Home » Head Trauma Strongly Linked To Chronic Traumatic Encephalopathy But Precise Relationship Not Yet Known
  • user warning: Can't find record in 'cache_filter' query: SELECT data, created, headers, expire FROM cache_filter WHERE cid = '3:3771bee03ba71c26d2c0538deecdb8c8' in /home/momsteam/public_html/includes/database.mysql.inc on line 174.
  • user warning: Can't find record in 'cache_filter' query: UPDATE cache_filter SET data = '<!--paging_filter-->\n<h2>Causal link likely exists, just not yet proven </h2>\n<p>\nIt is important to emphasize that such researchers are <i><b>not</b></i> saying that such a causal link won\'t ever be established. As Gardner admits,  &quot;Ultimately, scientific research might establish that participation in contact sports leads to a distinct neuropathological syndrome, and this neuropathology causes psychiatric, cognitive and physical problems.&quot;<sup><b>[19]</b></sup>   \n</p>\n<p>\nIndeed, the authors of one recent paper<sup><b>[40]</b></sup> acknowledge that &quot;it simply makes good clinical sense to continue practices to minimize the number of concussions sustained and that allow for adequate recovery after any concussion&quot; while awaiting the results of such studies. The authors of the 2015 <i>BJSM</i> editorial on CTE<sup><b>[67]</b></sup> take the same view: &quot;Despite uncertainties, strategies to reduce the number of concussive and subconcussive head impacts in American football [and in other sports, presumably, such as soccer, lacrosse, and hockey] should be a top priority.&quot;\n</p>\n<p>\nAt the same time, however, they say it is &quot;essential to avoid embracing preliminary results derived from relatively small case numbers and methodologically problematic studies as undisputed medical fact, and to allow such results to redirect clinical practice away from established standards.&quot;\n</p>\n<p>\nA concerted effort is thus needed, they say, to educate medical professionals and the public at large regarding the state of the science of mTBI and CTE in order to avoid &quot;catastrophizing&quot; mTBI, to mitigate the &quot;collective anxiety&quot; that has resulted, and to reduce the likelihood that outcomes after mTBI will be actually be made worse as a result of the media frenzy around CTE.\n</p>\n<hr />\n<p>\n<span style=\"line-height: 1.6em\">Sources: </span>\n</p>\n<p>\nMcKee A, Cantu R, <i>et. al.</i> Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy After Repetitive Head Injury. <i>J Neuro Exp. Neurol  </i>2009; 68(7): 709-735\n</p>\n<p>\nGavett B, Stern R, Cantu R, Nowinski C, McKee A. Mild traumatic brain injury: a risk factor for neurodegeneration.  <i>Alzheimer\'s Research &amp; Therapy </i>2010; 2:18\n</p>\n<p>\nGaletta KM, Barret J, Allen M, <i>et. al.</i> &quot;The King-Devick test as a determinant of head trauma and concussion in boxers and MMA fighters.&quot; <i>Neurology</i> 2011; Prepublished online February 2, 2011. \n</p>\n<p>\nDaneshvar DH, Baugh CM, <i>et. al.</i> Helmets and Mouth Guards: The Role of Personal Equipment in Preventing Sports-Related Concussion.  <i>Clin Sports Med</i> 2011;30:145-163. \n</p>\n<p>\nFootnotes:<span style=\"line-height: 1.6em\"> </span>\n</p>\n<p>\n1.  Lincoln A, Caswell S, Almquist J, Dunn R, Norris J, Hinton R. Trends in Concussion Incidence in High School Sports: A Prospective 11-Year Study. <i>Am J Sports Med </i>2011;30(10) accessed January 31, 2011 @ <a href=\"http://ajs.sagepub.com/content/early/2011/01/29/0363546510392326.full.pdf+html\" title=\"http://ajs.sagepub.com/content/early/2011/01/29/0363546510392326.full.pdf+html\">http://ajs.sagepub.com/content/early/2011/01/29/0363546510392326.full.pd...</a>\n</p>\n<p>\n2. <span style=\"line-height: 1.6em\"></span><span style=\"line-height: 1.6em\">Schatz P, Moser RS, Covassin T, Karpf.  Early Indicators of Enduring Symptoms in High School Athletes with Multiple Previous Concussions. </span><span style=\"line-height: 1.6em\"> </span><i style=\"line-height: 1.6em\">Neurosurgery (</i><span style=\"line-height: 1.6em\">accepted for publication); 2011 at n. 3-5.</span>\n</p>\n<p>\n<span style=\"line-height: 1.6em\">3. Stern R, Riley D, Daneshvar D, Nowinski C, Cantu R, McKee A. Long-term Consequences of Repetitive Brain Trauma: Chronic Traumatic Encephalopathy. </span><span style=\"line-height: 1.6em\"> </span><i style=\"line-height: 1.6em\">Phys Med &amp; Rehab</i><span style=\"line-height: 1.6em\">. 2011;3;S460-S467. DOI:10.1016/j.pmrj.2011.08.008.</span> \n</p>\n<p>\n4. <span style=\"line-height: 1.6em\">Boston University Center for Alzheimer\'s Research. Selected CSTE Cases: Eighteen year old high school football player. 