A New Study Sheds Light on Prevalence of CTE in Youth
"A lot of people think CTE is a result of high-level, professional play such as football, ice hockey, and boxing, but it can affect amateur athletes and can affect people at a young age," says Dr. Ann McKee, lead author of a comprehensive study regarding youth athletes and CTE.
Last month a comprehensive study was published in the Journal of the American Medical Association (JAMA) pertaining to the prevalence of CTE in young contact-sport players. Chronic traumatic encephalopathy, CTE, is a progressive and fatal brain disease associated with repeated traumatic brain injuries, including concussions and repeated blows to the head. Unfortunately, CTE is only diagnosed by studying brain tissue postmortem, which makes understanding the effects of the disease on the living very difficult. Most often when we’ve heard of CTE it is in retired professional football players. Just a few months ago, Boston University’s CTE center published a study focusing on NFL players and found that over ninety-one percent showed signs of CTE in those studied.
This new study out of Boston focuses on younger brains. This gives the researchers the large-scale study to confirm that the disease can develop in young people. Boston University’s CTE Center, led by Dr. Ann Mckee, found that out of 152 brains studied, forty-one percent (63 brains) exhibited neuropathological abnormalities consistent with CTE. However, the high prevalence recorded is not the only key part to take away from this study. These brain samples were taken from contact-sport players under thirty and seventy-one percent of them only played in amateur leagues like high-school and college. So, what does this mean? We’ve known for a while that CTE develops in contact sport players who play at the professional level and above. And we’ve always suspected that it develops earlier than previous studies suggest. This new study confirms that the initial stages of CTE (stage I or II) is present in the youth brains studied at staggeringly high numbers.
61 of the 63 young brain donors with CTE were diagnosed with mild CTE (stages I or II). Young athletes with confirmed CTE included American football players, ice hockey players, soccer and rugby players, amateur wrestlers, military veterans, and a professional wrestler. The study highlights that CTE can affect amateur as well as professional contact sports athletes, with 45 (71.4%) of the athletes diagnosed with CTE playing only at the high school or college level.
Not all individuals exposed to repeated head impacts will develop CTE, and 89 donors (58.6%) in this sample did not have CTE. Despite the narrow age range of the sample, brain donors with CTE were older, were more likely to play American football, had longer duration of football play, and were more likely to play at an elite level, in line with previous studies of older players. These findings emphasize the dual role of age and duration in the development of CTE. Young donors exposed to repeated head injuries were highly symptomatic regardless of CTE status, and the causes of symptoms in this sample, as reported by informants, are likely multifactorial and include repeated head impacts and non-repeated head impact-related causes. Furthermore, despite all donors being symptomatic, 58.6% did not have pathologic evidence of CTE.
This study reiterates the importance of TREATing all head injuries, regardless of the presumed severity. By treating the injury, we are preventing further damage including post-concussion syndrome (PCS) and potentially CTE. As such, it is therefore important to let the brain rest after a head impact. A common sentiment among coaches and parents is to get their kids back in school and back to playing sports as soon as possible. Unfortunately, this can cause worsening side effects and an increased risk of repeat concussions. If a pitcher tore a muscle in their arm, we wouldn't tell that player to go back to throwing pitches in a game. We’d have them rest, recover, and only once the arm is repaired are they to start light practicing. This same logic applies to the brain. We only have one brain to take us through life. What are we willing to do to repair and protect that brain?
Disclaimer: Now, there is a statistic in this study that may catch the eyes of many people. Over fifty percent of the brains studied came from players who had committed suicide. The first conclusion one would make is that there is a direct relation between players getting CTE and committing suicide. That is not the case from this study. The study also states that there was no difference in types of deaths between brains diagnosed with CTE and those that were not. The truth is that suicide is one of the leading causes of death for ALL individuals under 30. There is evidence to suggest CTE can cause depression and mood changes, leading to potential suicide, but not a direct link as assumed above.
By: Tanner Mjelde, Certified Hyperbaric Technician