing what we can at all levels in all sports to minimize these repeated hits."

Playing American football before the age of 12 may have long-term consequences for players' mood and behavior, according to a study involving 214 professional and amateur football players, published in the open access journal Translational Psychiatry.