2010; </span><a href=\"http://www.bu.edu/cste/case-studies/18-year-old/\" style=\"line-height: 1.6em\">http://www.bu.edu/cste/case-studies/18-year-old/</a><span style=\"line-height: 1.6em\"> </span><span style=\"line-height: 1.6em\">(Accessed March 2, 2011).</span><span style=\"line-height: 1.6em\"> </span>\n</p>\n<p>\n<span style=\"line-height: 1.6em\"></span><span style=\"line-height: 1.6em\">5. Talavage T, Nauman E, Breedlove E, et. al. Functionally-Detected Cognitive Impairment in High School Football Players Without Clinically-Diagnosed Concussion. J Neurotrauma. 2010; DOI: 10.1089/neu.2010.1512.</span>\n</p>\n<p>\n<span style=\"line-height: 1.6em\">6. Crisco JJ, Fiore R, Beckwith JG, <i>et al.</i> Frequency and location of head impact exposures in individual collegiate football players.  </span><i style=\"line-height: 1.6em\">J. Athl Train</i><span style=\"line-height: 1.6em\"> 2010;45:549-559.</span>\n</p>\n<p>\n7. Field M, Collins MW, Lovell MR, Maroon J. Does age play a role in recovery from sports related concussion? A comparison of high school and collegiate athletes.  <i>J Pediatr.</i> 2003;414:546-553.\n</p>\n<p>\n8. Pullela R, Raber J, Pfankuch T.<i> et al. </i>Traumatic injury to the immature brain results in progressive neuronal loss, hyperactivity and delayed cognitive impairments.  <i>Dev Neurosci</i> 2006;28:396-409. \n</p>\n<p>\n9. Kirkwood MW, Randolph C, Yeates KO. Sport-Related Concussion: A Call for Evidence and Perspective Amidst the Alarms.  <i>Clin J Sport Med</i> 2012;22(5):383-384.\n</p>\n<p>\n10. Zuckerman SL, Solomon GS, Forbes JA, Haase RF, Sills AK, Lovell MR.  Response to acute concussive injury in soccer players: is gender a modifying factor?  <i>J Neurosurg: Pediatrics</i> 2012; DOI:10.3171/2012.8.PEDS12139 (published online ahead of print October 2, 2012)(accessed October 15, 2012). \n</p>\n<p>\n11. Bazarian JJ, Zhu T, Blyth B, Borrino A, Zhong J.  Subject-specific changes in brain white matter in diffusion tensor imaging after sports-related concussion.  <i>Magnetic Resources Imaging</i>. 2012; 30(2): 171-180.\n</p>\n<p>\n12. March N, Bazarian JJ, Puvenna V, Janigro M, Ghosh C, <i>et. al. </i>Consequences of Repeated Blood-Brain Barrier Disruption in Football Players. <i>PLoS ONE</i> 2013;8(3): e56805. doi: 10.1371/journal.pone.0056805. \n</p>\n<p>\n13. McCrory P, <i>et al.</i> Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. <i>Br J Sports Med</i> 2013;47:250-258. \n</p>\n<p>\n14. McKee A, <i>et al.</i> The spectrum of disease in chronic traumatic encephalopathy. <i>Brain</i> 2012; doi:10.1093/brain/aws307 (published online ahead of print December 2, 2012)(accessed March 20, 2013). \n</p>\n<p>\n15. D\'Alessandro D, &quot;Scientists claim that link between concussions and CTE is &quot;unproven&quot; could impact NFL lawsuits.&quot; NewJersey.com (March 17, 2013)http://www.nj.com/ledger-dalessandro/index.ssf/2013/03/scientists_claim_that_link_between_concussions_and_cte_is_unproven_could_impact_nfl_lawsuits.html (accessed March 20, 2013).\n</p>\n<p>\n16. <span style=\"line-height: 1.6em\">Broglio SP, Martini D, Kasper L, Eckner JT, Kutcher JS.  Estimation of Head Impact Exposure in High School Football: Implications for Regulating Contact Practices. </span><span style=\"line-height: 1.6em\"> </span><i style=\"line-height: 1.6em\">Am J Sports Med</i><span style=\"line-height: 1.6em\"> </span><span style=\"line-height: 1.6em\">2013;20(10). DOI:10.1177/036354651302458 (epub September 3, 2013).</span>\n</p>\n<p>\n17. &quot;League of Denial&quot; Wrap Up and Reax, <a href=\"http://theconcussionblog.com/2013/10/09/league-of-denial-wrap-up-and-reax/\" title=\"http://theconcussionblog.com/2013/10/09/league-of-denial-wrap-up-and-reax/\">http://theconcussionblog.com/2013/10/09/league-of-denial-wrap-up-and-rea...</a> (accessed October 9, 2013).\n</p>\n<p>\n19. Gardner A, Iverson G, McCrory P. Chronic traumatic encephalopathy in sport: a systematic review. <i>Br J Sports Med. </i>Published Online First: June 26, 2013. doi: 10.1136/bjsports-2013-092646. \n</p>\n<p>\n20. Jordan BD. The clinical spectrum of sport-related traumatic brain injury.  <i>Nat Rev Neurol</i> 2013;9:227-30.\n</p>\n<p>\n21. McKee AC, Stein TD, Nowinski CJ, <i>et al</i>. The spectrum of disease in chronic traumatic encephalopathy. <i>Brain</i>. 2013;136:43-64. \n</p>\n<p>\n22. McCrory P, Meeuwisse WH, Kutcher JS, Jordan BD, Gardner A.  What is the evidence for chronic concussion-related changes in retired athletes: behavioral, pathological and clinical outcomes? <i>Br J Sports Med</i> 2013;47:327-330. \n</p>\n<p>\n23. Giza CC, Kutcher JS, Ashwal S, <i>et al</i>. Summary of evidence-based guideline update: Evaluation and management of concussion in sports: Report of the Guideline Development Subcommittee of the American Academy of Neurology. <i>Neurology</i> 2013 (epub before print Marchf 18, 2013); doi:10.1212/WNL.0b013e31828d57dd. \n</p>\n<p>\n24. <span style=\"line-height: 1.6em\">Baillargeon A, Lassonde M, Leclerc S, Ellemberg D. Neuropsychological and neurophysiological assessment of sport concussion in children, adolescents and adults.