Chronic Traumatic Encephalopathy in Athletes

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Athletics are a worldwide phenomenon. From a young age, many children are exposed to sports that they continue to play into their early twenties. Many individuals, with great talent and work ethic, have the opportunity to turn their athletic talents into a career. However, there is a debate over the impact that athletics has on individuals. While it has many positive impacts such as allowing individuals to stay active and healthy and implementing many life skills that stick with people in all aspects of life, it also has many negative side effects that people believe outweigh the positive aspects of the sport. Injuries have impacted many athletes during their athletic career, some that in turn force individuals to not play the sport anymore. Amongst these injuries are concussions. Concussions have a lasting impact that may or may not produce adverse effects later in life. Aside from sports, military personnel and many other people with high impact professions may experience the jarring of their brain through every day activities.

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In the late 1920s, Harrison Martland found professional boxers at the time to have a syndrome, which he labeled as “punch drunk syndrome”. 75 years following Martland’s findings, only 50 similar cases were confirmed in brain trauma victims. However, in 2005, a pathologist by the name of Bennet Omalu studied Mike Webster, a former Pittsburgh Steelers football player. Omalu found evidence of chronic traumatic encephalopathy in Webster. In today’s popular media, a movie by the name of Concussion was produced. The movie told of Bennet Omalu and his fight to get the world to understand the CTE is a serious and deadly disease. It highlights, with the help of dramatic add-ins, the hardships Omalu faced and how the world disbelieved that something so deadly could go untold and unrecognized for a long time. After a long battle with the NFL and the unfortunate deaths of many NFL superstars, Omalu was successful in getting the World to understand that this disease is here, it is deadly, and it needs to be acknowledged in order to save the lives of current and future football players. After Omalu’s findings became well known, the Concussion Legacy Foundation, Boston University, and the US Department of Veterans Affairs formed an organization called the Brain Bank. Since its formation, there have been over 500 brains donated. Of those 500 brains, at least 300 of them were found to have chronic traumatic encephalopathy, also known as CTE, all throughout them.

Repeated brain trauma causes degeneration of the brain. Symptoms of this include memory loss, confusion, impaired judgment, impulse control, and many psychological disorders. The symptoms of chronic traumatic encephalopathy can worsen over time or they can remain dormant for years before becoming worse. Typically, cognitive issues do not develop until a long time after behavioral symptoms are present, however, it is still possible for cognitive symptoms to occur first. Chronic traumatic encephalopathy is essentially caused by a protein that produces detrimental effects. A protein called Tau begins to slowly clump in the brain; it proceeds to move throughout the brain while it virtually kills every brain cell that it can engulf. It has been seen in people as young as seventeen, but is not typically common until a person is around 40 years of age. Control problems, aggression, and paranoia are usually the early warning signs of chronic traumatic encephalopathy. Memory loss, dementia, and impaired judgment begin to set in once the person has had CTE for a long period of time.

The interest in studying those affected by repetitive brain trauma has become widely studied. When the link between dementia and repetitive brain trauma was discovered, it moved repetitive brain trauma into a category that was taken seriously by many psychologists and doctors. However, since then chronic traumatic encephalopathy has been discovered, it moved higher on the list of important areas of study. Typically those who play sports that require a lot of collisions or those in the military are the ones affected by this the most because they experience brain trauma multiple times over a long period of time. Recently, there was a diagnostic criteria set in place for CTE that was able to help scientists decipher between chronic traumatic encephalopathy and other neurodegenerative diseases. However, even though it has been concluded through studies done on chronic traumatic encephalopathy that repetitive brain trauma is the leading risk factor for CTE, it is still formally hard for scientists to get accurate results due to selection bias. The United States Department of Defense Blast Injury Research Program conducted a study to identify the significance between blast-related injuries and chronic traumatic encephalopathy. The most that the research proved was that there needs to be more risk factors identified, achieving a wider range of test subjects, and finding a way to diagnose chronic traumatic encephalopathy in living individuals.

Due to the nature of the disease, it is hard to understand how and why exactly this disease has formed. Typically, the people diagnosed with chronic traumatic encephalopathy have suffered numerous amounts of impacts to the head due to sports with heavy contact or explosions from working for the military. However, many scientists found that a leading cause to chronic traumatic encephalopathy is “sub-concussive impacts.” These impacts are the most dangerous because they do not show any signs of a concussion. There could be various people who have chronic traumatic encephalopathy, but never knew they even had a concussion. The age and length of exposure is very important when understanding chronic traumatic encephalopathy. Long playing careers and long military careers are a substantial risk factor; also, playing a sport before the age of twelve has been found to lead to a greater risk of chronic traumatic encephalopathy than those who start sports after the age of twelve. This disease is incredibly dangerous due to the fact that it can only be fully diagnosed after death through brain tissue analysis. Scientists take deceased brains and use chemicals that make Tau clumps visible. It was only until recently that Dr. Ann McKee from the Brain Bank created a guideline for understanding chronic traumatic encephalopathy, so more doctors are able to understand and diagnose chronic traumatic encephalopathy.

Since CTE cannot be identified until after death, there are very few treatments. Actually, the only treatments for chronic traumatic encephalopathy are specific treatments used to treat the symptoms; the main symptoms of chronic traumatic encephalopathy are mood changes, headaches, and memory problems. For example, a person suffering from mood changes such as depression, irritability, and anxiety can go through cognitive behavioral therapy in order to reduce their mood changes. Those who suffer from headaches can get acupuncture, medications, and massages. If a person is found to have severe memory problems, they can go through memory training exercises or note-taking strategy lessons.

The future holds many possibilities for chronic traumatic encephalopathy. Scientists are looking into the possibility that chronic traumatic encephalopathy could be a genetic factor, causing more people to get it than others. Unfortunately, chronic traumatic encephalopathy has been found to cause progressive dementia and thoughts of suicide as well. Chronic Traumatic Encephalopathy also has very similar symptoms to those who suffer from Alzheimer’s disease, making it even more difficult to diagnose. Due to these two heinous traits, CTE has become widely studied in order to find a better way to diagnose a person when he or she is alive, in order to catch it earlier and approve the affected individuals’ overall quality of life.

Works cited

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  3. Omalu, B. (2011). Chronic traumatic encephalopathy in a national football league player. Neurosurgery, 69(5), 1197-1205.
  4. Mez, J., Daneshvar, D. H., Kiernan, P. T., Abdolmohammadi, B., Alvarez, V. E., Huber, B. R., ... & Alosco, M. L. (2017). Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football. JAMA, 318(4), 360-370.
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