Combating the CTE Crisis – Scientific Advancements

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As professional and collegiate football programs begin to prepare for bowl games and the playoffs, many of us will watch at least one football game during this holiday season. The high level of physicality inherent in football is easily apparent to viewers while watching this sport. However, most spectators do not realize the repetitive brain traumas many of these athletes endure each game. This type of injury is harder to fully appreciate since the effects are not readily apparent compared to most other injuries, but the long-term consequences can be devastating.

 

The CTE Crisis

The body of research continues to grow regarding the development of a devastating neurological disorder known as chronic traumatic encephalopathy (CTE) in football players, which has caused the national football league to face a major crisis. CTE is characterized by the accumulation of tau proteins in the brain resulting in cognitive impairment, impulsive behavior, depression or apathy, impaired executive function, short-term memory loss, and emotional instability.1One recent study reported finding CTE in 110 of 111 former NFL players included in the study.2These discoveries have influenced some professional players to retire early and file class action lawsuits against the NFL.3The majority of states have even seen a decline in high school football participation between 2011 and 2017.4

A study, published in the journalBrain, concludes that repeated minor traumatic brain injuries cause CTE, not just solely concussions.5Researchers involved in this study highlight that although exposure to high-acceleration forces to the head is a big problem for the National Football League, it is an even larger problem for amateur, young athletes whose brains are still in the process of developing.5,6

 

Improved Helmet Safety

In order to combat this crisis, researchers, manufacturers, and medical professionals are attempting to come up with solutions to essentially make football safer through lessening trauma incurred to the brain. A new helmet made by VICIS has a soft thermoplastic outer shell that compresses similarly to that of a car bumper upon impact. This design serves to decrease and distribute the forces over a larger surface area. On the inside, a specially designed cushioning layer works to further cushion the blows. In order to ensure proper helmet fit, VICIS also now offers helmets in 300 different sizing combinations in place of the small, medium, and large sizing system.3,7

Unfortunately, even though this helmet has been touted as the safest helmet in NFL football,8clinical trials to validate if these new helmets provide significantly improved protection from CTE development have not yet been conducted. The cost of one of these helmets is currently priced at $950, which practically eliminates players outside of professional and collegiate programs from currently being able to afford this equipment.7

 

Vaccine Prevention

        United Neuroscience, a young biotech company, announced in February this year that it was in the process of developing a drug to protect the brain against CTE.9Protecting against a protein that naturally occurs in the brain without neurological pathology, such as Tau, is an especially difficult task to try to accomplish. Getting rid of additional Tau proteins and preventing excessive buildup of these proteins may not actually put a stop to CTE, since the exact etiology remains largely unknown. Nevertheless, as more research on the etiology of CTE is performed to provide scientists with a better understanding on the cause/s of CTE, preventative methods such as this may be a viable option to decrease its incidence.

 

Updating Concussion and Return-to-Play Protocols

        The most practical changes that can currently be implemented to improve the safety of football players include concussion screening education, and multidisciplinary concussion management protocols.10In addition, new NFL rules have been implemented which limit head to head contact in “defenseless” players.11In next week’s blog post I will introduce the most current concussion screening and return-to-play guidelines, along with a brief overview of the supporting research.

 

References:

  1. Mayo Clinic staff. Chronic traumatic encephalopathy. Mayoclinic.org. https://www.mayoclinic.org/diseases-conditions/chronic-traumatic-encephalopathy/symptoms-causes/syc-20370921. Published April 20, 2016. Accessed December 6, 2018.

 

  1. Mez J, Daneshvar DH, Kiernan PT, et al. Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football.JAMA. 2017;318(4):360-370. doi:10.1001/jama.2017.8334

 

  1. Basen, R. Can science solve football’s conBcussion crisis? Nbcnews.com. https://www.nbcnews.com/mach/science/can-science-solve-football-s-concussion-crisis-ncna809771. Updated October 27, 2017. Accessed December 6, 2018.

 

  1. Nuckols, B. Football’s decline has some high schools disbanding teams. Apnews.com. https://apnews.com/66e699491a3b478293620c1e5069dc9e. Published October 6, 2017. Accessed December 6, 2018.

 

  1. Tagge CA, Fisher AM, Minaeva OV, et al. Concussion, microvascular injury, and early tauopathy in young athletes after impact head injury and an impact concussion mouse model. Brain. 2018;141:422-458. doi:10.1093/brain/awx350

 

  1. Boren, C. A new study shows that hits to the head, not concussions, cause CTE.Washingtonpost.com.https://www.washingtonpost.com/news/early-lead/wp/2018/01/18/a-new-study-shows-that-hits-to-the-head-not-concussions-cause-cte/?utm_term=.fc6e460e4cae.Published January 18, 2018. Accessed December 6, 2018.

 

  1. Zero1. Vicis.com. https://vicis.com/products/zero1. Accessed December 6, 2018.

 

  1. Helmet laboratory testing performance results. Playsmartplaysafe.com. https://www.playsmartplaysafe.com/resource/helmet-laboratory-testing-performance-results. Published 2017. Accessed December 7, 2018.

 

  1. United Neuroscience and Boston University Lee Goldstein Laboratory form collaboration to research Tau-targeted therapeutics for treatment and prevention of Chronic Traumatic Encephalopathy (CTE). Prnewswire.com. https://www.prnewswire.com/news-releases/united-neuroscience-and-boston-university-lee-goldstein-laboratory-form-collaboration-to-research-tau-targeted-therapeutics-for-treatment-and-prevention-of-chronic-traumatic-encephalopathy-cte-300629683.html. Published April 16, 2018. Accessed December 7, 2018.

 

  1. Patricios JS, Ardern CL, Hislop MD, et al. Implementation of the 2017 Berlin Concussion in Sport Group Consensus Statement in contact and collision sports: a joint position statement from 11 national and international sports organisations. Br J Sports Med. 2018;52(10):635. doi:10.1136/bjsports-2018-099079

 

  1. New NFL rules designed to limit head injuries. Nfl.com. http://www.nfl.com/news/story/09000d5d81990bdf/article/new-nfl-rules-designed-to-limit-head-injuries. Published August 6, 2010. Accessed December 7, 2018.