</span><span style=\"line-height: 1.6em\"> </span><i style=\"line-height: 1.6em\">Brain Injury</i><span style=\"line-height: 1.6em\"> </span><span style=\"line-height: 1.6em\">2012;26(3):211-220.</span><span style=\"line-height: 1.6em\"> </span>\n</p>\n<p>\n<span style=\"line-height: 1.6em\">25. Howell D, Osternig L, Van Donkelaar P, Mayer U, Chou L.  Effects of Concussion on Attention and Executive Function in Adolescents.  </span><i style=\"line-height: 1.6em\">Med Sci Sports Exer.</i><span style=\"line-height: 1.6em\"> 2013;45(6):1023-1029.</span>\n</p>\n<p>\n<span style=\"line-height: 1.6em\"></span>26. Randolph C, Karantzoulis S, Guskiewicz K. Prevalence and Characterization of Mild Cognitive Impairment of Retired National Football League Players. <i>J Int\'l Neuropschol Soc.</i> 2013;19:1-8.  \n</p>\n<p>\n27. Broglio SP, Eckner JT, Paulson HL, Kutcher JS. Cognitive Decline and Aging: The Role of Concussive and Subconcussive Impacts. <i>Exer. &amp; Sports Sci Rev.</i> 2012;40(3):138-144.\n</p>\n<p>\n28. Loyola University Health System, News Release, &quot;Study Casts Doubt on Theory that Retired NFL Players Suffer Unique Cognitive Disorder.&quot; August 8, 2013 (accessed October 14, 2013 at <a href=\"http://www.newswise.com/articles/study-casts-doubt-on-theory-that-retired-nfl-players-suffer-unique-cognitive-disorder\" title=\"http://www.newswise.com/articles/study-casts-doubt-on-theory-that-retired-nfl-players-suffer-unique-cognitive-disorder\">http://www.newswise.com/articles/study-casts-doubt-on-theory-that-retire...</a>) \n</p>\n<p>\n29. Shakespeare\'s Hamlet, act III, scene II (accessed October 14, 2013 at  http://en.wikipedia.org/wiki/The_lady_doth_protest_too_much,_methinks) \n</p>\n<p>\n30. Randolph C, Kirkwood, M.W. What are the real risks of sport-related concussion, and are they modifiable? <i>Journal of the<br />\nInternational Neuropsychological Society</i>. <span style=\"line-height: 1.6em\">2009;</span><span style=\"line-height: 1.6em\">15:512-520. </span>\n</p>\n<p>\n31. David Epstein. The Damage Done: While Concussive Hits Dominate the Debate, A Groundbreaking New Study Suggests That Minor Blows - And There Can Be Hundreds Each Game - Are Just As Traumatic. <i>Sports Illustrated</i>. November 1, 2010 (accessed October 14, 2013 at http://sportsillustrated.cnn.com/vault/article/magazine/MAG1176377/2/). \n</p>\n<p>\n32.  \n<a href=\"http://regressing.deadspin.com/the-hidden-victims-of-the-nfls-concussion-crisis-1443101890/@kylenw?utm_campaign=socialflow_deadspin_twitter&amp;utm_source=deadspin_twitter&amp;utm_medium=socialflow\" title=\"http://regressing.deadspin.com/the-hidden-victims-of-the-nfls-concussion-crisis-1443101890/@kylenw?utm_campaign=socialflow_deadspin_twitter&amp;utm_source=deadspin_twitter&amp;utm_medium=socialflow\">http://regressing.deadspin.com/the-hidden-victims-of-the-nfls-concussion...</a>\n</p>\n<p>\n33. Savica R, Parisi JE, Wold LE, Josephs KA, Ahlskog JE.  High School Football and Risk of Neurodegeneration: A Community-Based Study.  <i>Mayo Clin Proc</i> 2012;87(14):335-340. \n</p>\n<p>\n34. Shaunacy Ferro, &quot;Does CTE, The Brain Disease Found In NFL Players, Really Exist?&quot;; <a href=\"http://www.popsci.com/science/article/2013-08/does-cte-brain-disease-found-nfl-players-really-exist\">http://www.popsci.com/science/article/2013-08/does-cte-brain-disease-found-nfl-players-really-exist</a> (accessed October 19, 2013) \n</p>\n<p>\n35. Science Daily. &quot;Study Casts Doubt On Theory That Retired NFL Players Suffer Unique Cognitive Disorder&quot; (<a href=\"http://www.sciencedaily.com/releases/2013/08/130807204631.htm\">http://www.sciencedaily.com/releases/2013/08/130807204631.htm</a> (accessed October 19, 2013)\n</p>\n<p>\n36. Megan Brooks, Medscape.com. &quot;Study Casts Doubt on CTE in Retired NFL Players&quot; <a href=\"http://www.medscape.com/viewarticle/809542\" title=\"http://www.medscape.com/viewarticle/809542\">http://www.medscape.com/viewarticle/809542</a> (October 19, 2013)\n</p>\n<p>\n37. Study: NFL Players Are Not at Risk of CTE; <a href=\"http://concussionpolicyandthelaw.com/tag/cte/\" title=\"http://concussionpolicyandthelaw.com/tag/cte/\">http://concussionpolicyandthelaw.com/tag/cte/</a> (accessed October 19, 2013)\n</p>\n<p>\n38. Jordan BD, <i>et al</i>.<i> </i>Head trauma and participation in contact sports as risk factors for Alzheimer\'s disease. <i>Neurology</i> 1990;40:347.