One-third of former NFL players in Harvard study believe they have brain damage

By Susan Kreimer
Health News
Sept. 23, 2024 

 It is not unusual for players to land on their heads, like this play in which Los Angeles Chargers safety Derwin James Jr. pulls down Pittsburgh Steelers wide receiver George Pickens after a reception in the first quarter at Acrisure Stadium on Sunday in Pittsburgh. Photo by Archie Carpenter/UPI | License Photo

NEW YORK, Sept. 23 (UPI) -- A Harvard study of almost 2,000 former National Football League players revealed that about one-third believe they have chronic traumatic encephalopathy, a degenerative brain disorder linked to repeated head impacts.

The study, published Monday in JAMA Neurology, draws attention to the injuries transpiring over a livelihood of training and playing on the field. A definitive diagnosis of CTE is possible only by performing an autopsy of the brain after death.

Researchers who surveyed former players found a strong connection between perceived CTE (34%) and mental well-being. One-fourth of the players who believe they have CTE reported experiencing thoughts and behaviors related to committing suicide, compared to only 5% of players who don't think they have CTE.

Knowing the share of retired players with perceived CTE and the associated increase in thoughts of self-harm is a major step in helping them pursue mental health treatment, researchers said.

"Until we have a way to diagnose CTE and treat it, going after conditions that cause cognitive problems that add to their CTE anxieties represents the best way to give these guys hope and more good years," said the study's lead author, Rachel Grashow, director of epidemiological research initiatives at the Football Players Health Study at Harvard University.

"We may be able to reduce the burden of these symptoms and improve the health and outlook of former players," said Grashow, who has a doctorate in computational neuroscience.

Players who thought they had CTE often reported cognitive symptoms, low testosterone, depression, pain and other treatable conditions that can affect thinking, learning and understanding.

"Low testosterone also impacts the brain and could be contributing to their depression and absentmindedness," she said.

The study used electronic and paper surveys to query players who played professionally from 1960 to 2020.

Collected data included demographics and football-related exposures, such as position and career duration. It also listed current health problems, such as anxiety, attention-deficit/hyperactivity disorder, diabetes, headache, high cholesterol, elevated blood pressure, pain and sleep apnea.

"This study is one of the largest surveys attempting to address CTE symptoms in former American-style football players," said Dr. Ray Chu, clinical chief of neurosurgery at Cedars-Sinai Medical Center is Los Angeles. He was not involved in the study.

"It is important to have physicians on the sidelines helping players recognize concussion symptoms and sitting out while they are symptomatic to try and reduce the odds of brain injury," said Chu, a concussion specialist who works with the Los Angeles Rams at home games.

Medical professionals and family members should be aware if a patient or loved one has perceived CTE. "Screening for suicidality and providing mental health resources could be life-saving," said Dr. Chris Miles, a sports medicine specialist at Atrium Health Wake Forest Baptist Medical Center in Winston-Salem, N.C.

However, it's wise to exercise caution in making a diagnosis. Attributing symptoms to CTE may miss other possibly reversible causes, Miles said.

Significant changes have made football safer, especially for high school players and younger athletes. For instance, Chu noted that the kickoff is no longer one of the most dangerous portions of the game, with two teams running at each other head on with significant speed.

"Most games now have changed the kickoff so that is not the case, or even for young players, eliminated the kickoff entirely," he said. "For the NFL this year, there is an alteration in the kickoff such that the teams are standing in place until the receiver catches the ball, which hopefully will decrease the chance of that player being hit at high speeds while relatively unprepared."

It's critical to investigate how frequent suicidality is among former players to implement appropriate screening and treatment, said Jeffrey Schaffert, an assistant professor of psychiatry at UT Southwestern Medical Center in Dallas who has published research evaluating cognitive outcomes in former NFL players.

Social media platforms feature comments from people who attribute depression and suicidal thoughts to playing football or contact sports years ago, Schaffert said.

While they may suffer from a mental health problem rather than an uncurable neurodegenerative disease, he stressed the importance of seeking treatment for depression, irritability, anxiety, suicidality or any related symptoms.