Gwenyth Mercep ’22

Chronic traumatic encephalopathy (CTE) is a brain disease associated with exposure to repetitive head impacts, such as those from tackle American football [1]. CTE can cause numerous and debilitating early-life symptoms like behavioral and mood disturbances, most notable, impulse control and depression [1]. Episodic memory loss and dementia, forms of cognitive dysfunction, are reported by patients with CTE later in life [1]. CTE can only be officially diagnosed posthumously by discovery of abnormal “Tau” protein deposition, which makes clinical diagnoses and treatment difficult [1]. Researchers from the Boston University School of Medicine focused on determining if the age which tackle football players started playing the sport, exacerbated the severity of their condition or affected the onset of  CTE symptomatology [1].

The sample included amateur and professional tackle football players whose brains were donated to the Veteran’s Affairs-Boston University-Concussion Legacy Foundation Brain Bank [1]. Of the 246 participants, 211 were diagnosed with CTE [1]. By contacting living relatives, they were able to collect data on their age of first exposure to tackle football and the age of cognitive and behavioral or mood symptom onset for the individual being studied [1]. CTE diagnostic severity was graded using a four-stage classification scheme that is based on the extent of the “Tau ” protein [1]. The results concluded that the age of exposure was not associated with CTE severity, but in the 211 participants with CTE, onset of cognitive dysfunction was reported 2.44 years earlier per each year younger a participant began to play tackle football [1]. Similarly, onset of behavioral and mood symptoms were reported 2.50 years earlier for every one year younger an individual started playing tackle football [1]. The results also predicted that exposure before 12 years old result in cognitive and behavioral/mood symptom onset by 13.39 and 13.28 years earlier[1]. 

This association between youth tackle football and earlier symptom onset of neurological damage is critical because youth exposure is prevalent in our society with football being an integral part of American culture. If efforts to cease youth participation in tackle football are not realistic, then increasing the age of first exposure can decrease premature symptom onset. Additionally, CTE is also associated with repeated head trauma, suggesting all head trauma should be treated with the same level of awareness, regardless of states of concussion.  With this information and the growing public health concern surrounding tackle football, more prospective studies of former tackle football players are required to further understand the association between youth tackle football exposure and long-term neurobehavioral outcomes.

[1]M. Alosco, et al., “Age of First Exposure to Tackle Football and Chronic Traumatic Encephalopathy” Annals of Neurology 83, 886-901 (2018). Doi:  10.1002/ana.25245

[2]Image retrieved from: http://www.ufmcpueblo.com/football-brain-injury/