\n</p>\n<p>\n39. <span style=\"line-height: 1.6em\">Iverson GL. Chronic traumatic encephalopathy and risk of suicide in former athletes. Br J Sports Med. 2013; doi:10.1136/bjsports-2013-092935 (epub October 31, 2013).</span>\n</p>\n<p>\n40. Wortzel HS, Brenner LA, Arciniegas DB.  Traumatic Brain Injury and Chronic Traumatic Encephalopathy: A Forensic Neuropsychiatric Perspective.  <i>Behav. Sci. Law;</i> 2013; doi:10.1002/bsl.2079 (epub on line).\n</p>\n<p>\n41. Karantzoulis S, Randolph C. Modern Chronic Encephalopathy in Retired Athletes: What is the Evidence?  <i>Neuropyschol Rev</i> 2013; doi:10.1007/s11065-013-9243-4 (epub November 22, 2013)\n</p>\n<p>\n<span style=\"line-height: 1.6em\">42 Tator CH. Chronic traumatic encephalopathy: How serious a sports problem is it?  </span><i style=\"line-height: 1.6em\">Br J Sports Med.</i><span style=\"line-height: 1.6em\"> 2013; doi:10.1136/bjsports-2013-093040 (epub November 22, 2013). </span> \n</p>\n<p>\n43. McAllister TW, Ford JC, Flashman LA, et al. Effect of head impacts on diffusivity measures in a cohort of collegiate contact sport athletes. <i>Neurology</i> 2013; doi:10.1212/01.wnl.000438220.16190.  \n</p>\n<p>\n44. Robert Cantu and Mark Hyman, <i>Concussions and Our Kids: America\'s Leading Expert on How to Protect Young Athletes and Keep Sports Safe</i> (Boston: Houghton Mifflin Harcourt, 2012), p. 103. \n</p>\n<p>\n45. Davenport EM, Whitlow CT, Urban JE, <i>et. al.</i> Abnormal White Matter Integrity Related To Head Impact Exposure in a Season of High School Varsity Football. <i>J Neurotrauma</i> 2014;31:1617-1624. \n</p>\n<p>\n46. Breedlove EL, Robinson M, Talavage TM, et al. Biomechanical correlates of symptomatic and asymptomatic neurophysiological impairment in high school football. <i>J Biomech.</i> 2012;45(7):1265-1272. \n</p>\n<p>\n47.March N, Bazarian JJ, Puvenna V, Janigro M, Ghosh C, et. al. Consequences of Repeated Blood-Brain Barrier Disruption in Football Players. <i>PLoS ONE</i> 2013;8(3): e56805. doi: 10.1371/journal.pone.0056805.\n</p>\n<p>\n<span style=\"line-height: 1.6em\">48. McAllister TW, Ford JC, Flashman LA, et al. Effect of head impacts on diffusivity measures in a cohort of collegiate contact sport athletes. <i>Neurology</i> 2013; doi:10.1212/01.wnl.000438220.16190.</span>\n</p>\n<p>\n<span style=\"line-height: 1.6em\"></span><span style=\"line-height: 1.6em\">49. </span><span style=\"line-height: 1.6em\">McAllister TW, Flashman LA, Maerlender A, Greenwald RM, Beckwith JG, et al. Cognitive effects of one season of head impacts in a cohort of collegiate contact sports athletes. <i>Neurology</i> 2012;78:1777-1784.</span>\n</p>\n<p>\n<span style=\"line-height: 1.6em\"></span><span style=\"line-height: 1.6em\">50. Koerte IK, E Hartl, Bouix S, Pasternak O, Kubicki M, Rausher A, Li D, <i>et al.</i> A prospective study of physician-observed concussion during a varsity university hockey season: white matter integrity in ice hockey players. Part 3 of 4. <i>Neurosurgical Focus</i>. 2012;33:E3.</span>\n</p>\n<p>\n<span style=\"line-height: 1.6em\"></span><span style=\"line-height: 1.6em\">51. Davenport EM, Whitlow CT, Urban JE, et. al. Abnormal White Matter Integrity Related To Head Impact Exposure in a Season of High School Varsity Football. <i>J Neurotrauma</i> 2014;31:1617-1624.</span>\n</p>\n<p>\n<span style=\"line-height: 1.6em\"></span><span style=\"line-height: 1.6em\">52. Bahrami N, Davenport E, Whitlow CT, et. al. Head Impacts and White Matter Changes in High School Football: A TBSS Analysis. (research paper). <i>Radiological Society of America</i>. December 1, 2014.</span>\n</p>\n<p>\n<span style=\"line-height: 1.6em\"></span><span style=\"line-height: 1.6em\">53. Reynolds BB, Patrie J, Henry EJ, Goodkin HP, Broshek DK, Wintermark M, Druzgal TJ. Practice type effects on head impact in collegiate football. <i>J. Neurosurg. </i>Published online August 4, 2015; DOI:10.3171/2015.5.JNS15573.</span>\n</p>\n<p>\n<span style=\"line-height: 1.6em\"></span><span style=\"line-height: 1.6em\">54. \'Deviant brain metabolism\' found in high school football players. Purdue University News. August 19, 2015. (accessed at <a href=\"http://www.purdue.edu/newsroom/releases/2015/Q3/deviant-brain-metabolism\" title=\"http://www.purdue.edu/newsroom/releases/2015/Q3/deviant-brain-metabolism\">http://www.purdue.edu/newsroom/releases/2015/Q3/deviant-brain-metabolism</a>...)</span>\n</p>\n</span>\n<p>\n55. Breedlove KM, Breedlove EL, Robinson M, Poole VN, King JR, Rosenberger P, Nauman EA. Detecting neurocognitive &amp; neurophysiological changes as a result of subconcussive blows in high school football athletes. <i>Ath. Tr. &amp; Sports Health Care</i>. 2014;6(3):119-127.