What You Need to Know About Brain Injury and CTE

According to Boston University Research, “Chronic traumatic encephalopathy  (CTE) is a progressive degenerative disease of the brain found in people with a history of repetitive brain trauma (often athletes), including symptomatic concussions as well as asymptomatic subconcussive hits to the head that do not cause symptoms.” Essentially, repeated trauma damages brain tissue. And, over time, sufferers of CTE experience problems with memory and brain function including aggression, depression, and dementia. The disease is a controversial one because there is much that is still unknown about it. And the stakes are high for athletes and the business of sports.

CTE is associated with concussion, but research shows that the disease can manifest in people who have suffered from lesser-grade head trauma. People who have experienced repeated “sub-concussive” impacts—or blows to the head that are serious, without concussion—are at risk of developing CTE.

CTE is typically seen in athletes, soldiers who have served in combat, and victims of ongoing domestic abuse. Muhammad Ali, Frank Gifford, and Brett Favre are among some of the many famous athletes with suspected cases of CTE by the medical community. Boxing, hockey, and football are all sports that are linked to higher rates of CTE.

In 2017 a report was published in the Journal of the American Medical Association (JAMA) that studied the brains of 111 deceased N.F.L. football players. Of the 111 specimens, 110 of the brains studied had CTE. In an in-depth story covering the JAMA report, the New York Times profiled many of the players whose brains were analyzed. The story concludes, “The N.F.L.’s top health and safety official has acknowledged a link between football and C.T.E., and the league has begun to steer children away from playing the sport in its regular form, encouraging safer tackling methods and promoting flag football.”

Clearly, contact sports are risky when it comes to CTE. However, raising awareness for the disease can help mitigate the damage the disease causes. CTE doesn’t occur after a single injury. Any while preventing all head injuries is ideal, the real fallout from CTE can be prevented by identifying risky behaviors and avoiding them. No helmet will prevent concussions, but advancements in technology provide us with better safety gear that absorbs shock more effectively. And professional leagues such as footballers clubs across Europe are educating players and fans alike about the dangers of headers. In an interview for BBC, brain expert Dr. Bennet Omalu urged: “Kids under the age of 12 to 14 should play a less contact form of soccer which we should develop for them. Kids between 12 and 18 can play but should not head the ball.”

Diagnosing CTE

For the most part, CTE can only be truly diagnosed after death using an autopsy. However, the medical community has made strides that may soon lead to the ability to diagnose CTE in living patients. In September 2017, researchers identified a protein that may be a marker for CTE. The science is in its preliminary stages and therefore treatment protocols are non-existent. There is no cure for CTE and researchers are learning to understand the risk factors.

You should always see your physician after a head injury. The symptoms of CTE are similar or the same as the symptoms of many other neurological conditions. If you experience any of the following symptoms after a single head injury or multiple incidents, see your doctor immediately.

  • Sudden, unexplained personality changes
  • Suicidal tendencies
  • Inability to focus
  • Memory problems
  • Unexplained rage

If you suffer from a head injury and lose consciousness, feel extremely confused, vomit or experience a seizure, go directly to the emergency room. Head injuries can be fatal and may not seem as serious as they actually are; seek medical attention immediately.

Protecting the Brain

Even though helmets cannot prevent concussions, always wear protective equipment when participating in contact sports. Helmets do protect the head from other injuries and can lessen the severity of trauma. Downhill skiing and recreational bicycle riding are examples of activities that have positively progressed over the years. Fifteen or fewer years ago, it was uncommon to see skiers and bikers wearing helmets. Now, it’s the norm. Other activities such as skateboarding and figure skating are lacking in helmet usage. Stigma and vanity no doubt are factors.

A lesser-known means to protect the head is to build neck strength. In fact, the National Center for Biotechnology Information (NCBI) is currently conducting a study to find out how strengthening the neck muscles can help reduce brain trauma. In an abstract about the study, NCBI notes, “Neck strength, and improvement of neck strength will be compared between concussed and non-concussed athletes to determine if neck strength can indeed reduce the risk of concussion.”

Building awareness about CTE and head trauma with coaches, parents, and sports fans is also an effective way to help prevent the disease. Although scientists continue to evolve their understanding of the disease, the underlying fact is that repeated trauma to the brain can cause Alzheimer’s-like symptoms. By simply increasing the general public’s baseline understanding of the disease will likely result in more care and prevention.

Are you a coach? Parent of a student-athlete? Pro athlete competing in a compact sport? If you have any questions or need further resources about CTE, please contact our Concussion Care Team. We are here to provide information and share our medical expertise in an effort to raise awareness about this difficult disease.