According to the Center of Disease Control and Prevention, there are approximately 300,000 sport-related concussions that occur annually in the United States. Hence, why this topic has become one of the more popular amongst news and social media outlets. Comparisons between concussion studies continue to be considered complicated because of a general lack of agreement pertaining to the actual definition and how to differentiate between the severities. An early definition frequently cited by the American Association of Neurological Surgeons group defines it as “a clinical syndrome characterized by immediate and transient post-traumatic impairment of neural functions, such as alteration of consciousness, disturbance of vision, and equilibrium due to biomechanical forces.” The most commonly reported symptoms associated with concussions are confusion, amnesia, and headaches. The injury is most often produced by the acceleration/deceleration of a freely moving head, making its significance even more relevant with the growing interest our society has in sports and athletics today.
Sports-related concussion have gained increased prominence, in part due to media coverage of several well-known athletes who have died from the consequences of what is now termed chronic traumatic encephalopathy (CTE). The emergence of CTE is becoming more understood and has increased awareness due to film being released on Christmas Day, “Concussion”, that is starring Will Smith who portrays Dr. Bennet Omalu, a forensic pathologist who was able to discover the disease after an autopsy performed on a former NFL player. Since the discovery, Dr. Omalu has fought against efforts by the National Football League to suppress his research on the brain damage suffered by professional football players. In the past 10 years, it has been one of the most discussed topics associated with not only football, but all contact sports.
CTE was first described by Martland in 1928 as a syndrome seen in boxers who had experienced significant head trauma from repeated blows. The classic symptoms of impaired cognition, mood, behavior, and motor skills also have been reported in professional football players, and in 2005, the histopathological findings of CTE were first reported in a former National Football League (NFL) player by Dr. Bennet Omalu. These findings were similar to Alzheimer’s disease in some ways, but differed in critical areas such as a predominance of tau protein deposition over amyloid. The pathophysiology is still unknown, but involves a history of repeated concussive and subconcussive blows followed by a period of lag before CTE symptoms become evident.
Along with Dr. Omalu, there has been an increasing amount of research performed recently to find more evidence of brain damage that may be related to prior or current concussions. Many of the research performed includes conducting a battery of tests on the brain and other tissue from former professional , college, and high school football players. Research has shown, including a study performed by researched at the John Hopkins School of Medicine found that on average, former NFL players showed an injury to the temporal lobe of the brain, specifically the amygdala, The amygdala is a part of the brain that plays an important part for people to regulate their mood. The same study also found that these players had lower scores than normal when tested for memory and verbal learning.
Concussions and the lingering effects from this injury will continue to be an important topic for years to come when it comes to the protection of athletes. It will be important for us as health care professionals to learn more about the disease process as well as what diagnostic tools and treatment options to successfully care for these athletes.