Researchers have reported an alarming case of chronic traumatic encephalopathy (CTE) in a 25-year-old former college football player. Details of the investigation were published in JAMA Neurology.
While CTE has been detected in people as young as 17, this case, from the UNITE Study, stands out because the subject’s brain showed widespread CTE consistent with someone decades older and with greater exposure to concussive trauma.
The subject, who died at 25 from a congenital heart defect, began playing tackle football at age 6 and continued on to play in college at Missouri State University. By the time he was a junior, he had sustained more than 10 concussions and was experiencing headache, neck pain, blurred vision, tinnitus, insomnia, anxiety, and difficulty with memory and concentration, which forced him to stop playing the sport.
The subject continued to experience the aforementioned symptoms in addition to apathy, anhedonia, decreased appetite, hypersomnia, feelings of worthlessness, and passive suicidal ideations. He struggled to maintain employment, became verbally and physically abusive, and became increasingly dependent on his wife.
Upon autopsy, investigators found pathological lesions of hyperphosphorylated tau (ptau) around the small blood vessels in the frontal and temporal lobes, as well as in the parietal lobes, entorhinal cortex, anterior hippocampus, hypothalamus, nucleus basalis of Meynert, substantia nigra, locus coeruleus, and median raphe, all of which are considered pathognomonic for CTE.
“It was the worst CTE I’ve seen in an individual this young,” study coauthor Ann C. McKee, MD, of Boston University School of Medicine, told NBC News. “It was quite widespread.”
Dr McKee suspects that the subject’s condition is partially due to the young age at which he began playing tackle football, noting that “brain injury is cumulative.” Still, the severity of CTE suggests that the subject may have been genetically predisposed to have worse outcomes from concussion.
The authors note that this case is the first of pathologically confirmed CTE that includes a neuropsychological test profile. Future studies that include neuropsychological testing, imaging, and fluid biomarkers may help improve the diagnosis of CTE during life.
- Mez J, Solomon TM, Daneshvar DH, et al. Pathologically confirmed chronic traumatic encephalopathy in a 25-year-old former college football player. JAMA Neurol. 2015; doi:10.1001/jamaneurol.2015.3998.
- Carrol L. Football player had worst brain trauma seen in someone so young, doctor says. NBC News website. Published January 4, 2016. Accessed January 5, 2016. http://www.nbcnews.com/health/health-news/football-player-had-worst-brain-trauma-seen-someone-so-young-n489856.