New Football Brain Injury Study: What Does It Mean?
A devastating disease has been found in the brains of 99 percent of NFL players whose brains were donated for research.
The disease, called chronic traumatic encephalopathy or CTE, has been linked to repeated blows to the head. Signs of the disease were observed in the brains of 110 out of 111 NFL players studied in research that was published recently in the Journal of the American Medical Association (JAMA).
To help shed light on the football brain injury study and its meaning, we asked Thomas Watanabe, MD, clinical director of the Drucker Brain Injury Center at Einstein Healthcare Network’s MossRehab, for his thoughts.
Q. Could you explain in layman’s terms what chronic traumatic encephalopathy is?
A. CTE is a progressive neurologic condition that affects some people who have had repeated impacts to the head. It can lead to changes in mood, behavior, thinking and a physical decline as well.
Q. CTE in football players has been studied before. What makes this research different?
A. This is the largest study to date that has looked at the percentage of football players who have developed evidence of CTE based on evaluations of their brains after they have died.
Q. What are the potential long-term effects?
A. People can have more difficulty living independently, interacting with others and moving about.
Q. How do we know CTE is linked to head blows?
A. There are characteristic signs of CTE that are found when one examines brain tissue. This has been linked to an exposure to blows to the head, as these findings have not been demonstrated in people who have not had such exposure.
Q. Do these findings have implications for younger players?
A. These findings may have implications for younger players. At present, it is uncertain if there is a threshold of number of hits to the head that may lead to CTE. There are likely genetic factors that make some people more or less at risk of developing CTE.
It should be pointed out that the study is not a random sample of all professional football players, but rather those who made the decision to be involved in the study, likely because they had a suspicion that they might have this condition.
I think that the best interpretation of these results is that people exposed to multiple blows to the head have a risk of developing CTE, but the extent of that risk for the individual athlete, younger or older, is uncertain.
Q. What should players, coaches and parents be thinking about in terms of prevention? Or are head blows just an unavoidable part of playing football?
A. At present, it appears that impacts to the head (this includes hits to the head that are too minor to cause concussions) are the main risk factor for developing CTE. Presumably, decreasing the number of these impacts to the head would decrease the likelihood of developing CTE, but it is uncertain whether there is a threshold and what that threshold is.
It appears that the only way to truly prevent CTE in football would be to eliminate any impact to the head, which would clearly mean a significant change in how American football is played.