\n</p>\n<p>\n56. Poole VN, Breedlove EL, Shenk TE, Abbas K, Robinson ME, Leverenz LJ, Nauman EA, Dydek U, Talavage TM. Sub-concussive HIt Characteristics Predict Deviant Brain Metabolism in Football Athletes. <i>Developmental Neuropsychology</i> 2015;40(1):12-17, DOI:10.1080/87565641.2014.984810.\n</p>\n<p>\n57. Nauman EA, Breedlove KM, Breedlove EL, Talavage TM, Robinson ME, Leverenz LJ. Post-Season Neurophysiological Deficits Assessed By ImPACT and fMRI in Athletes Competing in American Football. <i>Developmental Neuropsychology</i>. 2015;40(2):85-91. doi:10.1080/87565641.2015.1016161.\n</p>\n<p>\n58.<span style=\"line-height: 1.6em\">Robinson ME, Shenk TE, Breedlove EL, Leverenz LJ, Nauman EA, Talavage TM. The Role of Location of Subconcussive Head Impacts in fMRI Brain Activation Change. <i>Developmental Neuropsychology </i>2015;40(2): 74-79. doi:10.1080/87565641.2015.101224.</span>\n</p>\n<p>\n<span style=\"line-height: 1.6em\"></span><span style=\"line-height: 1.6em\">59. Shenk TE, Robinson ME, Svaldi DO, Abbas K, Breedlove KM, Leverenz LJ, Nauman EA, Talavage TM. fMRI of Visual Working Memory in High School Football Players. Developmental Neuropsychology 2015;40(2):63-68. doi:10.1080/87565641.2015.1014088.</span>\n</p>\n<p>\n60. Svaldi DO, Joshi C, Robinson ME, Shenk TE, Abbas K, Nauman EA, Leverenz LJ, Talavage TM. Cerebrovascular Reactivity Alterations in Asymptomatic High School Football Players. <i>Developmental Neuropsychology</i> 2015;40(2):80-84. doi:10.1080/87565641.2014.973959.\n</p>\n<p>\n61. Abbas K, Shenk TE, Poole VN, Robinson ME, Leverenz LJ, Nauman EA, Talavage TM. Effects of Repetitive Sub-Concussive Brain Injury on the Functional Connectivity of Default Mode Network in High School Football Athletes. <i>Developmental Neuropsychology</i> 2015;40(1):51-56. doi:10.1080/875665641.2014.990455. \n</p>\n<p>\n62. Chun IY, Mao X, Breedlove EL, Leverenz LJ, Nauman EA, Talavage TM. Detection of Longitudinal WM Abnormalities Due to Accumulated Head Impacts.<i> Developmental Neuropsychology</i> 2015;40(2):92-97. doi: 10.1080/87566541/2015.1020945. \n</p>\n<p>\n63.  Reynolds BB, Patrie J, Henry EJ, Goodkin HP, Broshek DK, Wintermark M, Druzgal TJ. Practice type effects on head impact in collegiate football. <i style=\"line-height: 19.2px\">J Neurosurg. </i><span style=\"line-height: 1.6em\">Published online August 4, 2015; DOI:10.3171/2015.5.JNS15573.</span>\n</p>\n<p>\n64. Bazarian JJ, Zhu T, Zhong J, et al. Persistent, Long-term Cerebral White Matter Changes after Sports-Related Repetitive Head Impacts. <i>PLOS ONE</i>. 2014;9(4):e94734. \n</p>\n<p>\n65. Stamm JM, Bourlas AM, Baugh CM, Fritts NG. Daneshvar D, Martin BM, McLean MD, Tripodis Y, Stern RA. Age of First Exposure to Football and Later-Life Cognitive Impairment in Former NFL Players. <i>Neurology. </i>published online before print January 28, 2015, doi: http:/​/​dx.​doi.​org/​10.​1212/​WNL.\n</p>\n<p>\n66. Stamm JM, Koerte IK, Muehlman M, <i>et al. </i>Age of First Exposure to Football is Associated with Altered Corpus Callosum White Matter Microstructure in Former Professional Football Players. <i>J Neurotrauma</i>. published online ahead of print, July 22, 2015; doi:10.1089/neu.2014.3822.\n</p>\n<p>\n67.Asplund CA, Best TM. Brain damage in American Football Inevitable consequence or avoidable risk? <i>Br J Sports Med</i> 2015;49:1015-1016.  \n</p>\n<p>\n68. Maroon JC, Winkleman R, Bost J, <i>et al. </i>Chronic traumatic encephalopathy in sports; a systematic review of all reported pathalogical cases.  <i>PLoS</i> <i>One</i> 2015;10:e1117338. \n</p>\n<p>\n69. Report from the First NIH Consensus Conference to Define the Neuopathological Criteria for the Diagnosis of Chronic Traumatic Encephalopathy.(<a href=\"http://www.ninds.nih.gov/research/tbi/ReportFirstNIHConsensusConference.htmhttp://www.ninds.nih.gov/research/tbi/ReportFirstNIHConsensusConference.htm\" title=\"http://www.ninds.nih.gov/research/tbi/ReportFirstNIHConsensusConference.htmhttp://www.ninds.nih.gov/research/tbi/ReportFirstNIHConsensusConference.htm\">http://www.ninds.nih.gov/research/tbi/ReportFirstNIHConsensusConference....</a>)\n</p>\n<p>\n70. &quot;Football and the Brain&quot; CBS News, <i>Sixty Minutes</i>. November 15, 2015 (last accessed November 16, 2015 at <a href=\"http://www.cbsnews.com/news/football-and-the-brain-nfl-60-minutes/\" title=\"http://www.cbsnews.com/news/football-and-the-brain-nfl-60-minutes/\">http://www.cbsnews.com/news/football-and-the-brain-nfl-60-minutes/</a>\n</p>\n<p>\n<i>Originally posted February 8, 2011 Last updated November 16, 2015</i>\n</p>\n<p>\n&nbsp;\n</p>\n<p>\n&nbsp;\n</p>\n<p>\n&nbsp;\n</p>\n', created = 1566449860, expire = 1566536260, headers = '' WHERE cid = '3:3771bee03ba71c26d2c0538deecdb8c8' in /home/momsteam/public_html/includes/database.mysql.inc on line 174.

