Athletes who play contact sports like football and hockey may have a similar risk of chronic traumatic encephalopathy (CTE) regardless of what position they play, a small postmortem study suggests. Researchers examined autopsy data for 35 men who played hockey (n=11) or football (n=24) at a professional or elite level and died at a mean age of 63 years. Overall, 17 men (48.6%) had CTE based on an analysis of brain tau deposits and 24 men (68.6%) had other neuropathologies. In 13 cases, both CTE and other neuropathologies were present. The study team found no correlations between CTE and position played in hockey or football, how many times players had penalties or fights, or age at retirement, according to the report in Neurology. "There is no doubt that brain trauma can lead to future brain health issues in some individuals, and risk of late life neurodegenerative disease is increased if a person sustains repeated brain trauma," said senior study author Dr. Lili-Naz Hazrati, an associate professor in laboratory medicine and pathobiology at the University of Toronto in Canda. "However, our study found that at the individual level, the risk cannot be determined or predicted by variables such as length of exposure, position in game etc.," Dr. Hazrati said by email. Other factors might play a role in the risk for CTE in these athletes, including genetics, environmental exposures, use of drugs or alcohol, pollutants, and lifestyle factors, Dr. Hazrati said. The small sample size may have contributed to the lack of associations between CTE and several risk factors explored in the study, researchers note. Another limitation is that many men in the study played before helmets or head protection were mandatory for professional hockey and football. Results from this cohort of men who didn't have neurological symptoms while they were alive also may not be generalizable to all athletes who play contact sports, particularly those who did experience symptoms, the authors note as well. The current study also did not include any aged-matched controls, said Jonathan Godbout, a professor of neuroscience and faculty director of the Chronic Brain Injury Program at the Ohio State University Wexner Medical Center in Columbus. "The truth is that everyone has some level of brain change with age, whether it is atrophy, white matter loss, tau tangles, and even plaques," Godbout, who wasn't involved in the study, said by email. "Head injury would increase some of these things and show evidence of glial scarring. A history of concussions certainly puts one at a greater risk for brain pathologies, like CTE, later in life, and the paper suggests that other factors beyond these injuries on the field may also impact the risk, Godbout said. "This is a sound conclusion, because there are multiple risk factors that affect brain aging and could influence brain pathology," Godbout added. "One of the big unknowns for clinicians is when is it safe for an athlete to return to play, and we need to continue to be vigilant in detecting/treating concussions and protecting players from returning to the field prematurely." —Lisa Rapaport Source
