Results from a small study reportedly reveal additional evidence reinforcing potential long-term neurological risk to football players who sustain concussion, and the need for improved player protections.

Jennifer Coughlin, MD, assistant professor of psychiatry and behavioral sciences, Johns Hopkins University School of Medicine, articulates the researchers’ hopes that the findings yielding from the study, which encompassed nine former NFL football players, will help further inform the game.

In a Johns Hopkins Medicine news release, she adds, “That may mean individuals are able to make more educated decisions about whether they’re susceptible to brain injury, advise how helmets are structured or inform guidelines for the game to better protect players.”

According to the release, several accounts and studies indicate that athletes, including collegiate and professional football, hockey, and soccer players, who are exposed to repeat concussions could sustain permanent brain damage and deficits from these events. The mechanism driving the damage and the source of these deficits has been unclear.

To shed light on this topic, the release notes that Coughlin, Yuchuan Wang, PhD, assistant professor of radiology and radiological science at the Johns Hopkins University School of Medicine, and their colleagues used tests to directly detect deficits and quantify localized molecular differences between the brains of former players and healthy individuals who did not play football.

Nine former NFL players ranging in age from 57 to 74 years old were recruited for the study. The release states that the men had played in a variety of team positions and also had a wide range of self-reported, historical concussions, varying from none for a running back to 40 for a defensive tackle. The researchers also enlisted nine age-matched healthy controls who had no reason to suspect they had brain injuries.

Each study participant underwent a positron emission tomography (PET) scan. The researchers then focused on the translocator protein, which signals the degree of damage and repair in the brain. The researchers found that while healthy individuals have low levels of this protein spread throughout the brain, individuals with brain injuries tend to have concentrated zones with high levels of translocator protein wherever an injury has occurred.

Study participants also underwent MRIs, the release says, allowing the researchers to match up the PET scan findings with anatomical locations in the volunteers’ brains and check for structural abnormalities. A battery of memory tests were also administered.

Control volunteers exhibited no evidence of brain damage. However, PET scans suggest that on average, the group of former NFL players had evidence of brain injury in several temporal medial lobe regions, including the amygdala. Imaging also pinpointed injuries in many players’ supramarginal gyrus.

The release says that while the hippocampus did not exhibit evidence of damage in the PET scans, MRIs of the former players’ brains showed atrophy of the right-side hippocampus, indicating that the region may have shrunk in size as a result of previous damage. Many of the former NFL players also scored low on memory testing, particularly in tests of verbal learning and memory.

While researchers emphasize that this is a pilot study, they add in the release that the evidence among the nine former NFL players suggests there are molecular and structural changes in specific brain regions of athletes who have a history of repetitive hits to the head, even after many years of having left active play.

Source: Johns Hopkins Medicine