Football May Take a Toll on the Brain, Even Without Concussions

After a season of college football, portions of players’ brains can show worrying signs of damage, even if they did not experience a concussion, according to a timely new study of contact sports and brain health. The study, which concentrated on changes to white matter in players’ brains, amplifies growing concerns about the effects of repeated, subconcussive hits to the head and whether we are doing enough to protect athletes from knocks that once might have seemed minor.

Few athletes, parents, coaches, fans or researchers involved with football — and other contact sports, including soccer, lacrosse and hockey — are unaware of the evidence linking sports-related concussions and later cognitive problems, including, at the extreme, chronic traumatic encephalopathy, a form of degenerative dementia.

But many sports-related hits to the head do not cause concussions, a condition that, by definition, is a cluster of symptoms. Someone with a concussion might lose consciousness, have a headache, feel dizzy or disoriented, be unable to follow a moving finger with his or her eyes, and hear ringing in the ears after a resounding hit to the head.

Someone else might absorb a similar hit, however, without displaying those symptoms and would not, then, be said to have suffered a concussion.

After the scans were complete, the players began playing. During all subsequent practices and games, they wore helmets containing specialized accelerometers that tracked the number and intensity of every head impact and how the athletes’ heads moved when they were hit.

At the end of the season, the researchers gathered the helmet data and re-scanned players’ midbrains. Two of the athletes had sustained concussions; their information was removed.

The other 38 players had not been concussed but had whacked their heads with regularity, their helmets recording a total of 19,128 impacts, some slight and others packing a wallop.

When the researchers next compared the scans and the helmet data, they saw a disconcerting pattern. Most of the players’ midbrains were subtly different. The area’s white matter, which is the tissue that connects neurons, was slightly less healthy now, the scans showed.

“There was a kind of fraying” of the tissue, Dr. Hirad says.

And the players whose heads had absorbed the most hits, especially if those hits involved slightly off-center impacts and head rotations, showed the greatest disruption inside their midbrain’s white matter.

For all of them, Dr. Mahon says, these brain injuries “were clinically silent,” causing no symptoms.

The researchers next scanned the brains of 28 athletes who had been diagnosed with a recent concussion, to check whether the subconcussive brain changes mimicked those seen in these players and found the same pattern of slight disintegration in their midbrains’ white matter.

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