College football players are not healthy, says study

College football players may appear healthy, but this is not the case. A significant number have abnormalities in coordination and inflammation, according to a new study.

December 16, 2021

Source:

Northwestern University

Summary:

Collegiate football athletes with a decade or more of experience with the sport have related abnormalities in inflammation, energy production and coordination that are apparent before the football season and across the season, a new study has found. The abnormalities are related to routine repetitive head impacts from tackling and blocking.

College football players may appear healthy and successful on the field, but a number of biological measures say otherwise.

A new study between Northwestern Medicine, Pennsylvania State University and other collaborating universities has found collegiate football athletes with a decade or more of experience with the sport have related abnormalities in inflammation, energy production and coordination that are apparent before the football season and across the season. The abnormalities are related to routine repetitive head impacts from tackling and blocking.

Most head trauma studies tend to focus on injury being severe enough to cause a clinical concussion, as opposed to assessing the routine effect of repeated tackles or blows to the head over a season. These findings argue that impact sport athletes, regardless of history of concussion, have chronic problems.

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These problems were found in measures that show abnormal regulation of inflammation, less coordinated movement and abnormalities in how cells produce energy. These three measures are significantly related to each other before the football season and to changes observed across the football season. They were also related to the number of head impacts a player received over the season.

"These findings support over a decade of reports about the negative effects of repetitive head impacts along with studies of animal brain injury," said co-senior author Dr. Hans Breiter, professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. "At this point, it appears the canary is dead in the coal mine."

"This problem affects much of youth and professional impact sports in the U.S., along with training of U.S. military personnel," said co-senior author Dr. Semyon Slobounov, professor of neurosurgery at Penn State College of Medicine.

A new study between Northwestern Medicine, Pennsylvania State University and other collaborating universities has found collegiate football athletes with a decade or more of experience with the sport have related abnormalities in inflammation, energy production and coordination that are apparent before the football season and across the season. The abnormalities are related to routine repetitive head impacts from tackling and blocking.

Most head trauma studies tend to focus on injury being severe enough to cause a clinical concussion, as opposed to assessing the routine effect of repeated tackles or blows to the head over a season. These findings argue that impact sport athletes, regardless of history of concussion, have chronic problems.

These problems were found in measures that show abnormal regulation of inflammation, less coordinated movement and abnormalities in how cells produce energy. These three measures are significantly related to each other before the football season and to changes observed across the football season. They were also related to the number of head impacts a player received over the season.

"These findings support over a decade of reports about the negative effects of repetitive head impacts along with studies of animal brain injury," said co-senior author Dr. Hans Breiter, professor of psychiatry and behavioral sciences at Northwestern University Feinberg School of Medicine. "At this point, it appears the canary is dead in the coal mine."

"This problem affects much of youth and professional impact sports in the U.S., along with training of U.S. military personnel," said co-senior author Dr. Semyon Slobounov, professor of neurosurgery at Penn State College of Medicine.

The brain, in simple, non-technical language. 

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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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Hits, not concussions, cause CTE

It's Super Bowl week and America turns its eyes to the biggest event of the year. America loves its football. But will the game survive the concussion/CTE crisis affecting those who play the game?

New insights into the disease show head impact, not concussion, triggers CTE and pave way for early detection, prevention and treatment January 18, 2018 Boston University School of Medicine Researchers have identified evidence of early Chronic Traumatic Encephalopathy (CTE) brain pathology after head impact ­­ even in the absence of signs of concussion.

Early indicators of CTE pathology not only persisted long after injury but also spread through the brain, providing the best evidence to date that head impact, not concussion, causes CTE.

Researchers have identified evidence of early Chronic Traumatic Encephalopathy (CTE) brain pathology after head impact ­­ even in the absence of signs of concussion. Early indicators of CTE pathology not only persisted long after injury but also spread through the brain, providing the best evidence to date that head impact, not concussion, causes CTE.

