{"id":116016,"date":"2023-08-29T07:45:10","date_gmt":"2023-08-29T11:45:10","guid":{"rendered":"http:\/\/www.bumc.bu.edu\/camed\/?p=116016"},"modified":"2023-08-29T07:45:10","modified_gmt":"2023-08-29T11:45:10","slug":"young-amateur-athletes-at-risk-of-cte-bu-study-finds","status":"publish","type":"post","link":"https:\/\/www.bumc.bu.edu\/camed\/2023\/08\/29\/young-amateur-athletes-at-risk-of-cte-bu-study-finds\/","title":{"rendered":"Young Amateur Athletes at Risk of CTE, BU Study Finds"},"content":{"rendered":"<figure id=\"attachment_116018\" aria-describedby=\"caption-attachment-116018\" style=\"width: 2010px\" class=\"wp-caption aligncenter\"><img loading=\"lazy\" src=\"\/camed\/files\/2023\/08\/Brink-29-Aug-2023-CTE-under-30-feat.jpg\" alt=\"Two female soccer players competing for the ball, aerial view.\" class=\"size-full wp-image-116018\" width=\"2000\" height=\"1335\" srcset=\"https:\/\/www.bumc.bu.edu\/camed\/files\/2023\/08\/Brink-29-Aug-2023-CTE-under-30-feat.jpg 2000w, https:\/\/www.bumc.bu.edu\/camed\/files\/2023\/08\/Brink-29-Aug-2023-CTE-under-30-feat-636x425.jpg 636w, https:\/\/www.bumc.bu.edu\/camed\/files\/2023\/08\/Brink-29-Aug-2023-CTE-under-30-feat-1024x684.jpg 1024w, https:\/\/www.bumc.bu.edu\/camed\/files\/2023\/08\/Brink-29-Aug-2023-CTE-under-30-feat-768x513.jpg 768w, https:\/\/www.bumc.bu.edu\/camed\/files\/2023\/08\/Brink-29-Aug-2023-CTE-under-30-feat-1536x1025.jpg 1536w\" sizes=\"(max-width: 2000px) 100vw, 2000px\" \/><figcaption id=\"caption-attachment-116018\" class=\"wp-caption-text\">For parents, the latest findings about CTE present a dilemma. If the price of playing certain contact sports raises the risk of brain damage later in life, is it worth it? Photo by isitsharp\/iStock<\/figcaption><\/figure>\n<p>It\u2019s perhaps not especially surprising that after enduring decades of head-thumping collisions on the football field, many NFL veterans spend their retirements grappling with declining brain health. Almost all\u2014<a rel=\"noreferrer noopener\" href=\"https:\/\/www.bu.edu\/articles\/2023\/bu-finds-cte-in-nearly-92-percent-of-former-nfl-players-studied\/\" target=\"_blank\">92 percent<\/a>\u2014of ex-NFL players studied have been diagnosed with chronic traumatic encephalopathy (CTE). Worryingly though, a new study from the Boston University CTE Center suggests that it\u2019s not just grizzled old pros who should be concerned about the degenerative brain disease. Researchers found that young, amateur athletes who play some of the most physical contact sports also seem to be at risk, despite their comparatively short, lower-profile playing careers.<\/p>\n<p>After examining the brains of 152 contact sport participants who had died under age 30, they discovered 41.4 percent had signs of CTE. More than 70 percent of those diagnosed were amateur athletes who\u2019d played sports like football, ice hockey, soccer, rugby, and wrestling. The study also included the first American female athlete diagnosed with CTE, a 28-year-old collegiate soccer player whose identity remains private. The results were <a href=\"https:\/\/jamanetwork.com\/journals\/jamaneurology\/fullarticle\/2808952?resultClick=1\" target=\"_blank\" rel=\"noreferrer noopener\">published in <em>JAMA Neurology<\/em><\/a>.<\/p>\n<p>\u201cIt seems to be well accepted now that you can play at a very high level of elite American football or ice hockey and get CTE,\u201d says <a rel=\"noreferrer noopener\" href=\"https:\/\/www.bu.edu\/cte\/about\/leadership\/ann-mckee-md\/\" target=\"_blank\">Ann McKee, director of the BU CTE Center<\/a>. \u201cBut we\u2019re seeing the beginnings of this disease in young people who were primarily playing amateur sports.\u201d<\/p>\n<p>For parents, the latest findings present a dilemma. Sports\u2014whether high-contact like ice hockey or largely collision-free like basketball\u2014are important for kids and young people, keeping them moving and socializing and teaching them a range of life skills. But if the price of playing certain sports is an increased risk of permanent and devastating damage to developing brains, is it worth it?<\/p>\n<h3>CTE Starts Early; Head Injuries Can Cause Depression<\/h3>\n<p>The researchers began by scrutinizing brain samples for signs of an abnormal buildup of a protein called tau\u2014a signature of CTE\u2014as well as for damage to the white matter and other brain tissue. All of the samples were pulled from the BU-led <a rel=\"noreferrer noopener\" href=\"https:\/\/www.bu.edu\/cte\/our-research\/brain-bank\/\" target=\"_blank\">UNITE Brain Bank<\/a>, a repository of more than 1,400 brains donated after death for study, which is run in partnership with the US Department of Veterans Affairs and the <a href=\"https:\/\/concussionfoundation.org\/\">Concussion Legacy Foundation<\/a>.