What about Chronic Traumatic Encephalopathy (CTE)?
What is CTE?To understand CTE, it helps to consider what each word means. Encephalopathy can be best understood by breaking the word into its two parts. “Encephalo-“ means brain while “-pathy” means disease, so “encephalopathy” is a disease of the brain. “Traumatic” means that the disease is caused by external blows or forces to the head. “Chronic” traumatic encephalopathy means that the disease requires repetitive injuries happening over and over again.
CTE was reported in 1928 by Dr. Harrison Martland, who recognized that in retirement some boxers were developing dementia and called it being “punch drunk.”(1) In 1973, scientists examined the brain tissue of deceased boxers and saw changes in their brain structures thought to be due to the repetitive trauma.(1) In their brains, specifically were tangles of protein called tau as well as loss of brain cells and scarring.(1)
More recently, scientists started asking the question, could playing American football or other contact sports possibly inflict enough brain trauma to cause similar damage to a player’s brain and ultimately lead to dementia?
This handout is designed to provide parents with an accurate look at what is currently known about the connection between sport-related head trauma and the development of CTE.
How do you get CTE and how do you know if a person has it?
It is unknown the number of impacts to the head and the magnitude of impacts needed to put a person at risk for developing CTE.(2) Dr. Thomas McAllister at Dartmouth found that while some athletes playing football develop concussions following very low-impact hits, others do not, even after harder hits.(2)
Given that repetitive head injuries has become a major public health issues, in 2012, 60 prominent scientists and doctors gathered at the National Institutes of Health (NIH) to review the CTE research. The group found that the research was limited because currently CTE can only be confirmed by examining the brain after death and because most CTE research was done on a “highly selected population of mostly professional athletes.”(2)
The NIH group recognized that Dr. Ann McKee at Boston University autopsied the brains of 85 men with a history of repetitive mild traumatic brain injury (concussions) and found a spectrum of abnormal tau proteins.(2) Another doctor noted how the proteins were deposited in a unique pattern.(2) Yet the group also noted that patients with Alzhemier’s and other forms of dementia have abnormal tau proteins regardless of trauma.(2)
One of the NIH group’s conclusions was that the ability to diagnose CTE needs to be advanced, which includes defining protocols to decide who has CTE when performing a larger autopsy-based study.(2)
Could playing contact sports put my child at risk for CTE?
Young athletes including football, soccer, and basketball players are at risk for concussions and the long term effects of these sport-related concussions are unknown. While some professional athletes develop CTE, we do not know if school-aged children and young adults playing contact sports such as soccer or football are at increased risk to develop CTE.(3)
The numbers of impacts sustained by football players may alarm parents: one study reported that over the course of competing in both high school and college football, a player may suffer upwards of 8,000 impacts.(2) Yet the same study did not find cognitive differences in their group of players before and after one football season(1), and a study of 438 former Minnesota high school football players found that the risk of dementia was the same as for the ex-football players as 140 of their classmates who were in the band and glee club.(2)
Concussion and CTE research tells us that there is no guarantee against future adverse outcomes or eventual complications of repetitive brain trauma.(2) Parents should be aware of best safety practices and should ensure their coaches are educated about concussions.
We hope this handout helps parents better understand CTE. We also encourage parents to consider the benefits as well as the risks of playing sports.