By: Shane Nicholls
Neuroscience MSc Student
Growing research has established a strong relationship between cognitive deficits and contact-induced brain injuries. Studies show a 30% reduction of participation in youth football due to the fear of head related injuries1. These injuries stem from various trauma, yet the latest evidence is directly focused on violent impact sports including football, hockey, and boxing. The increased awareness and research of these injuries has created polar opposing views of the topic. This battle between neuroscientists and major corporations (i.e. NFL) has induced much confusion to the general public. As such, the created dispute has the validity of the science and the integrity of the leagues put into question.
In the past decade, the hot topic in the field of concussions and other brain injuries have revolved around chronic traumatic encephalopathy (CTE). What is CTE? CTE is defined as a major neurodegenerative disorder caused by repetitive concussive impacts or mild traumatic brain injuries. This disorder is most common in retired athletes, yet other populations such as military veterans can develop CTE in their lifetime. CTE is currently undetectable until after an individual has passed away. It is characterized by various cognitive, memory, and emotional deficits in differing stages throughout an individual’s lifetime. The mild to moderate stages could include confusion, disorientation, and short-term memory loss, while the more severe stages could lead to more detrimental symptoms such as dementia or suicide.
However, recent studies suggest that sub-concussive hits, those that impact the head but do not induce a concussion, are an underlying contributor of CTE. Therefore, concussions themselves are not the direct link to CTE in athletes. For example, evidence has come forward that soccer players have also been shown to develop CTE. Soccer is not a sport most people would first think of when thinking of concussions, but the sub-concussive head impacts endured by these athletes have shown to be a major risk factor for the development of CTE. How is this information portrayed in the media? With all the potential injuries associated with contact sports, could the emergence of this disorder push a worried parent over the edge? This is the case when CNN headlines state, “CTE found in 99% of studied brains from deceased NFL players” (2017). Mckee and colleagues at the CTE center in Boston University found post-mortem diagnostic evidence of CTE in 110 out of the 111 NFL football players. This major finding created a non-refutable image to the public; that playing high contact sports will likely lead you on a path to severe repercussions.
On the other hand, diving into the science reveals major flaws that most people will look past. At the surface level, there seems to be concrete information showing the long-term effects of playing football, one of which is a very high risk of suicide. However, transparency is a major weakness in this study. Specifically, this study had a serious selection bias, in which only brains that were thought to have CTE were donated to the study. Dr. Christopher Giza, a renowned expert in concussions in the NFL mentioned, “If you’ve put together a bag of apples, you shouldn’t be surprised when you reach in and pull out an apple”. Therefore, if you restrict subjects that only fall under your specific criterium, then your end results will eventually be skewed. Thus, even the soundest studies will have drawbacks which affect the main result.
On another note, contact sports and CTE do not have a linear relationship. Even if the risk of CTE is strongly increased due to playing high contact sports, that doesn’t mean that there aren’tprecautionary protocols that could be followed. Due to the buzz of CTE, there are many well studied guidelines out there that could even be implemented in your own household. First, after a hard impact to the head, the athlete should rest appropriately, but return to play with light aerobic
exercise to aid in the healing process. Second, the time between concussive hits must be increased to allow adequate neural repair. These protocols are actively being utilized in professional leagues such as the NFL and NHL and need to be employed in all levels of contact sport.
The CTE conundrum in contact sports has many parents fearing the protection and safety of their child. As such, jumping to the conclusion too soon of a cause and effect relationship might be too rash. Instead, disregard the blown-up headlines and follow necessary injury protocols to ensure your own head is at ease.
References:
https://www.cnn.com/2017/07/25/health/cte-nfl-players-brains-study/index.html https://www.sciencedaily.com/releases/2017/07/170725122124.htm
https://www.mensjournal.com/health-fitness/should-you-let-your-kid-play-football-the-truth- about-concussions/
https://www.acsh.org/news/2017/07/25/be-skeptical-will-99-nfl-players-really-develop-cte- 11608
https://www.nytimes.com/interactive/2017/07/25/sports/football/nfl-cte.html
Original Article:
Mez, J., Daneshvar, D. H., Kiernan, P. T., Abdolmohammadi, B., Alvarez, V. E., Huber, B. R., ... & Cormier, K. A. (2017). Clinicopathological evaluation of chronic traumatic