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Chronic traumatic encephalopathy (CTE), a progressive degenerative disease found in the brains of athletes with a history of repetitive brain trauma, has been known to affect sportspeople such as boxers since the 1920s.

Repeated traumatic events such as punches lead to the progressive degeneration of brain tissue that can begin years or even decades after the end of an athlete’s career.

Studies in the past couple of decades have looked at the effect of repetitive mild traumatic brain injury on dementia in athletes from a wide range of sports including ice hockey, rugby and boxing.

As probably the most high-profile of all the CTE-related sports, the link between CTE and American football has been well documented in recent years both in news stories and legal cases.

American footballers two teams on the field
Image: pixabay.com

Researchers in the US have repeatedly made headlines across the globe by revealing the strong link between playing American Football and an increased risk of CTE. At least 90 former N.F.L players have donated their brains to the Boston University CTE centre and been discovered to have the symptoms of CTE.

Just last year, after years of denying any connection between their beloved sport and CTE, a top N.F.L official acknowledged that playing football and having CTE were “certainly” linked, effectively stopping any public dispute over whether the disorder could be caused by concussive events.

Until now there had only been a few individual case reports of footballers (or, as Americans would call them, ‘soccer players’) with CTE in the UK.

All that seems to be changing due to a new paper published in the journal Acta Neuropathalogica last fortnight.

Football players in the box head the ball in a goal-side scuffle
Image: Wikimedia Commons

Researchers from University College London and Cardiff University examined the brains of five professional footballers and one dedicated amateur. All six had played football since a young age and gone on to develop dementia in their 60s.

Average players head the ball between 6 and 12 times a game, meaning footballers over a 20-year career could be heading the ball over 2000 times during matches alone.

A diagnosis of CTE cannot be confirmed until after death so post-mortem studies were carried out on each of the ex-players to confirm the diagnosis.

The brains were revealed to have near-identical pathology to that of long-term boxers. The researchers discovered signs of Alzheimer’s disease in each brain alongside CTE pathology so suspect that the patients’ dementia was due to a combination of neurodegenerative diseases. While the two diseases share some neuropathological similarities, the pattern of protein tangles and plaques differ, allowing objective diagnoses of each disease.

“footballers over a 20-year career could be heading the ball over 2000 times during matches alone”

CTE has some clinical similarities to Alzheimer’s disease but generally presents itself earlier in patients, emerging in one’s forties as opposed to the septuagenarian onset seen in most Alzheimer’s patients.

Rather than initially affecting memory processes as in Alzheimer’s, CTE generally affects reasoning, problem solving and impulse control. Sufferers might be recognisable due to their impaired speech, motor skills or behavioural changes that often begin decades after the period of repeated trauma.

In response to the study, a number of neuroscientists have cautioned against the extrapolation of the findings to casual footballers. The sample size of only six footballers is small and so largescale case-control studies are still needed to definitively confirm the causal link between headers and brain damage.

a casual game of footy in the park
Image: geograph

Regular games of football for local teams or in the park with friends are unlikely to cause the long-term damage seen in the study.

In fact, many of the neuroscientists took the opportunity to emphasise the fact that retired footballers actually have lower mortality rates than the rest of the population through the general fitness benefits gained from such a healthy lifestyle.

It seems as though the 265 million people who play football globally needn’t hang up the boots just yet.

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