Talking With Parents of High School Football Players About Chronic Traumatic Encephalopathy

Abstract

Over the past decade, athletic-related chronic traumatic encephalopathy (CTE) has garnered a great deal of attention in the popular press and, more recently, in the scientific press. With increasing frequency, sports medicine practitioners and providers are faced with questions from the parents of high school football players about CTE and the risk posed to children who participate in this or other contact or collision sports. The purpose of this review was to summarize the research on CTE in an attempt to provide some evidence-based answers to frequently asked questions in clinics from parents. Addressed are (1) the definitions of CTE and its symptoms, (2) the evidence for CTE in football, (3) abnormal tau protein, (4) the use of neuroimaging in CTE diagnosis, (5) risk for CTE, (6) CTE diagnosis in youth, (7) CTE and its relationship to suicide, and (8) contact and collision sports as a risk factor for permanent brain injury or death.

The Diagnosis and Management of Concussion in Children and Adolescents

“…Although further study is necessary, Love and Solomon deny a compelling reason to withhold a high school athlete from sports because of a concern for CTE. 161 …”

Alzheimer’s disease and chronic traumatic encephalopathy: Distinct but possibly overlapping disease entities

“…31,32 Behavioral changes are also common including but not limited to impulsivity, aggression, and judgment issues. 33,34 Sometimes these behavioral changes are associated with explosive and violent outbursts. 35 Cognitive changes can be severely debilitating.…”

Diagnosis and management of paediatric concussion

“…At present, there are no clinical epidemiological, cross‐sectional or prospective studies on CTE, and data are insufficient to confirm a causal link . However, animal models show that repeated frequent concussive injuries correlate with greater neuropathological brain changes and are associated with persistent long‐term behavioural and neurocognitive impairment …”

“…The diagnosis of CTE remains limited to autopsy findings, characterised by specific amounts and patterns of abnormal tau protein deposition in the brain. Neuroimaging does not currently play a role in its diagnosis …”

“…This suggests other factors play a role, such as genetic predisposition, differing co‐morbidities or drug or alcohol abuse . However, the contribution of additional risk factors is still largely unknown …”