Tackling Brain Injury

With Super Bowl LV being done and dusted, it’s timely to discuss and re-ignite conversation surrounding acquired brain injuries (ABI). Recently, multiple studies have explored the prevalence of this condition using updated diagnostic criteria. Alarmingly, the percentage of players who had experienced lifetime CTE have hovered around 80% across these groups. Especially with Brain Awareness Month on the horizon, it is certainly worthwhile to examine the latest findings in a topic eerily neglected in face of looming repercussions. Even less discussed, are the mental health implications of these injuries. All of these topics are explored in depth, in Willer et al. (2021)’s paper.

A well known fact about Chronic Traumatic Encelopathy, - the brain injury condition commonly seen in football players, is its difficult to diagnose nature. Generally speaking, CTE can only be determined upon death, by autopsy and observation of degenerative brain tissue. However, Willer and colleagues point out a shimmer of hope with the latest advances in imaging studies. PET, an imaging technique used prominently in brain research, stands for Positron Emission Tomography. By using radioactive markers, it is able to highlight areas of interest in the brain. Notably, recent PET studies have started to show viability in detecting indicators of CTE in the brain, opening up potential opportunities to diagnose this disease while an individual is alive.

This promising finding has strong relevance towards clinical practice, aligning well with the current healthcare paradigm shift towards a preventative stance towards disease. Being able to detect CTE would be a critical juncture in providing early and proactive care to increase the chances of survival. Along with these ventures, researchers are also investigating potential behavioural correlates of CTE, again examining other variables to help determine a diagnosis.

While exciting, the discoveries of these imaging studies are only in their infancy and require further work. Hopefully, these studies can continue to demonstrate success, as this would certainly be welcome news to alleviate the growing anxieties that come with playing contact sports such as football.

Interestingly, the authors point out in the literature the current lack of agreement on whether concussions result in impaired future cognition. This mix of evidence could appear to some as questionable, as one may think head injuries would naturally be a risk factor for lowered cognitive capacity in the future. This uncertainty is troubling, as definite evidence is needed to inform policy and prevention strategies to ensure players have a cognitively sound future.

While the neurological effects of CTE are definitely important matters, the mental health aspects are equally deserving of attention. Depression and suicidal ideation are seen in higher numbers in individuals with contact sport backgrounds - especially so when they have experienced head injuries as well. What’s alarming is the undeniable link between repeated injuries and severity of mood disorder.

Pain, as one could imagine, is yet another symptom contact sport players often experience post retirement. Chronic pain has been historically associated with mood disorders, introducing another avenue these individuals’ mental health can be impacted. The chronic nature can greatly wear down one’s confidence and abilities, further deteriorating quality of life.

On the opposite end of the spectrum, the article weighs the psychosocial benefits of playing contact sports, versus abstaining from them to counteract the chances of ABI. It appeared that the mental health benefits of participating in these sports outweigh the chances of brain degeneration in the long term. Thus, it is important to continue acknowledging these benefits and advocating for safer precautions and protocols in light of sustaining mental health. This movement will certainly be appreciated by the fans and provide a sense of relief, as they understand the risks these players endure for the sake of their entertainment.

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Source:

• Willer, B. S., Haider, M. N., Wilber, C., Esopenko, C., Turner, M., & Leddy, J. (2021). Long-Term Neurocognitive, Mental Health Consequences of Contact Sports. Clinics in Sports Medicine, 40(1), 173-186.