<\/p>\n<p>That neuropathologic examination showed that a majority of the athletes with CTE had a mild, early stage of the disease, but a small number\u2014three\u2014had reached the third of its four stages. (Another recent BU CTE Center study also revealed that playing <a href=\"https:\/\/www.bu.edu\/articles\/2023\/study-tackle-football-at-young-age-raises-risk-for-brain-decline-later\/\" target=\"_blank\" rel=\"noreferrer noopener\">tackle football at a young age was tied to brain decline<\/a> in later life.) At the moment, CTE can only be diagnosed after death.<\/p>\n<p>The researchers, who conducted detailed interviews with the donors\u2019 relatives, also determined most of the athletes were suffering from clinical symptoms during their short lives, even if they didn\u2019t have CTE. More than 70 percent of them had apathy and a similar number were depressed, while more than half had difficulty controlling their behavior; many also had issues with substance use.<\/p>\n<p>\u201cThose symptoms might be a result of the head injury itself,\u201d says McKee, a BU Chobanian &amp; Avedisian School of Medicine professor of neurology and pathology, a William Fairfield Warren Distinguished Professor, and a chief of neuropathology at the VA Boston Healthcare System. \u201cThe study suggests that some of the symptoms these young athletes are experiencing are not caused by the early tau pathology of CTE. The head impacts themselves might cause damage to the white matter and vascular injury, a breach of the blood-brain barrier.\u201d<\/p>\n<p>She and her team concluded that even just a couple of more years on the field made a big difference. Those diagnosed with CTE played, on average, for an additional 3.8 years more than those without it.<\/p>\n<p>The study didn\u2019t include samples from young people who played noncontact sports\u2014the UNITE Brain Bank mainly takes donations from those who\u2019d been concerned about their brain health during life. McKee says the number of CTE cases found in young contact sport players compared to the general public is startling.<\/p>\n<p>\u201cThis study clearly shows that the pathology of CTE starts early,\u201d says McKee. \u201cThe fact that over 40 percent of young contact and collision sport athletes in the UNITE Brain Bank have CTE is remarkable\u2014considering that studies of community brain banks show that fewer than 1 percent of the general population has CTE.\u201d<\/p>\n<div class=\"wp-block-bu-pullquote brink-block-bu-pullquote alignwide has-image-focus-center-middle\">\n<div class=\"wp-block-bu-pullquote-inner\">\n<figure><\/figure>\n<blockquote>\n<div class=\"container-lockup\">\n<div class=\"container-icon-outer\">\n<div class=\"container-icon-inner\"><\/div>\n<\/div>\n<div class=\"container-text\">\n<hr \/>\n<h4 class=\"quote-sizing\"><em><strong>This study clearly shows that the pathology of CTE starts early. The fact that over 40 percent of young contact and collision sport athletes in the UNITE Brain Bank have CTE is remarkable\u2014considering that studies of community brain banks show that fewer than 1 percent of the general population has CTE.<\/strong><\/em><\/h4>\n<footer class=\"caption\">Ann McKee<\/footer>\n<hr \/>\n<\/div>\n<\/div>\n<\/blockquote>\n<\/div>\n<\/div>\n<h3>Should Parents Let Their Kids Play Contact Sports?<\/h3>\n<p>McKee recognizes the challenges the new findings will present to parents.<\/p>\n<p>\u201cThe brain is obviously so critical to a child\u2019s productivity and their potential in life,\u201d she says. \u201cWe want our kids to be physically fit, to get the benefits from playing team sports\u2014that\u2019s important for a child\u2019s development. But we don\u2019t want to sacrifice the brain, and I do think the importance of maintaining brain health is gaining traction worldwide.\u201d<\/p>\n<p>McKee is a coauthor of the \u201c<a rel=\"noreferrer noopener\" href=\"https:\/\/concussionfoundation.org\/sites\/default\/files\/2023-06\/CTE%20prevention%20protocol%20062023.pdf\" target=\"_blank\">CTE Prevention Protocol<\/a>,\u201d a joint project between the BU CTE Center and the Concussion Legacy Foundation. It\u2019s a guide to reducing hits to the head\u2014and the force of those blows\u2014in a range of sports. Suggestions include cutting back on drills that involve hits and teaching defensive techniques that help lower the power of tackles and collisions. The protocol also suggests rule changes, like banning fighting in ice hockey, headers after goal kicks in soccer, and home plate collisions in baseball. And, with youth players in mind, another idea is taking head impacts out of the game entirely until a certain age: no headers in soccer, no body checking in ice hockey, no tackling in football. McKee suspects many younger players are open to some of those changes, including at the professional level, even if some fans entrenched with a lifetime of memories aren\u2019t.