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The findings, published online in the journal Brain, are based on analysis of human brains from teenagers with recent head injury and mouse models that recreate sports­related head impact and military­related blast exposure. The investigators also performed laboratory experiments and computer modeling. Study results shed light on the origins of CTE and relationship to traumatic brain injury (TBI), concussion and subconcussive head injury. CTE is a neurodegenerative disease characterized by abnormal accumulation of tau protein around small blood vessels in the brain. CTE causes brain cell death, cognitive deficits, and dementia. The brain pathology of CTE has been observed in brains of teenagers and adults with exposure to repeated head injury, both concussive and subconcussive episodes. However, the mechanisms that cause CTE and relationship to concussion, subconcussive injury and TBI remain poorly understood. In the first part of their study, the researchers examined four postmortem brains from teenage athletes who had sustained closed­head impact injuries 1, 2, 10 and 128 days prior to death. Neuropathological analysis of these brains showed a spectrum of post­traumatic pathology, including one case of earlystage CTE and two cases with abnormal accumulation of tau protein. Brains from four age­matched athletes without recent head injury did not show the pathological changes observed in the head­injury group.

To investigate causal mechanisms underlying these changes, the researchers conducted laboratory experiments using mouse models of two different injury mechanisms ­­ repeat closed­head impact and blast exposure ­­ both linked to CTE. The investigators compared brain responses to the experimental injuries and relationship to CTE pathology over time. Based on pathological findings in human cases, the researchers hypothesized that early CTE may result from damaged blood vessels in the brain that become leaky, resulting in blood proteins spilling into brain tissue and triggering brain inflammation. The researchers utilized a brain scan called dynamic contrastenhanced magnetic resonance imaging (DCE­MRI) to detect leaky blood vessels in the brains of mice subjected to head impact.

The investigators also found that head impact caused persistent changes in brain electrical functions, which may explain cognitive difficulties experienced by some people after these injuries. "The same brain pathology that we observed in teenagers after head injury was also present in headinjured mice. We were surprised that the brain pathology was unrelated to signs of concussion, including altered arousal and impaired balance, among others. Our findings provide strong causal evidence linking head impact to TBI and early CTE, independent of concussion," explained corresponding author Lee E. Goldstein, MD, PhD, an associate professor at Boston University School of Medicine and College of Engineering. "The results may explain why approximately 20 percent of athletes with CTE never suffered a diagnosed concussion."

Source: ScienceDaily, Boston University

Aaron Hernandez' CTE diagnosis 'devastating' news for NFL

From Yahoo News (Sept. 21, 2017):

"Based on his violent outbursts, mood swings and self-medicating ways, it comes as little surprise that Aaron Hernandez suffered from chronic traumatic encephalopathy (CTE), as his lawyer alleges in a new lawsuit against the NFL and the New England Patriots.

The degenerative brain disease has been most commonly found in football players, soldiers and others who have suffered from repeated concussions.

“Aaron had Stage III CTE usually seen in players with a median age of death of 67 years,” reads a lawsuit attorney, Jose Baez, filed in the name of Hernandez’s daughter, Avielle.

Learn more about concussions, CTE, and football.

It may explain, yet hardly excuse, Hernandez of murdering Odin Lloyd in 2013 or being charged for the 2012 slaying of Daniel de Abreu and Safiro Furtado. He beat the double murder because while there was no disputing he was in the car the night of the drive-by shooting, prosecutors couldn’t conclusively prove he was the triggerman. It may also provide insight into his prison suicide last spring while serving a life sentence for the Lloyd killing.

Based on his age, however, a CTE diagnosis this significant comes as not just a surprise, but a chilling moment for a sport that is trying everything to both make the game safer and convince young athletes, and their parents, that it is worth playing.

Sixty-seven years old? Advanced stages? That is the opinion of researchers at Boston University, who have been the leaders on CTE research.

Hernandez played just three seasons in the NFL, 44 games total for the Patriots, before being arrested at the age of 23 for the Lloyd murder. He was 27 when he took his life...."

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