Magazine article Clinical Psychiatry News

High Prevalence of TBI Found among Retired NFL Players

Magazine article Clinical Psychiatry News

High Prevalence of TBI Found among Retired NFL Players

Article excerpt


VANCOUVER -- Many retired National Football League players seeking care for neurocognitive symptoms have MRI evidence of traumatic brain injury, according to the largest study of this issue among living players.

Data reported at the annual meeting of the American Academy of Neurology show that 43% of a cohort of 40 symptomatic NFL retirees had abnormal results on diffusion tensor MRI and 30% had evidence of traumatic axonal injury on conventional MRI.

The likelihood of abnormal diffusion tensor MRI results was correlated, albeit weakly, with the length of the player's NFL career, but not with the number of concussions sustained.

"It appears that subconcussive hits--that is, the cumulative effects and longer playing careers--place retired alumni at risk for abnormal diffusion tensor MRI," commented lead author Dr. Francis X. Conidi, director of the Florida Center for Headache & Sports Neurology in Palm Beach and team neurologist for the Florida Panthers of the National Hockey League.

"This could be a possible link to chronic traumatic encephalopathy, as consensus is you need to have repetitive head trauma," he proposed. "Or this could be a separate entity whereby, in NFL players, the symptoms we are seeing are actually related to the traumatic brain injury itself and [in a subset] with some genetic predisposition, they will go on to have progressive neurological decline."

Although the cohort was quite young, only 39 years old on average, some had likely played football since youth, and that has implications for prevention, Dr. Conidi added in an interview. "One thing we need to consider is limiting the amount of contact that these people receive on a cumulative basis, starting when they are young and starting in practice, be* cause that's where most of the contact occurs," he recommended.

"It is important to note II that diffusion tensor imaging is not a routine part of a brain MRI study," session moderator Dr. Jose E. Cavazos, professor of neurology and assistant dean at the University of Texas Health Science Center in San Antonio, said in comments provided by email. "The significant correlation between duration of years played and abnormalities in diffusion tensor imaging is of concern given the popularity of the sport.

"The next step is to replicate the findings, but more importantly, it is to find surrogate markers for early detection for these abnormalities, aiming to intervene (sideline) those players at greater risk for developing cognitive deficits or other impairments," he added. …

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