Neuroscience News

High Prevalence of Evidence of CTE in Brains of Deceased Football Players

Summary: A new JAMA study reveals chronic traumatic encephalopathy was present in a high number of brains of former football players. Researchers looked at the brains of former high school, college and NFL football players. Of the 202 brains analyzed, 177 showed signs of CTE. 110 of the 111 former NFL players’ brains were diagnosed with CTE. Researchers say that, while the findings are significant, the findings could have limitations due to the players’ families being motivated to donate the brains as a result of public awareness of the lasting effects of head injuries in football players.

Source: JAMA Network.

Chronic traumatic encephalopathy (CTE) was diagnosed post-mortem in a high proportion of former football players whose brains were donated for research, including 110 of 111 National Football League players, according to a study published by JAMA.

CTE is a progressive neurodegeneration associated with repetitive head trauma and players of American football may be at increased risk of long-term neurological conditions, particularly CTE.

Ann C. McKee, M.D., of the Boston University CTE Center and VA Boston Healthcare System, and colleagues conducted a study that examined the brains of 202 deceased former football players to determine neuropathological features of CTE through laboratory examination and clinical symptoms of CTE by talking to players’ next of kin to collect detailed histories including on head trauma, athletic participation and military service.

Among the 202 football players (median age at death was 66), CTE was neuropathologically diagnosed in 177 players (87 percent) who had had an average of 15 years of football participation. The 177 players included: 3 of 14 high school players (21 percent); 48 of 53 college players (91 percent); 9 of 14 semiprofessional players (64 percent); 7 of 8 Canadian Football League players (88 percent); and 110 of 111 NFL players (99 percent).

CTE is a progressive neurodegeneration associated with repetitive head trauma and players of American football may be at increased risk of long-term neurological conditions, particularly CTE. NeuroscienceNews.com image is for illustrative purposes only.

Neuropathological severity of CTE was distributed across the highest level of play, with all three former high school players having mild pathology and the majority of former college (56 percent), semiprofessional (56 percent), and professional (86 percent) players having severe pathology. Among 27 participants with mild CTE pathology, 96 percent had behavioral or mood symptoms or both, 85 percent had cognitive symptoms, and 33 percent had signs of dementia. Among 84 participants with severe CTE pathology, 89 percent had behavioral or mood symptoms or both, 95 percent had cognitive symptoms, and 85 percent had signs of dementia.

“In a convenience sample of deceased football players who donated their brains for research, a high proportion had neuropathological evidence of CTE, suggesting that CTE may be related to prior participation in football,” the article concludes. The authors acknowledge several other football-related factors may influence CTE risk and disease severity, including but not limited to age at first exposure to football, duration of play, player position and cumulative hits.

The study has several limitations, including that it is a skewed sample based on a brain donation program because public awareness of a possible link between repetitive head trauma and CTE may have motivated players and their families with symptoms and signs of brain injury to participate in this research. The authors urge caution in interpreting the high frequency of CTE in this study, stressing that estimates of how prevalent CTE may be cannot be concluded or implied.

About this neuroscience research article

Source: Ann C. McKee – JAMA Network
Image Source: NeuroscienceNews.com image is in the public domain.
Video Source: Video credited to JAMA.
Original Research: Full open access research for “Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football” by Jesse Mez, MD, MS; Daniel H. Daneshvar, MD, PhD; Patrick T. Kiernan, BA; Bobak Abdolmohammadi, BA; Victor E. Alvarez, MD; Bertrand R. Huber, MD, PhD; Michael L. Alosco, PhD; Todd M. Solomon, PhD; Christopher J. Nowinski, PhD; Lisa McHale, EdS; Kerry A. Cormier, BA; Caroline A. Kubilus; Brett M. Martin, MS; Lauren Murphy, MBA; Christine M. Baugh, MPH; Phillip H. Montenigro, BA; Christine E. Chaisson, MPH; Yorghos Tripodis, PhD; Neil W. Kowall, MD; Jennifer Weuve, MPH, ScD; Michael D. McClean, ScD; Robert C. Cantu, MD; Lee E. Goldstein, MD, PhD; Douglas I. Katz, MD; Robert A. Stern, PhD; Thor D. Stein, MD, PhD; and Ann C. McKee, MD in JAMA. Published online July 25 2017 doi:10.1001/jama.2017.8334