Head Trauma Strongly Linked To Chronic Traumatic Encephalopathy But Precise Relationship Not Yet Known

Other risk factors for CTE, incidence rate not yet known; connection has been "greatly overstated" says Cantu

Causal link likely exists, just not yet proven 

It is important to emphasize that such researchers are not saying that such a causal link won't ever be established. As Gardner admits,  "Ultimately, scientific research might establish that participation in contact sports leads to a distinct neuropathological syndrome, and this neuropathology causes psychiatric, cognitive and physical problems."[19]   

Indeed, the authors of one recent paper[40] acknowledge that "it simply makes good clinical sense to continue practices to minimize the number of concussions sustained and that allow for adequate recovery after any concussion" while awaiting the results of such studies. The authors of the 2015 BJSM editorial on CTE[67] take the same view: "Despite uncertainties, strategies to reduce the number of concussive and subconcussive head impacts in American football [and in other sports, presumably, such as soccer, lacrosse, and hockey] should be a top priority."

At the same time, however, they say it is "essential to avoid embracing preliminary results derived from relatively small case numbers and methodologically problematic studies as undisputed medical fact, and to allow such results to redirect clinical practice away from established standards."

A concerted effort is thus needed, they say, to educate medical professionals and the public at large regarding the state of the science of mTBI and CTE in order to avoid "catastrophizing" mTBI, to mitigate the "collective anxiety" that has resulted, and to reduce the likelihood that outcomes after mTBI will be actually be made worse as a result of the media frenzy around CTE.


Sources: 

McKee A, Cantu R, et. al. Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy After Repetitive Head Injury. J Neuro Exp. Neurol  2009; 68(7): 709-735

Gavett B, Stern R, Cantu R, Nowinski C, McKee A. Mild traumatic brain injury: a risk factor for neurodegeneration.  Alzheimer's Research & Therapy 2010; 2:18

Galetta KM, Barret J, Allen M, et. al. "The King-Devick test as a determinant of head trauma and concussion in boxers and MMA fighters." Neurology 2011; Prepublished online February 2, 2011.

Daneshvar DH, Baugh CM, et. al. Helmets and Mouth Guards: The Role of Personal Equipment in Preventing Sports-Related Concussion.  Clin Sports Med 2011;30:145-163. 

Footnotes: 

1.  Lincoln A, Caswell S, Almquist J, Dunn R, Norris J, Hinton R. Trends in Concussion Incidence in High School Sports: A Prospective 11-Year Study. Am J Sports Med 2011;30(10) accessed January 31, 2011 @ http://ajs.sagepub.com/content/early/2011/01/29/0363546510392326.full.pd...

2. Schatz P, Moser RS, Covassin T, Karpf.  Early Indicators of Enduring Symptoms in High School Athletes with Multiple Previous Concussions.  Neurosurgery (accepted for publication); 2011 at n. 3-5.

3. Stern R, Riley D, Daneshvar D, Nowinski C, Cantu R, McKee A. Long-term Consequences of Repetitive Brain Trauma: Chronic Traumatic Encephalopathy.  Phys Med & Rehab. 2011;3;S460-S467. DOI:10.1016/j.pmrj.2011.08.008. 

4. Boston University Center for Alzheimer's Research. Selected CSTE Cases: Eighteen year old high school football player. 2010; http://www.bu.edu/cste/case-studies/18-year-old/ (Accessed March 2, 2011). 

5. Talavage T, Nauman E, Breedlove E, et. al. Functionally-Detected Cognitive Impairment in High School Football Players Without Clinically-Diagnosed Concussion. J Neurotrauma. 2010; DOI: 10.1089/neu.2010.1512.

6. Crisco JJ, Fiore R, Beckwith JG, et al. Frequency and location of head impact exposures in individual collegiate football players.  J. Athl Train 2010;45:549-559.

7. Field M, Collins MW, Lovell MR, Maroon J. Does age play a role in recovery from sports related concussion? A comparison of high school and collegiate athletes.  J Pediatr. 2003;414:546-553.

8. Pullela R, Raber J, Pfankuch T. et al. Traumatic injury to the immature brain results in progressive neuronal loss, hyperactivity and delayed cognitive impairments.  Dev Neurosci 2006;28:396-409. 

9. Kirkwood MW, Randolph C, Yeates KO. Sport-Related Concussion: A Call for Evidence and Perspective Amidst the Alarms.  Clin J Sport Med 2012;22(5):383-384.

10. Zuckerman SL, Solomon GS, Forbes JA, Haase RF, Sills AK, Lovell MR.  Response to acute concussive injury in soccer players: is gender a modifying factor?  J Neurosurg: Pediatrics 2012; DOI:10.3171/2012.8.PEDS12139 (published online ahead of print October 2, 2012)(accessed October 15, 2012). 

11. Bazarian JJ, Zhu T, Blyth B, Borrino A, Zhong J.  Subject-specific changes in brain white matter in diffusion tensor imaging after sports-related concussion.  Magnetic Resources Imaging. 2012; 30(2): 171-180.

12. March N, Bazarian JJ, Puvenna V, Janigro M, Ghosh C, et. al. Consequences of Repeated Blood-Brain Barrier Disruption in Football Players. PLoS ONE 2013;8(3): e56805. doi: 10.1371/journal.pone.0056805. 

13. McCrory P, et al. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012. Br J Sports Med 2013;47:250-258. 

14. McKee A, et al. The spectrum of disease in chronic traumatic encephalopathy. Brain 2012; doi:10.1093/brain/aws307 (published online ahead of print December 2, 2012)(accessed March 20, 2013). 

15. D'Alessandro D, "Scientists claim that link between concussions and CTE is "unproven" could impact NFL lawsuits." NewJersey.com (March 17, 2013)http://www.nj.com/ledger-dalessandro/index.ssf/2013/03/scientists_claim_that_link_between_concussions_and_cte_is_unproven_could_impact_nfl_lawsuits.html (accessed March 20, 2013).

16. Broglio SP, Martini D, Kasper L, Eckner JT, Kutcher JS.  Estimation of Head Impact Exposure in High School Football: Implications for Regulating Contact Practices.  Am J Sports Med 2013;20(10). DOI:10.1177/036354651302458 (epub September 3, 2013).

17. "League of Denial" Wrap Up and Reax, http://theconcussionblog.com/2013/10/09/league-of-denial-wrap-up-and-rea... (accessed October 9, 2013).

19. Gardner A, Iverson G, McCrory P. Chronic traumatic encephalopathy in sport: a systematic review. Br J Sports Med. Published Online First: June 26, 2013. doi: 10.1136/bjsports-2013-092646. 

20. Jordan BD. The clinical spectrum of sport-related traumatic brain injury.  Nat Rev Neurol 2013;9:227-30.

21. McKee AC, Stein TD, Nowinski CJ, et al. The spectrum of disease in chronic traumatic encephalopathy. Brain. 2013;136:43-64. 

