Most fans will track first downs and touchdowns on Sept. 7, the opening game of the National Football League’s (NFL’s) 2017 season. If he tunes in, Robert Stern, PhD, no doubt will focus on any traumatic brain injuries (TBI) that occur during the game. These can range from mild TBI – as in a concussion – to severe TBI.
Dr. Stern also will watch for those more common head impacts that do not result in symptoms of concussion or draw the attention of the television cameras. Called “subconcussive” trauma, those hits are associated with a brain disease that is the focus of Dr. Stern’s research.
“Alzheimer’s disease is my primary focus professionally,” Dr. Stern said. “But some years ago, I started to learn more about another neurodegenerative disease called CTE. I soon realized that CTE had the potential to become a major public health issue. That’s when CTE research became a passion.”
CTE is a progressive, degenerative brain disease, similar to Alzheimer’s disease, found in people with a history of repetitive brain trauma. That brain trauma could include concussions as well as those subconcussive hits to the head that do not have symptoms. The trauma can trigger a series of events in the brain that progressively destroy its tissue, resulting in CTE. The symptoms that accompany CTE are similar to Alzheimer’s disease: changes in memory and cognition as well as changes in mood and behavior. Eventually, it can lead to dementia.
TBI, CTE & Alzheimer’s: Are they Connected?
Is there a connection between TBI, CTE and Alzheimer’s?
“I used to refer to TBI as a risk factor for Alzheimer’s disease, because early research suggested that,” said Dr. Stern. “However, more recent research suggests that the relationship between the two is not very clear.”
That means people who experience TBI at any age – a hit on the football field as a youth or a fall on the stairs as an older adult – do not appear to increase their chance of developing Alzheimer’s disease.
Concussion Controversies in Sports
Now let’s head back to the football field.
A 2016 Harris Poll showed pro football is continuing its reign as America’s favorite sport. Its popularity persists in spite of concern about the sport’s long-term impact on players’ brain health that began in the early 2000s. At that time, autopsies of deceased American football players revealed evidence of CTE. Years later, research from the BU center published recently in the Journal of the American Medical Association found that 110 out of 111 deceased former NFL players had CTE.
Dr. Stern estimates that in some contact sports like football, there can be 1,000 or more subconcussive hits per season of play. And these impacts can leave their mark on an athlete and eventually lead to CTE.
“There’s research that indicates even after one season of youth football, children ages 8-10 years old, had structural changes to their brains that were directly associated with the number of hits to the head they received,” Dr. Stern said. “Research from my team at BU has shown a dose-response relationship between the total estimated number of those repetitive head impacts a football player receives through youth, high school, and college football, and later life cognitive impairments and problems with depression and behavior. We have to take these repetitive head impacts seriously.”
And thanks to Dr. Stern, that message is getting out.
StudyTalks Webinar: Head Injury & Alzheimer's Disease: Does Playing Football Lead to Dementia?
Want to learn more about head injury and CTE? Join Dr. Robert A. Stern, PhD, Clinical Core Director of the BU Alzheimer’s Disease Center online as he discusses the role of head injury in developing dementia later in life.