TBI MedSLP

View Original

From Sports to Concussions: The Link to Chronic Traumatic Encephalopathy

In the world of contact sports, there's a hidden danger that lurks beneath the excitement and adrenaline – concussions. These seemingly innocuous brain injuries can have long-lasting and devastating effects on athletes. Repetitive concussions can have a multitude of implications. One of the most concerning consequences is chronic traumatic encephalopathy (CTE). CTE is a progressive degenerative brain disease. In this post, we will explore the link between sports and concussions, and how they contribute to the development of CTE.

According to a journal article from the American Academy of Neurology, more than 90% of concussions do not involve a loss of consciousness.

From football to hockey, rugby to boxing, athletes of various sports face the risk of suffering concussions. The repeated blows to the head that occur during these high-impact sports can result in brain trauma. Over time, this trauma can lead to the accumulation of abnormal proteins, known as tau, in the brain, which are a hallmark of CTE. Also, diffuse atrophy of the brain including the cerebral cortex, mammillary bodies, corpus callosum, thalamus, brainstem, and cerebellum characterizes CTE.

Understanding the connection between concussions and CTE is crucial. This helps raise awareness about the potential long-term consequences of these injuries. Awareness emphasizes the importance of proper diagnosis, treatment, and prevention strategies for athletes. By shedding light on this topic, we can take steps towards minimizing the risk and improving the safety of athletes.

Understanding the link between sports and CTE

Various sports including:

  • football

  • hockey

  • rugby

  • boxing

and many more put athletes of various competitive levels at a high risk for suffering concussions. The repeated blows to the head that occur during these high-impact sports can result in brain trauma. Over time, this trauma can lead to the accumulation of abnormal proteins, known as tau. The accumulation of tau in the brain is a hallmark of CTE.

The connection between sports and CTE lies in the repetitive head injuries that athletes experience throughout their careers. Each concussion increases the risk of developing CTE. Studies show that athletes who have experienced multiple concussions are more likely to develop the disease. The intensity and frequency of these brain injuries contribute to the accumulation of tau protein. This protein disrupts normal brain function and leads to the symptoms of CTE.

It is important to note that CTE is not limited to professional athletes. Even individuals who participate in amateur or recreational sports are at risk. The impact required to cause a concussion can occur in any level of competition. Understanding this link is crucial for raising awareness and implementing preventive measures to protect athletes at all levels.

Common sports associated with CTE

There are common sports known for their high risk of concussions and subsequent CTE development. Football, with its physical nature and frequent collisions, has gained significant attention in recent years due to its association with CTE. Studies have shown that professional football players are at a significantly higher risk of developing CTE compared to the general population.

Other contact sports, such as hockey and rugby, also pose a risk of concussions and CTE. The fast-paced and aggressive nature of these sports increases the likelihood of head injuries. Combat sports, like boxing and mixed martial arts, are particularly concerning due to the direct impact to the head that fighters endure during matches.

However, it is important to note that concussions and CTE are not limited to contact sports alone. Activities such as cycling, skiing, and even soccer can also lead to head injuries and subsequent development of CTE. It is essential for athletes and their support systems to recognize the risks associated with their chosen sport and take appropriate measures to minimize the impact of concussions.

Signs and symptoms of CTE

CTE is a degenerative brain disease that develops over time. Symptoms often appear years or even decades after the initial head injuries. The early stages of CTE may present with subtle changes in mood, behavior, and cognition. These can include depression, irritability, memory loss, and difficulty concentrating.

As the disease progresses, individuals with CTE may experience more severe symptoms. These symptoms can include confusion, aggression, impulse control problems, and even suicidal thoughts. They may also develop movement disorders, including tremors, difficulty with balance, and problems with coordination.

It is important to note that the symptoms of CTE can vary from person to person. Also, not all individuals who have suffered concussions will develop the disease. However, recognizing the signs and seeking medical attention is crucial for early diagnosis and appropriate management of the condition.

