A groundbreaking study on chronic traumatic encephalopathy (CTE) in football players has unveiled a significant revelation: the risk of CTE is not primarily influenced by the number of diagnosed concussions but rather by the cumulative number and intensity of head impacts. Employing a pioneering tool known as a positional exposure matrix (PEM), scientists assert that reducing the frequency and force of head impacts during practice and games could potentially decrease the likelihood of athletes developing CTE.
Researchers from Mass General Brigham and Boston University have developed this new tool, which has paved the way for the first-ever playbook to prevent chronic traumatic encephalopathy in football.
In the most extensive study on CTE conducted to date, examining 631 deceased football players, it was discovered that the number of diagnosed concussions alone did not correlate with the risk of CTE. Instead, the likelihood of developing CTE was found to be associated with both the number of head impacts and their intensity.
The study, carried out by researchers from Mass General Brigham, Harvard Medical School, and Boston University, was recently published in Nature Communications. It employed a novel positional exposure matrix (PEM) that synthesized data from 34 independent studies to estimate the number and severity of head impacts sustained by football players over their careers.
Senior author of the study, Dr. Jesse Mez, MD, MS, Associate Professor at BU Chobanian and Avedisian School of Medicine and Co-Director of Clinical Research at the BU CTE Center, emphasized, “These findings provide additional evidence that repeated non-concussive head injuries play a significant role in CTE pathology, rather than symptomatic concussions, as commonly believed in medical and popular literature.”
The newfound data has the potential to equip football with a playbook to prevent CTE among current and future players, according to the researchers. Lead author Dr. Dan Daneshvar, MD, PhD, Assistant Professor at Harvard Medical School and Physician at Mass General Brigham affiliate Spaulding Rehabilitation, stated, “This study suggests that by reducing the number and force of head impacts during practice and games, we could lower the chances of athletes developing CTE.”
The PEM tool was utilized by the researchers to estimate the cumulative number of head impacts as well as the cumulative linear and rotational accelerations associated with those impacts. These estimations were based on the positions played by athletes throughout their football careers.
The study concluded that cumulative repetitive head impact (RHI) exposure exhibited correlations with CTE status, severity, and pathologic burden in football players. Furthermore, models employing the intensity of impacts proved more effective in predicting CTE status and severity compared to models based solely on duration of play or the number of head hits.
The PEM is a valuable tool that can enhance research on the risks of football participation. By utilizing the PEM in future studies, researchers can explore other potential effects of repetitive head impact (RHI) beyond CTE, contributing to a better understanding of the specific types of RHI that are most likely to cause such problems.
Dr. Daneshvar highlighted, “Although this study focused on football players, it also provides insights into the impact characteristics that are primarily responsible for CTE pathology in other contact sports, military exposures, or cases of domestic violence. The brain does not differentiate between different types of impacts.”
A limitation of the study is its reliance on a convenience sample of brain donors who were football players, and who tended to have higher exposure to repetitive head impacts compared to the general population of football players. Nevertheless, the findings can still be extrapolated to most football players as a substantial number of donors had lower exposures.
Reference: “Leveraging football accelerometer data to quantify associations between repetitive head impacts and chronic traumatic encephalopathy in males” by Daniel H. Daneshvar, Evan S. Nair, Zachary H. Baucom, Abigail Rasch, Bobak Abdolmohammadi, Madeline Uretsky, Nicole Saltiel, Arsal Shah, Johnny Jarnagin, Christine M. Baugh, Brett M. Martin, Joseph N. Palmisano, Jonathan D. Cherry, Victor E. Alvarez, Bertrand R. Huber, Jennifer Weuve, Christopher J. Nowinski, Robert C. Cantu, Ross D. Zafonte, Brigid Dwyer, John F. Crary, Lee E. Goldstein, Neil W. Kowall, Douglas I. Katz, Robert A. Stern, Yorghos Tripodis, Thor D. Stein, Michael D. McClean, Michael L. Alosco, Ann C. McKee, and Jesse Mez, 20 June 2023, Nature Communications.
DOI: 10.1038/s41467-023-39183-0
The study received support through grants and funding from the National Institutes of Health, Department of Veterans Affairs, Department of Defense, the Alzheimer’s Association, the Nick and Lynn Buoniconti Foundation, the Concussion Legacy Foundation, the Adlinger Foundation, and World Wrestling Entertainment Inc.
Table of Contents
Frequently Asked Questions (FAQs) about CTE in football players
What did the study on CTE in football players reveal?
The study revealed that the risk of CTE in football players is primarily driven by the cumulative number and intensity of head impacts, rather than the number of diagnosed concussions alone.
What tool did the researchers use in the study?
The researchers utilized a novel tool called a positional exposure matrix (PEM) to estimate the number and severity of head impacts sustained by football players over their careers.
How can the findings of the study help prevent CTE in football players?
The findings suggest that reducing both the frequency and force of head impacts during practice and games could potentially lower the odds of athletes developing CTE. This information can guide the development of preventive strategies and a playbook to protect current and future football players.
Were concussions found to be irrelevant to CTE risk?
While the study found that the number of diagnosed concussions alone was not associated with the risk of CTE, it is important to note that concussions can still have adverse effects on an individual’s health and should not be disregarded. The focus of the study was on understanding the role of cumulative head impacts in CTE development.
Can the findings of this study be applied to other contact sports or scenarios?
The study’s findings are likely applicable to other contact sports and situations involving repetitive head impacts, such as military exposure or cases of domestic violence. The study provides insights into the impact characteristics that are primarily responsible for CTE pathology, regardless of the specific context.
More about CTE in football players
- Nature Communications – The published study in Nature Communications.
- Mass General Brigham – Website of Mass General Brigham, one of the institutions involved in the study.
- Boston University CTE Center – Website of the Boston University CTE Center, where one of the study’s senior authors is affiliated.
- Harvard Medical School – Website of Harvard Medical School, where the study’s lead author is affiliated.
- Concussion Legacy Foundation – Website of the Concussion Legacy Foundation, one of the organizations providing support and funding for the study.
5 comments
wow this is groundbreakin research! its intrestin how the numbR of concussions doesnt matter as much as the hEad impacts. now they need to f1gure out how to prevent cte in playrs!
it’s imp0rtant to remmber that concussions can still have bad effects on health, even if they’re not the main factor in cte. this research g1ves us new insight into the role of head impacts. let’s take care of our athletes!
the use of positional exposure matrix (PEM) in this study is a clevr approach to estimate head impacts. now they can focus on reducing the intensity and frequency of those hits. great step towards prevnting cte!
cte is a srs problm in sports, so this study is super important. the pem tool sounds impresive & can help them develop strategies to protect playrs. need more research on this topic!
didn’t kn0w that concussions alone dont lead to cte. the cumulative impacts are the real culprit. this study sh0ws the importance of changing how footbal is played & practiced. play safe!