The research and science behind head injuries and professional football has been well known for years. Chronic Traumatic Encephalopathy (CTE) is common in football players, but since it cannot be diagnosed until after a player has died, treatments for it have been difficult to develop. Many NFL players both current and retired have expressed concerns about the impact of repeated head trauma. CTE can cause depression, can result in anxiety and an inability to manage anger and can eventually lead to dementia and death.
What hasn’t been understood until recently is the risk that players in youth sports, face. New research from Wake Forest University shows that children as young as 12 years old can suffer neurological damage as a result of participating in youth football and that young players don’t necessarily have to incur a concussion for the damage to happen.
In the United States there are about 3 million young people participating in youth football. The Wake Forest study, published online in the journal Radiology, showed that even head impacts that do not result in a concussion, can cause damage to young brains. Even just a single season of youth football has been shown to cause definitive brain changes in players who never suffered an actual concussion.
The study's lead author, Christopher T. Whitlow, M.D., Ph.D., M.H.A., associate professor and chief of neuroradiology at Wake Forest School of Medicine in Winston-Salem, N.C. stated in a press release, "Most investigators believe that concussions are bad for the brain, but what about the hundreds of head impacts during a season of football that don't lead to a clinically diagnosed concussion? We wanted to see if cumulative sub-concussive head impacts have any effects on the developing brain."
In order to get information on these sub-concussive impacts the research team studied 25 male youth football players between the ages of 8 and 13. The data for head impacts was collected using the Head Impact Telemetry System (HITs), which is the gold standard of head impact studies and has been used at the high school and collegiate level to study the frequency, severity and cognitive outcomes of helmet impacts in American Football. The data was analyzed to sort out the risk of the cumulative exposure of one season of play. Study volunteers underwent pre- and post-season evaluation with multimodal neuroimaging, including diffusion tensor imaging (DTI) of the brain. While traditional MRIs can show some brain changes, DTI is an advanced MRI technique, which identifies changes in brain white matter at a microscopic level. In addition, any game that included a study participant was videotaped and reviewed in order to collate data on reported impacts and what actually happened on the field
White matter in the brain is evaluated by looking at how water molecules move throughout the brain, a measurement called fractional anisotropy. It’s an indicator of brain health because the more efficiently water moves in the brain, the healthier the tissue. DTI MRI scans can pick up this movement. The results of the scans conducted on the Wake Forest Study volunteers showed a significant relationship between head impacts and decreased FA in specific white matter tracts and tract terminals, where white and gray matters meet. Dr. Whitlow explained the finding stating, "We found that these young players who experienced more cumulative head impact exposure had more changes in brain white matter, specifically decreased FA, in specific parts of the brain. These decreases in FA caught our attention, because similar changes in FA have been reported in the setting of mild TBI."
These results are important because none of the players that had these brain changes had suffered a concussion. The research is the first to show that even without an actual diagnosis of concussion, brain changes still happen and they can impact the brain health of these very young players. The video below explains more about this study and what needs to happen in youth sports to protect the most vulnerable players.
Sources: Radiology Wake Forest University
, NBC News