Chronic traumatic encephalopathy (CTE) is the neurological degeneration of structures in the brain in areas ranging from the cerebral hemispheres, medial temporal lobe, and brainstem (to name a few). The degeneration is caused by repetitive brain trauma, often associated with high impact sports like football, boxing, and dwarf wrestling (random, I know). Outcomes of CTE can be connected to memory loss, personality changes, Parkinsonism, and both physical and verbal stuttering.
Recently, CTE has become an extremely hot topic of debate as it is starting to expose the dangerous side effects of concussions received by professional athletes; more specifically, the National Football League.
In a Nature review, Dr. Ann McKee, a neurologist and co-director of the Center for the Study of Traumatic Encephalopathy at Boston University in Massachusetts; McKee focused on 48 cases of CTE in amateur/professional boxers, football and soccer players (and a few random cases like head banging and circus clowning). Besides their findings of mood changes, memory loss, and lack of logic; McKee found a reduction in brain weight, enlargement of the lateral and medial ventricles, thinning of the corpus callosum, and scarring. Moreover, around 25 locations of the brain were shown to be affected in this review alone. The mechanisms of injury seem to be directly related to the force of impact given, with blows on the side of the head more severe than those from the front or back. McKee theorizes that the blood brain barrier is broken and therefore more susceptible to neurotoxins. Furthermore, the paper examined the lifespan of the illness, ranging around 20 years with only one third of athletes showing symptomatic signs of CTE upon retirement.
McKee did an excellent review, covering psychological testing and section staining, to biomarker assays. The multiple approaches provided for a more holistic view of CTE. Still, I would have liked to have seen a few more long term studies indicating a specific time of concussion to neurodegeneration. Animal models would have been a nice addition to be able to see this effect.
This information will definitely put more pressure on the NFL to enforce safety precautions. However, I’m still not convinced that this information will have any meaningful results. Early steps have already started to be taken by redesigning helmets to try and reduce the impact and therefore severity of concussion, but I don’t think that that’s enough. Rules have to be enforced regulating illegal hits to the head and play time after having a concussion. Most people think of a ‘concussion’ and don’t actually realize the severity of what might have happened. If we want to see pro-sports continue, the safety of the players has to be reconsidered and something has to be done.