Concussion in sport: CTE found in more than half of athletes who donated brains | Concussion in sport

Groundbreaking research into the long-term ramifications of concussions in sport has revealed chronic traumatic encephalopathy in the brains of more than half of a cohort of donors, including three under 35.

The Australian Sports Brain Bank reported on Monday its preliminary findings after examining the 21 brains posthumously donated by sportspeople since the center was established in 2018.

Of these – all of whom had played sports with risks of repetitive head injury, including 17 in football codes – 12 donors had CTE lesions, while all but one had some form of neurodegeneration.

CTE, which can only be definitively diagnosed at autopsy, is a neurodegenerative condition linked to repeated head trauma. Lifetime symptoms include cognitive impairment, impulsive behaviors, depression, suicidal thoughts, short-term memory loss, and emotional lability.

Among the group with CTE are the previously reported cases of top Australian footballers Danny Frawley, Shane Tuck and Polly Farmer, as well as two unnamed former professional rugby league players. Frawley and Tuck committed suicide, while Farmer suffered from Alzheimer’s disease – another illness linked to head injuries.

But additional findings made by Associate Professor Michael Buckland, a neuropathologist at the Royal Prince Alfred Hospital and the University of Sydney, and his brain bank colleagues, underscored the prevalence and severity of traumatic brain injury in all age groups and collision levels. sport.

“CTE has been identified in the brains of older former professionals with long playing careers, but also in younger, non-professional athletes and in recent professionals who had played under modern concussion guidelines,” they said. writes Buckland and his fellow researchers in the article published by the Medical Journal. from Australia.

“Three donors with CTE were under 35 years old. Six of 12 donors with CTE and one of nine without CTE had died by suicide, suggesting that CTE may be a risk factor for suicide.

“Screening for CTE in all suicide deaths is probably not practical, but our results suggest it should be undertaken if a history of repetitive head trauma is known or suspected.”

Clinical Associate Professor Michael Buckland.
Associate Professor Michael Buckland, neuropathologist at the Royal Prince Alfred Hospital and the University of Sydney. Photography: Joel Carrett/AAP

The conversation around the link between concussions – and subclinical concussions – and irreversible brain damage has engulfed collision-based sports globally.

In Australia, class action lawsuits against the governing bodies of the Football Codes in particular are attracting more and more current and former players, increasing the pressure on sporting institutions to act in a manner proportionate to this ongoing epidemic.

The least commonly reported victims are amateur athletes, who this research concluded are no less at risk than their professional counterparts.

The researchers acknowledged that “bias in determining abnormal neuropathology was inevitable,” given that brain donations were driven either by clinical diagnoses or concerns of family members.

But they also said it was “remarkable that CTE was found in more than half of these cases”.

“Furthermore,” they wrote, “in half of donor brains with CTE, it was the only neurodegenerative pathology… our findings should encourage clinicians and policy makers to develop measures that further mitigate risk of sport-related repetitive head injury”.

Since 2018, the brain has received more than 600 pledges from amateur and professional athletes.