22. McCrory P, Meeuwisse WH, Kutcher JS, Jordan BD, Gardner A.  What is the evidence for chronic concussion-related changes in retired athletes: behavioral, pathological and clinical outcomes? Br J Sports Med 2013;47:327-330. 

23. Giza CC, Kutcher JS, Ashwal S, et al. Summary of evidence-based guideline update: Evaluation and management of concussion in sports: Report of the Guideline Development Subcommittee of the American Academy of Neurology. Neurology 2013 (epub before print Marchf 18, 2013); doi:10.1212/WNL.0b013e31828d57dd. 

24. Baillargeon A, Lassonde M, Leclerc S, Ellemberg D. Neuropsychological and neurophysiological assessment of sport concussion in children, adolescents and adults. Brain Injury 2012;26(3):211-220. 

25. Howell D, Osternig L, Van Donkelaar P, Mayer U, Chou L.  Effects of Concussion on Attention and Executive Function in Adolescents.  Med Sci Sports Exer. 2013;45(6):1023-1029.

26. Randolph C, Karantzoulis S, Guskiewicz K. Prevalence and Characterization of Mild Cognitive Impairment of Retired National Football League Players. J Int'l Neuropschol Soc. 2013;19:1-8.  

27. Broglio SP, Eckner JT, Paulson HL, Kutcher JS. Cognitive Decline and Aging: The Role of Concussive and Subconcussive Impacts. Exer. & Sports Sci Rev. 2012;40(3):138-144.

28. Loyola University Health System, News Release, "Study Casts Doubt on Theory that Retired NFL Players Suffer Unique Cognitive Disorder." August 8, 2013 (accessed October 14, 2013 at http://www.newswise.com/articles/study-casts-doubt-on-theory-that-retire...

29. Shakespeare's Hamlet, act III, scene II (accessed October 14, 2013 at  http://en.wikipedia.org/wiki/The_lady_doth_protest_too_much,_methinks) 

30. Randolph C, Kirkwood, M.W. What are the real risks of sport-related concussion, and are they modifiable? Journal of the
International Neuropsychological Society
2009;15:512-520. 

31. David Epstein. The Damage Done: While Concussive Hits Dominate the Debate, A Groundbreaking New Study Suggests That Minor Blows - And There Can Be Hundreds Each Game - Are Just As Traumatic. Sports Illustrated. November 1, 2010 (accessed October 14, 2013 at http://sportsillustrated.cnn.com/vault/article/magazine/MAG1176377/2/). 

32.  http://regressing.deadspin.com/the-hidden-victims-of-the-nfls-concussion...

33. Savica R, Parisi JE, Wold LE, Josephs KA, Ahlskog JE.  High School Football and Risk of Neurodegeneration: A Community-Based Study.  Mayo Clin Proc 2012;87(14):335-340.

34. Shaunacy Ferro, "Does CTE, The Brain Disease Found In NFL Players, Really Exist?"; http://www.popsci.com/science/article/2013-08/does-cte-brain-disease-found-nfl-players-really-exist (accessed October 19, 2013)

35. Science Daily. "Study Casts Doubt On Theory That Retired NFL Players Suffer Unique Cognitive Disorder" (http://www.sciencedaily.com/releases/2013/08/130807204631.htm (accessed October 19, 2013)

36. Megan Brooks, Medscape.com. "Study Casts Doubt on CTE in Retired NFL Players" http://www.medscape.com/viewarticle/809542 (October 19, 2013)

37. Study: NFL Players Are Not at Risk of CTE; http://concussionpolicyandthelaw.com/tag/cte/ (accessed October 19, 2013)

38. Jordan BD, et al. Head trauma and participation in contact sports as risk factors for Alzheimer's disease. Neurology 1990;40:347.

39. Iverson GL. Chronic traumatic encephalopathy and risk of suicide in former athletes. Br J Sports Med. 2013; doi:10.1136/bjsports-2013-092935 (epub October 31, 2013).

40. Wortzel HS, Brenner LA, Arciniegas DB.  Traumatic Brain Injury and Chronic Traumatic Encephalopathy: A Forensic Neuropsychiatric Perspective.  Behav. Sci. Law; 2013; doi:10.1002/bsl.2079 (epub on line).

41. Karantzoulis S, Randolph C. Modern Chronic Encephalopathy in Retired Athletes: What is the Evidence?  Neuropyschol Rev 2013; doi:10.1007/s11065-013-9243-4 (epub November 22, 2013)

42 Tator CH. Chronic traumatic encephalopathy: How serious a sports problem is it?  Br J Sports Med. 2013; doi:10.1136/bjsports-2013-093040 (epub November 22, 2013).  

43. McAllister TW, Ford JC, Flashman LA, et al. Effect of head impacts on diffusivity measures in a cohort of collegiate contact sport athletes. Neurology 2013; doi:10.1212/01.wnl.000438220.16190.  

44. Robert Cantu and Mark Hyman, Concussions and Our Kids: America's Leading Expert on How to Protect Young Athletes and Keep Sports Safe (Boston: Houghton Mifflin Harcourt, 2012), p. 103. 

45. Davenport EM, Whitlow CT, Urban JE, et. al. Abnormal White Matter Integrity Related To Head Impact Exposure in a Season of High School Varsity Football. J Neurotrauma 2014;31:1617-1624. 

46. Breedlove EL, Robinson M, Talavage TM, et al. Biomechanical correlates of symptomatic and asymptomatic neurophysiological impairment in high school football. J Biomech. 2012;45(7):1265-1272. 

47.March N, Bazarian JJ, Puvenna V, Janigro M, Ghosh C, et. al. Consequences of Repeated Blood-Brain Barrier Disruption in Football Players. PLoS ONE 2013;8(3): e56805. doi: 10.1371/journal.pone.0056805.

48. McAllister TW, Ford JC, Flashman LA, et al. Effect of head impacts on diffusivity measures in a cohort of collegiate contact sport athletes. Neurology 2013; doi:10.1212/01.wnl.000438220.16190.

