About one-third of former NFL players believe they have chronic traumatic encephalopathy ( CTE), a condition linked to repeated head trauma, according to a new study of nearly 2, 000 former players. Those who believed they had CTE reported higher levels of mental problems, depression, chronic problems, and depression compared to those who did no.
Researchers stress that many of these symptoms may be the result of treatable conditions and that CTE can only be detected post-mortem. In order to reduce symptoms and improve cognitive heath, the research recommends a focus on treating co-occurring health problems.
Important Facts:
- Former NFL players who were 34 % certain of having CTE.
- People concerned about CTE reported more melancholy, mental problems, and depression.
- Treating co-occurring problems like chronic pain and lower testosterone does improve outcomes.
Origin: Mass General
About one-third of former NFL players believe they have chronic traumatic encephalopathy ( CTE), a neuropathological condition linked to repeated head trauma that can only be identified by a post-mortem examination of the brain, according to a new study of nearly 2, 000 former players.
According to the study writers, players who believed they had CTE reported considerably more mental problems and a higher percentage of small hormone, despair, headaches, and serious problems, compared with those who did not have concerns about CTE. These symptoms, along with others, have been shown to lead to mental problems even in people without brain injuries, which suggests they may not be related to CTE.
The study, which was conducted by a group including Mass General Brigham analysts who are part of the Football Players Health Study at Harvard University, is published Sept. 23 in , JAMA Neurology.
The experts issue a warning that clinicians must take all cognitive symptoms seriously. These include degenerative changes in the brain, considered and ruled out through cognitive assessments, including physical examinations, MRI and CT images. Because neurocognitive symptoms can only be clearly identified through an autopsy, which are caused by a variety of causes no connected to CTE.
Additionally, the experts warn that people who exhibit neurologic symptoms and depression may later be diagnosed with CTE, but that this can only be learned through a post-mortem test.
Our beliefs can have a significant impact on our health, according to author Ross Zafonte, Complete, president of Spaulding Rehabilitation and head of the sections of natural medicine and treatment at Massachusetts General Hospital and Brigham and Women’s Hospital. Additionally, Zafonte is the lead researcher for the Harvard Football Players Health Study.
” The symptoms that raise CTE concerns are real and CTE concerns are valid, but it’s crucial to understand that having persistent fears about this condition can have a toll on mental health. It’s our responsibility to intervene when these concerns prevent former NFL players from receiving effective treatments for other or interrelated physical and emotional health issues.
Receiving a diagnosis of incurable neurodegenerative diseases such as Alzheimer’s, Parkinson’s and Huntington’s disease are associated with elevated suicide risk. The researchers polled 1, 980 former professional football players to see if the perception of CTE has any similar associations with suicidality.
They sought to know how many people who thought they had CTE, which player traits were frequently linked to this belief, and whether CTE concerns were linked to frequent suicide or self-harm.
According to the analysis, 34 % of players think they have CTE. Participants who expressed concerns about CTE were more likely to report low testosterone, depression, mood instability, pain, cognitive symptoms and more reported head injury.
Approximately 25 % of participants who thought they had CTE also reported suicidality, compared to 5 % of those who thought they had not. Even if those who believed they had CTE reported comparable levels of depression, those who believed they had it were still twice as likely to report frequent suicide or self-harm in analyses that examined the impact of depressive symptoms on suicidality.
This finding suggests that some suicidality may be caused by the misconception that former players may not be depressed but rather by their perception of an untreatable neurodegenerative disease. While worries about CTE are legitimate, the researchers believe that treating comorbid conditions may lessen symptoms and improve overall mood.
” A key takeaway from this study is that many conditions common to former NFL players such as sleep apnea, low testosterone, high blood pressure and chronic pain can cause problems with thinking, memory and concentration”, says first author Rachel Grashow, PhD, MS, of Harvard T. H. Chan School of Public Health.
It is crucial that we identify conditions that are treatable while we wait for advancements in CTE research to better address living players ‘ experiences. These efforts may lower the likelihood that players prematurely attribute symptoms to CTE, which could lead to hopelessness and self-harm.
The researchers say it’s important for former players and their clinicians to concentrate on the things that can be treated because CTE can currently only be diagnosed on autopsy, which makes it unlikely that some of the players who reported concerns actually have CTE-related brain changes.
Former players and their physicians should research treatment interventions and positive health behavior changes that have been shown to improve cognitive function, overall health, and quality of life until clinical guidelines and treatments for CTE are developed, according to senior author Aaron Baggish, MD, a professor of medicine at the University of Lausanne in Switzerland, a senior faculty member of the Football Players Health Study and former director of the Massachusetts General Hospital Heart Center’s Cardiovascular Performance Program.
” Interventions including weight loss, exercise, improving sleep and implementing a low-salt diet may improve cognitive function”.
Authorship: In addition to Zafonte, Grashow, and Baggish, other Mass General Brigham authors include Grant L. Iverson, Frank E. Speizer, and Daniel H. Daneshvar. Additional authors include Douglas P. Terry, Heather DiGregorio, Inana Dairi, Cheyenne Brown, Paula S. Atkeson,, Alicia J. Whittington, LeRoy Reese, Jonathan H. Kim, Niki Konstantinides, Herman A. Taylor, and Marc G. Weisskopf.
Disclosures: Baggish has received funding from the National Institute of Health/National Heart, Lung, and Blood Institute, the National Football League Players Association ( NFLPA ), and the American Heart Association and receives compensation for his role as team cardiologist from the US Olympic Committee/US Olympic Training Centers, US Soccer, US Rowing, the New England Patriots, the Boston Bruins, the New England Revolution, and Harvard University.
Zafonte reported receiving royalties from Springer/Demos publishing for serving on the Myomo Inc. scientific advisory board and onecare while coediting the text Brain Injury Medicine. ai Inc., receiving grants from the NIH, and evaluating patients in the Massachusetts General Hospital Brain and Body–TRUST Program, which is funded by the NFLPA. The NFLPA provided grant funding for Grashow. Additional author disclosures can be found in the article.
Funding: The Football Players Health Study is supported by the NFLPA. The NFLPA did not contribute to the design and conduct of the study, collection, management, analysis, and interpretation of the data, preparation, review, or approval of the manuscript, and decision to submit the manuscript for publication.
This work received financial support from Harvard University and its affiliated academic healthcare centers, as well as financial support from The Harvard Clinical and Translational Science Center ( National Center for Advancement of Translational Sciences, National Institutes of Health, Award UM1TR004408 ) and from Harvard University.
The authors are solely responsible for the content, which does not necessarily reflect the official opinions of Harvard Catalyst, Harvard University, its affiliated academic healthcare centers, or the National Institutes of Health.
About this news about neurology and CTE research
Author: Ryan Jaslow
Source: Mass General
Contact: Ryan Jaslow – Mass General
Image: The image is credited to Neuroscience News
Original Research: The findings will appear in JAMA Neurology
