At the peak of Georgetown University’s fall football season, concerns about player safety continue to dominate discussions off the field. Central to these concerns is the growing body of research linking football-related head injuries to Chronic traumatic encephalopathy (CTE), a degenerative brain disease caused by repetitive head impacts.
CTE has been linked to participation in contact sports, with athletes who play contact sports like football making up a large portion of those diagnosed with CTE due to their consistent exposure to tackling and falling. This repeated head trauma can potentially result in brain trauma.
A survey published in medical journal JAMA Neurology Sept. 23 found that 34% of former professional football players report perceived CTE. Perceived CTE is the belief that one has CTE due to symptoms of neurodegeneration, like memory loss, motor issues or behavioral changes, even though CTE can only be confirmed through autopsy after death.
Daniel Chapman, a doctoral candidate at Georgetown University School of Medicine, studied traumatic brain injury (TBI) with Georgetown University’s Burns Lab, a research group studying how TBI impacts normal brain function and potentially leads to neurodegenerative diseases, from 2019 to 2023. Chapman said that the new CTE survey is an indicator that scientists need more research to develop new ways to diagnose CTE, despite the relative lack of funding in the field.
“It’s become very popular in the media and I would venture that the media’s mentions of research funding ratio is not a favorable one. At the same time it’s a pretty rare diagnosis that is, for the time being, limited to high-risk groups like professional athletes in contact sport and military personnel,” Chapman wrote to The Hoya.
CTE is a tauopathy, meaning it is marked by accumulations of proteins, called tau, in the brain that spread in region and quantity as the disease progresses. Under the force of head impact, the functioning tau proteins that exist in all normal brains begin to dislodge and accumulate in certain regions of the brain, leading to matter loss and neurodegeneration.
As a concussion or loss of consciousness is not required for CTE to manifest, the medical presentation of CTE is extremely similar to Alzheimer’s disease and is otherwise indistinguishable before a physical brain examination. Symptoms include an uptick in aggression, explosivity, depression and irrational behavior. The limitations of diagnosing CTE during an individual’s lifetime, along with the severity of the symptoms, make it a serious threat to contact sport athletes.
Dr. Nicholas Streicher, a neurologist at MedStar Georgetown University Hospital, who specializes in sports neurology and neuromuscular medicine, said that raising awareness for CTE and modification of rules in practice and play may be beneficial, but that the priority should be to take good care of athletes immediately after a concussion.
“Beyond education, beyond rule changes, the best thing we can do is take good care of people with brain injury. So once someone’s had a concussion, really making sure that they go through an appropriate return to play protocol,” Streicher told The Hoya.
Streicher said that many contact sports athletes want to continue playing their sport even after learning the risk that CTE poses to their cognitive health.
“I see a lot of retired football players who come to me for evaluation because of the injuries they have,” Streicher said. “And I just ask them in a very nonjudgmental way, ‘Given all you’ve been through, would you do it again, knowing everything you know now?’ and most of them actually say yes.”
This directs the conversation of CTE risk amongst football players to the issue of personal choice. Once scientists have informed society of the causes, risks and manifestations of CTE, how do we balance the right to make individual choices with the potential of risk?
Chapman admitted his personal struggle to balance the conflict between the positive effects of exercise and the risk of neurodegeneration, but he still expressed an urgency to treat and prevent head injury.
