Football Brain Disease Evidence Seen in High School Players, Professionals: Study

New research indicates that a high proportion of deceased football players have evidence of brain disease linked to repeated head trauma, not only among professional athletes, but also among most college players and some that only played high school football.

In a study published this week in the Journal of the American Medical Association (JAMA), examinations of donated brains from former football players in the National Football League (NFL) revealed that nearly all had evidence of severe chronic traumatic encephalopathy (CTE), a brain disease caused by traumatic injuries which can lead to dementia.

While these findings confirm recent concerns about the impact of playing the sport at the highest levels, researchers with the Boston University Alzheimer’s Disease and CTE Center also found alarming rates of the brain disease among former semi-pro, college and even high school football players.

Donated brains from 202 deceased football players were examined, including individuals who played only at the high school level, and many who excelled at the sport, playing in the NFL.

Neuropathological evaluations were conducted, and a full trauma history was completed, as well as questionnaires concerning the player’s athletic and military history. Behavior, mood, and cognitive symptoms while the player was alive, as well as symptoms or diagnoses of dementia, were assessed for players who participated after 2014.

Researchers focused on a diagnosis of mild and severe CTE, which is a brain disease that has gained media attention in recent years after many National Football League (NFL) players were diagnosed with the disease. It involves a progressive degeneration of the brain, associated with repetitive head trauma and loss of brain matter. It can only be diagnosed after death, during brain examinations.

Symptoms of CTE before death may include depression, impulsivity, aggression, behavior changes, withdrawal, difficulty focusing, memory loss and confusion.

Overall, 87% of the player brains examined resulted in a CTE diagnosis, across all levels of play from high school to pro; a total of 177 of the 202 players. Among those, 110 of the 111 former NFL players were diagnosed with CTE, or 99% of players.

The number of NFL players positively diagnosed with CTE adds another link to a growing body of evidence indicating repetitive blows suffered during football cause severe and long term brain damage.

Additionally, 91% of American college football players were positively diagnosed with CTE, as well as 88% of Canadian Football League players, 65% of semiprofessional football players, and even 21% of American high school football players. No cases of the brain disease were seen among individuals who only played football before the high school level.

In 2011, a CDC study indicated that young athletes, playing at the elementary and high school levels, face a 60% increased risk of suffering traumatic brain injuries, putting them at risk for more serious cognitive side effects.

Among those former football players diagnosed with severe CTE, nearly 90% had experienced behavioral or mood symptoms while they were alive.

Cognitive symptoms affected 95% of players and 85% had signs of dementia. Previous studies have also warned of an increased risk of dementia following traumatic brain injury.

Among players diagnosed with mild CTE, 96% experienced behavioral or mood symptoms, 85% experienced cognitive symptoms. However, only 33% had signs of dementia.

“The severity of CTE pathology was distributed across the highest level of play, with all former high school players having mild pathology and the majority of former college, semiprofessional, and professional players having sever pathology,” the researchers concluded. “Behavior, mood, and cognitive symptoms were common among those with mild and severe CTE pathology and signs of dementia were common among those with severe CTR pathology.”

Researchers cautioned that the high rates seen among the brains sampled may not apply to living players. They noted that most of the brains used in the study were donated because of constant hits to the head during games or recurring mood or behavioral symptoms before death. However, the findings support increasing concerns not only among professional athletes, but parents considering whether their child should ever play football.