Cite This NeuroscienceNews.com Article
JAMA Network “High Prevalence of Evidence of CTE in Brains of Deceased Football Players.” NeuroscienceNews. NeuroscienceNews, 26 July 2017.
<http://neurosciencenews.com/cte-nfl-7181/>.
JAMA Network (2017, July 26). High Prevalence of Evidence of CTE in Brains of Deceased Football Players. NeuroscienceNew. Retrieved July 26, 2017 from http://neurosciencenews.com/cte-nfl-7181/
JAMA Network “High Prevalence of Evidence of CTE in Brains of Deceased Football Players.” http://neurosciencenews.com/cte-nfl-7181/ (accessed July 26, 2017).

Abstract

Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football

Importance Players of American football may be at increased risk of long-term neurological conditions, particularly chronic traumatic encephalopathy (CTE).

Objective To determine the neuropathological and clinical features of deceased football players with CTE.

Design, Setting, and Participants Case series of 202 football players whose brains were donated for research. Neuropathological evaluations and retrospective telephone clinical assessments (including head trauma history) with informants were performed blinded. Online questionnaires ascertained athletic and military history.

Exposures Participation in American football at any level of play.

Main Outcomes and Measures Neuropathological diagnoses of neurodegenerative diseases, including CTE, based on defined diagnostic criteria; CTE neuropathological severity (stages I to IV or dichotomized into mild [stages I and II] and severe [stages III and IV]); informant-reported athletic history and, for players who died in 2014 or later, clinical presentation, including behavior, mood, and cognitive symptoms and dementia.

Results Among 202 deceased former football players (median age at death, 66 years [interquartile range, 47-76 years]), CTE was neuropathologically diagnosed in 177 players (87%; median age at death, 67 years [interquartile range, 52-77 years]; mean years of football participation, 15.1 [SD, 5.2]), including 0 of 2 pre–high school, 3 of 14 high school (21%), 48 of 53 college (91%), 9 of 14 semiprofessional (64%), 7 of 8 Canadian Football League (88%), and 110 of 111 National Football League (99%) players. Neuropathological severity of CTE was distributed across the highest level of play, with all 3 former high school players having mild pathology and the majority of former college (27 [56%]), semiprofessional (5 [56%]), and professional (101 [86%]) players having severe pathology. Among 27 participants with mild CTE pathology, 26 (96%) had behavioral or mood symptoms or both, 23 (85%) had cognitive symptoms, and 9 (33%) had signs of dementia. Among 84 participants with severe CTE pathology, 75 (89%) had behavioral or mood symptoms or both, 80 (95%) had cognitive symptoms, and 71 (85%) had signs of dementia.

Conclusions and Relevance In a convenience sample of deceased football players who donated their brains for research, a high proportion had neuropathological evidence of CTE, suggesting that CTE may be related to prior participation in football.

“Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football” by Jesse Mez, MD, MS; Daniel H. Daneshvar, MD, PhD; Patrick T. Kiernan, BA; Bobak Abdolmohammadi, BA; Victor E. Alvarez, MD; Bertrand R. Huber, MD, PhD; Michael L. Alosco, PhD; Todd M. Solomon, PhD; Christopher J. Nowinski, PhD; Lisa McHale, EdS; Kerry A. Cormier, BA; Caroline A. Kubilus; Brett M. Martin, MS; Lauren Murphy, MBA; Christine M. Baugh, MPH; Phillip H. Montenigro, BA; Christine E. Chaisson, MPH; Yorghos Tripodis, PhD; Neil W. Kowall, MD; Jennifer Weuve, MPH, ScD; Michael D. McClean, ScD; Robert C. Cantu, MD; Lee E. Goldstein, MD, PhD; Douglas I. Katz, MD; Robert A. Stern, PhD; Thor D. Stein, MD, PhD; and Ann C. McKee, MD in JAMA. Published online July 25 2017 doi:10.1001/jama.2017.8334

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