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 The young man had what’s known as chronic traumatic encephalopathy (CTE),
a traumatic brain disorder that can only be diagnosed during an
autopsy. He died of cardiac arrest related to an infection in his
heart, but the autopsy showed signs of brain damage consistent with
CTE, researchers report in JAMA Neurology.
“There is a common perception that CTE affects only professional
athletes; this case as well as many others shows us that contact
sports athletes at the amateur level are also at risk for the
disease,” lead study author Dr. Ann McKee of Boston University said
by email.
While this isn’t the first former football player to be diagnosed
with CTE after years playing contact sports, this particular athlete
had a series of psychological and cognitive tests before his death
that offer some insight into how symptoms of CTE might develop,
McKee and colleagues note in their report.
The athlete started playing American football at age six and
continued for 16 years; he played Division I college football as a
defensive linebacker and special teams player.
He suffered more than 10 concussions, all while playing football,
the first occurring at age eight. None resulted in hospitalization.
During his freshman year of college, he had a concussion with
momentary loss of consciousness followed by ongoing headaches, neck
pain, blurry vision, tinnitus, insomnia, anxiety, and difficulty
with concentration. Symptoms persisted, and he stopped playing
football at the beginning of his junior year.
His grades plummeted and he left school, as he continued to
experience symptoms ranging from loss of appetite to thoughts of
suicide, the researchers report.
At age 24, neurological tests found he had memory and recall
problems, speech and language impairment and difficulties
remembering and reproducing line drawings.
After his death, researchers examined his medical records and his
donated brain and agreed he had post-concussive syndrome with
possible CTE and major depression.
While more research is needed before drawing widespread conclusions,
the researchers conclude that CTE should possibly be considered in
young athletes who have repeated head trauma as well as persistent
mood and behavioral symptoms.
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Still, this athlete’s case history and profile didn’t neatly
distinguish CTE from post-concussion syndrome or depression, Dr.
James Noble of Columbia University Medical Center noted in an
accompanying editorial.
“The relevance of this case is that it underscores how our
conventional means of approaching a diagnosis in practice, including
history, exam and neuropsychological testing and MRI – all of which
were done for this patient – are insufficient to distinguish CTE
from other disorders,” Noble said by email.
A better system of tracking concussions, that goes beyond the
current practice of noting the injury rate based on the total hours
on the field, might ultimately improve our understanding of CTE,
Noble added. Because many injuries don’t result in concussions, it
might be useful to track what happens when athletes suffer hits to
the head, he said.
“Aside from a summary of hits, other factors including time between
hits, intensity or other hit qualities may refine our concern, but
other as yet unmeasured factors could be equally or more important
in establishing concussion diagnoses more accurately,” Noble said.
SOURCE: http://bit.ly/1O0JZTh JAMA Neurology, published online
January 4, 2016.
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