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Punch Drunk: Repetitive Brain Injury
Almost a century ago, a rare but serious form of dementia was linked to repetitive head injuries in boxing. The dementia was aptly named, “Boxer’s dementia.” Lately, this “punch drunk” dementia has been found to affect athletes in other sports, such as American football and soccer, where athletes' heads take repeated blows, so a broader term for this condition was needed.
Chronic traumatic encephalopathy (CTE), is a related brain disorder that has been shown to affect other kinds of athletes, and more rarely, non-athletes who sustain head injuries. It has been in the news lately because of two high-profile cases.
Dave Duerson, a former Chicago Bears player, committed suicide last year, after having suffered from memory problems, erratic and uncontrolled emotions, and violent behavior.(1) He left a note requesting that his brain be donated to the Boston University Center for the Study of Traumatic Encephalopathy so that it could be studied. These brain tests confirmed what he suspected: that he had suffered from CTE.
Professional hockey player Derek Boogaard was one of the youngest known athletes to be affected. After having suffered symptoms for years, Boogaard died of a drug overdose at 28. An autopsy revealed that CTE had been the cause of his neurological problems.(13)
Brain traumas, especially chronic injuries such as those sustained in sports can, over time, lead to irreversible brain damage. There is just so much jarring and shaking the brain can take. The difficulty is that the most serious, long-term symptoms often don't show up until later in life, but clearly CTE can develop almost any age. Here, we’ll discuss the symptoms, brain changes, and prevention of CTE in athletes and in all of us.
The Symptoms of CTE
Chronic traumatic encephalopathy affects many areas of a person’s functioning, including mood, emotional regulation, cognitive capacity, memory, and personality.(3) It often doesn’t develop for years after the traumas occurred, and can present with a different constellation of symptoms in each person it affects.
Its prevalence in boxers continues. One recent review study of athletes who were diagnosed with CTE found that of the 51 confirmed cases of CTE, 46 were in athletes – and of these, 39 were boxers.(2) Five football players, a soccer player, and a wrestler made up the remainder of the athletes affected by chronic brain trauma.
The most common initial symptoms of CTE are a variety of psychological and behavioral changes. Some experts have suggested that there are actually three phases of the disease. The first includes problems with attention, concentration, memory, and confusion; the second stage may bring with it more exaggerated behavioral symptoms like changes in social behavior, “erratic” behavior, and problems with judgment. Finally, the third stage can carry more severe cognitive deficits, full-blown dementia, and Parkinsonism.(2)(10)