49. McAllister TW, Flashman LA, Maerlender A, Greenwald RM, Beckwith JG, et al. Cognitive effects of one season of head impacts in a cohort of collegiate contact sports athletes. Neurology 2012;78:1777-1784.

50. Koerte IK, E Hartl, Bouix S, Pasternak O, Kubicki M, Rausher A, Li D, et al. A prospective study of physician-observed concussion during a varsity university hockey season: white matter integrity in ice hockey players. Part 3 of 4. Neurosurgical Focus. 2012;33:E3.

51. Davenport EM, Whitlow CT, Urban JE, et. al. Abnormal White Matter Integrity Related To Head Impact Exposure in a Season of High School Varsity Football. J Neurotrauma 2014;31:1617-1624.

52. Bahrami N, Davenport E, Whitlow CT, et. al. Head Impacts and White Matter Changes in High School Football: A TBSS Analysis. (research paper). Radiological Society of America. December 1, 2014.

53. Reynolds BB, Patrie J, Henry EJ, Goodkin HP, Broshek DK, Wintermark M, Druzgal TJ. Practice type effects on head impact in collegiate football. J. Neurosurg. Published online August 4, 2015; DOI:10.3171/2015.5.JNS15573.

54. 'Deviant brain metabolism' found in high school football players. Purdue University News. August 19, 2015. (accessed at http://www.purdue.edu/newsroom/releases/2015/Q3/deviant-brain-metabolism...)

55. Breedlove KM, Breedlove EL, Robinson M, Poole VN, King JR, Rosenberger P, Nauman EA. Detecting neurocognitive & neurophysiological changes as a result of subconcussive blows in high school football athletes. Ath. Tr. & Sports Health Care. 2014;6(3):119-127.

56. Poole VN, Breedlove EL, Shenk TE, Abbas K, Robinson ME, Leverenz LJ, Nauman EA, Dydek U, Talavage TM. Sub-concussive HIt Characteristics Predict Deviant Brain Metabolism in Football Athletes. Developmental Neuropsychology 2015;40(1):12-17, DOI:10.1080/87565641.2014.984810.

57. Nauman EA, Breedlove KM, Breedlove EL, Talavage TM, Robinson ME, Leverenz LJ. Post-Season Neurophysiological Deficits Assessed By ImPACT and fMRI in Athletes Competing in American Football. Developmental Neuropsychology. 2015;40(2):85-91. doi:10.1080/87565641.2015.1016161.

58.Robinson ME, Shenk TE, Breedlove EL, Leverenz LJ, Nauman EA, Talavage TM. The Role of Location of Subconcussive Head Impacts in fMRI Brain Activation Change. Developmental Neuropsychology 2015;40(2): 74-79. doi:10.1080/87565641.2015.101224.

59. Shenk TE, Robinson ME, Svaldi DO, Abbas K, Breedlove KM, Leverenz LJ, Nauman EA, Talavage TM. fMRI of Visual Working Memory in High School Football Players. Developmental Neuropsychology 2015;40(2):63-68. doi:10.1080/87565641.2015.1014088.

60. Svaldi DO, Joshi C, Robinson ME, Shenk TE, Abbas K, Nauman EA, Leverenz LJ, Talavage TM. Cerebrovascular Reactivity Alterations in Asymptomatic High School Football Players. Developmental Neuropsychology 2015;40(2):80-84. doi:10.1080/87565641.2014.973959.

61. Abbas K, Shenk TE, Poole VN, Robinson ME, Leverenz LJ, Nauman EA, Talavage TM. Effects of Repetitive Sub-Concussive Brain Injury on the Functional Connectivity of Default Mode Network in High School Football Athletes. Developmental Neuropsychology 2015;40(1):51-56. doi:10.1080/875665641.2014.990455.

62. Chun IY, Mao X, Breedlove EL, Leverenz LJ, Nauman EA, Talavage TM. Detection of Longitudinal WM Abnormalities Due to Accumulated Head Impacts. Developmental Neuropsychology 2015;40(2):92-97. doi: 10.1080/87566541/2015.1020945. 

63.  Reynolds BB, Patrie J, Henry EJ, Goodkin HP, Broshek DK, Wintermark M, Druzgal TJ. Practice type effects on head impact in collegiate football. J Neurosurg. Published online August 4, 2015; DOI:10.3171/2015.5.JNS15573.

64. Bazarian JJ, Zhu T, Zhong J, et al. Persistent, Long-term Cerebral White Matter Changes after Sports-Related Repetitive Head Impacts. PLOS ONE. 2014;9(4):e94734. 

65. Stamm JM, Bourlas AM, Baugh CM, Fritts NG. Daneshvar D, Martin BM, McLean MD, Tripodis Y, Stern RA. Age of First Exposure to Football and Later-Life Cognitive Impairment in Former NFL Players. Neurology. published online before print January 28, 2015, doi: http:/​/​dx.​doi.​org/​10.​1212/​WNL.

66. Stamm JM, Koerte IK, Muehlman M, et al. Age of First Exposure to Football is Associated with Altered Corpus Callosum White Matter Microstructure in Former Professional Football Players. J Neurotrauma. published online ahead of print, July 22, 2015; doi:10.1089/neu.2014.3822.

67.Asplund CA, Best TM. Brain damage in American Football Inevitable consequence or avoidable risk? Br J Sports Med 2015;49:1015-1016.  

68. Maroon JC, Winkleman R, Bost J, et al. Chronic traumatic encephalopathy in sports; a systematic review of all reported pathalogical cases.  PLoS One 2015;10:e1117338. 

69. Report from the First NIH Consensus Conference to Define the Neuopathological Criteria for the Diagnosis of Chronic Traumatic Encephalopathy.(http://www.ninds.nih.gov/research/tbi/ReportFirstNIHConsensusConference....)

70. "Football and the Brain" CBS News, Sixty Minutes. November 15, 2015 (last accessed November 16, 2015 at http://www.cbsnews.com/news/football-and-the-brain-nfl-60-minutes/

Originally posted February 8, 2011 Last updated November 16, 2015