The impact of concussions on CTE development

Concussions play a significant role in the development of CTE. When a concussion occurs, the brain undergoes a cascade of complex physiological changes. The impact causes the brain to move rapidly within the skull. This leads to stretching and tearing of nerve fibers. This then disrupts normal brain function and triggers a series of events that can ultimately result in the accumulation of tau protein.

Tau protein is normally found in the brain. Tau protein helps stabilize and support the structure of nerve cells. However, in CTE, tau becomes abnormally clumped together, forming tangles that interfere with cellular function. These tangles spread throughout the brain. This causes widespread damage and contributes to the symptoms of CTE.

The more concussions an individual experiences, the greater the risk of developing CTE. This is due to the cumulative effect of repeated brain injuries. Repeated brain injuries increase the likelihood of tau protein accumulation. The severity of concussions also plays a role, with more severe and prolonged concussions posing a higher risk.

Diagnosing and treating CTE

Diagnosing CTE can be challenging. The disease can only be definitively diagnosed after death through brain tissue examination. However, researchers and medical professionals are actively developing diagnostic criteria that can be utilized during an individual's lifetime.

Currently, the diagnosis of CTE is based on a combination of:

  • medical history

  • clinical symptoms

  • neuroimaging studies

Neuroimaging studies may include MRI scans, PET scans, and other imaging techniques that can help identify patterns of brain abnormalities associated with CTE.

Treatment for CTE is primarily focused on managing symptoms and improving quality of life.

This may include:

  • medications to address mood and behavioral changes

  • therapy to help with cognitive difficulties

  • support for managing physical symptoms

It is important for individuals with CTE to work closely with their healthcare team to develop a personalized treatment plan that addresses their specific needs.

Prevention strategies for athletes

Preventing concussions is key to reducing the risk of CTE in athletes. There are several strategies that can be implemented to minimize the impact of head injuries and promote player safety:

1. Education and awareness: Athletes, coaches, and parents should be educated about the signs and symptoms of concussions, as well as the potential long-term consequences. This knowledge can help ensure that concussions are recognized and addressed promptly.

2. Proper equipment: Athletes should wear appropriate protective gear, such as helmets, mouthguards, and padding, that is designed to reduce the risk of head injuries. It is important that this equipment is regularly inspected and maintained to ensure its effectiveness.

3. Rule changes and enforcement: Sports organizations should implement and enforce rules that prioritize player safety. This may include restrictions on certain types of contact or techniques that pose a higher risk of concussions.

4. Training and technique: Athletes should receive proper training on how to minimize the risk of head injuries through safe techniques and body control. This can help reduce the frequency and severity of concussions.

5. Monitoring and reporting: Coaches and medical professionals should closely monitor athletes for signs of concussions and encourage reporting of any head injuries. Prompt recognition and appropriate management can help prevent further damage and reduce the risk of CTE.

Support and resources for individuals affected by CTE

For individuals and families affected by CTE, support and resources are available to help.  Support groups, both in-person and online, provide a platform for individuals to connect with others who are experiencing similar struggles. These groups can offer emotional support, share coping strategies, and provide valuable information about available resources. The Concussion Legacy Foundation has a robust list of resources that are available here.

In addition, organizations dedicated to brain health and sports safety offer educational materials, advocacy initiatives, and research funding opportunities. These organizations strive to raise awareness about the risks of concussions and CTE and work towards implementing policies that prioritize athlete safety.

It is important for individuals affected by CTE to reach out and access these resources, as they can provide valuable support and guidance throughout their journey.

Conclusion: Raising awareness and promoting player safety

The link between sports, concussions, and CTE is a critical issue that requires attention and action. By understanding the connection and its potential consequences, we can work towards raising awareness. Essential components of a comprehensive approach to preventing concussions and reducing the risk of CTE include:

  • Education

  • proper equipment

  • rule changes 

  • training

  • monitoring 

Additionally, continued research and advancements in diagnostic techniques and treatment options will help improve outcomes for individuals affected by the disease.

By raising awareness, supporting research, and advocating for player safety, we can make a meaningful impact in the lives of athletes worldwide. Together, we can ensure that the thrill of sports is enjoyed without compromising long-term brain health.