<\/p>\n<p>\u201cPeople are very attached to these games,\u201d says McKee. \u201cBut they are all just products of our imagination and our wanting to be entertained. The rules aren\u2019t sacred. If we put our heads together, no pun intended, we can come up with an extremely exciting, entertaining game\u2014which is what everybody wants\u2014that doesn\u2019t injure the players in a way they can never recover from.\u201d<\/p>\n<h3>Supporting Youth Athletes\u2019 Mental Health<\/h3>\n<p>Some of the report\u2019s recommended changes are already happening. <a href=\"https:\/\/concussionfoundation.org\/news\/press-release\/new-york-high-school-football-league-bans-kickoffs\" target=\"_blank\" rel=\"noreferrer noopener\">A New York football league has removed kickoffs from high school games<\/a>; the United Kingdom has <a href=\"https:\/\/www.bbc.com\/sport\/football\/62208661\" target=\"_blank\" rel=\"noreferrer noopener\">ditched headers for younger soccer players<\/a>. But McKee says her team\u2019s latest study\u2014which highlighted a pattern of depression and behavior issues\u2014shows youth athletes also need broader support when it comes to their physical and mental health.<\/p>\n<p>For coaches, that means better tracking of how their players are doing, whether that involves monitoring their symptoms or using technology like accelerometers, which measure velocity, in helmets to get data on how many knocks players are taking. \u201cThese suggestions are going to be unpopular,\u201d says McKee, \u201cbecause no one wants to have a medical problem that precludes them from playing, so it\u2019s going to have to be mandated, I think.\u201d But, she says, the only known way to prevent CTE, or at least lower the risk of getting the disease, is to reduce or eliminate repetitive hits to the head.<\/p>\n<p>For everyone involved in the lives of young athletes, she says, it\u2019s also important to recognize when they need more help than a loved one or coach can offer.<\/p>\n<p>\u201cA lot of people with these symptoms feel desperate and they aren\u2019t taken seriously,\u201d she says. \u201cThey feel they need help, but aren\u2019t able to get it for many reasons. A lot of the time, medical care providers just aren\u2019t knowledgeable enough about what might be happening in the brain of a person who\u2019s had a lot of head impacts.<\/p>\n<p>\u201cIf a person is experiencing symptoms, they need to seek help, because it\u2019s highly probable that a lot of these symptoms can be managed.\u201d<\/p>\n<p>This <a href=\"https:\/\/www.bu.edu\/articles\/2023\/young-amateur-athletes-at-risk-of-cte-study-finds\/?utm_campaign=bu_today&amp;amp;utm_source=email_20230829&amp;amp;utm_medium=intrograph&amp;amp;utm_content=research_brain\">Brink<\/a> story was written by Andrew Thurston. Gina DiGravio contributed to the article.<\/p>\n","protected":false},"excerpt":{"rendered":"<p>More than 40 percent of football, soccer, ice hockey, and other contact sport participants under age 30 had signs of the degenerative brain disease, including the first American woman soccer player to be diagnosed.<\/p>\n","protected":false},"author":903,"featured_media":0,"comment_status":"closed","ping_status":"open","sticky":false,"template":"","format":"standard","meta":[],"categories":[91,1],"tags":[],"_links":{"self":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/116016"}],"collection":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts"}],"about":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/types\/post"}],"author":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/users\/903"}],"replies":[{"embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/comments?post=116016"}],"version-history":[{"count":5,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/116016\/revisions"}],"predecessor-version":[{"id":116022,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/posts\/116016\/revisions\/116022"}],"wp:attachment":[{"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/media?parent=116016"}],"wp:term":[{"taxonomy":"category","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/categories?post=116016"},{"taxonomy":"post_tag","embeddable":true,"href":"https:\/\/www.bumc.bu.edu\/camed\/wp-json\/wp\/v2\/tags?post=116016"}],"curies":[{"name":"wp","href":"https:\/\/api.w.org\/{rel}","templated":true}]}}