Brain scans of American football players have revealed subtle structural differences in the brain compared to men who have never played contact or collision sports, according to a new study led by NYU Langone Health and an international team of researchers. The findings may help predict which individuals are at higher risk for developing chronic traumatic encephalopathy (CTE), a neurodegenerative disease associated with repeated head trauma.
CTE is known to worsen over time and often affects athletes in contact and collision sports such as football, hockey, and boxing. Currently, CTE can only be diagnosed after death through autopsy, where signs include brain shrinkage and tau protein deposits near blood vessels in brain grooves called sulci.
The study found that former football players had shallower left superior frontal sulci than non-football players. These grooves are located on the top front left side of the brain and have previously been linked to CTE. Additionally, those with more years of playing experience had wider left occipitotemporal sulci compared to those not involved in contact sports.
The research analyzed MRI scans from 169 former college and professional football players and compared them to 54 men of similar age, weight, and education who did not play football or similar sports. The control group also excluded individuals with active military backgrounds.
“Our study shows what we believe can be the first structural differences that tell apart brains more at risk of developing chronic traumatic encephalopathy from the brains of people who are less at risk,” said Hector Arciniega, PhD, assistant professor in Rusk Rehabilitation at NYU Grossman School of Medicine. “The work also proves that we can apply what we know about the physical changes observed postmortem in the brains of those with confirmed chronic traumatic encephalopathy to brain scans of living people at increased risk for it.”
Dr. Arciniega, who is also part of NYU Langone’s Concussion Center, suggested these findings could serve as early biomarkers for CTE. This could help develop diagnostic tests so therapies might be applied before irreversible damage occurs. He emphasized that identifying those at risk is important because there is currently no cure for CTE.
Researchers noted that only one side of the brain showed these differences and that no significant variations were found in psychological tests for memory or learning, nor in measures related to tau protein buildup between groups.
A clinical diagnostic test remains years away; however, if future studies confirm these results, additional biomarkers could be used together for comprehensive CTE risk assessment.
Dr. Arciniega plans further research involving other contact sports and additional areas of the brain to better identify those most susceptible to CTE.
Participants included college football players with at least six years’ experience and professionals with a minimum of twelve years’ gameplay; quarterbacks were excluded due to lower exposure to head impacts.
Funding came from several National Institutes of Health grants as well as support from the Alzheimer’s Association.
In addition to Dr. Arciniega, other NYU Langone researchers involved were Leonard Jung, MD; Anya Mirmajlesi; Jared Stearns; Carina Heller; Brian S. Im; Shae Datta; and Laura J. Balcer. Collaborators included scientists from Harvard Medical School, Boston University, Arizona State University, Mayo Clinic Arizona, Cleveland Clinic Lou Ruvo Center for Brain Health, University of Nevada Las Vegas, Universite du Quebec Montreal, and Ludwig-Maximilians-Universitat Munchen in Germany.
NYU Langone Health operates a fully integrated health system recognized nationally for its patient outcomes and quality standards (https://nyulangone.org/news/nyu-langone-health-ranked-no-1-vizient-quality-and-accountability-fourth-consecutive-year). It has been ranked No. 1 among academic medical centers by Vizient Inc., while U.S. News & World Report named four clinical specialties as best in the nation (https://nyulangone.org/news/us-news-world-report-ranks-nyu-langone-hospitals-no-1-new-york-and-best-nation-specialties). The system provides care across seven inpatient locations plus outpatient sites throughout New York and Florida.
