NFL Head Injuries Linked to Depression
Tuesday, January 8, 2013 12:10 PM
Former National Football League players suffer more depression than ordinary people, according to research that may explain recent suicides in the group, including the all-star Junior Seau last year.
In a study of 34 retired NFL players, about 25 percent suffered with clinical depression, higher than the 15 percent seen in the general population. The research, published yesterday in the journal JAMA Neurology, also found physical abnormalities in the brains of some the athletes in medical scans. This is the first research in former players to connect the mental deficits with changes in brain structure.
Evidence has been mounting that repeated concussions harm brains, and a group of former players is suing the NFL seeking damages from the long-term effects of brain injuries suffered on the field. Several prominent suicides among professional players include that of Seau, who spent most of a 20-year career with the San Diego Chargers.
"This study gives us new ideas in terms of what is actually going wrong in people’s brains when they are developing cognitive or depression symptoms related to concussions," said John Hart, Jr., medical science director at the Center for BrainHealth and director of the BrainHealth Institute for Athletes, University of Texas at Dallas.
The NFL will share the report with its Head, Neck and Spine Committee, said Clare Graff, an NFL spokeswoman, in a statement. The league is working with the U.S. Centers for Disease Control and Prevention, the National Institutes of Health and other health organizations to support a wide range of research focused on promoting player safety, she said.
The league has donated $30 million to the Foundation for the National Institutes of Health to perform more research in the area, wrote Ramon Diaz-Arrastia and Daniel Perl, both at the Uniformed Services University of the Health Sciences in Bethesda, in an accompanying editorial.
The incidence of dementia found by the study wasn’t different from that in the general population in the same age group, the authors wrote. The incidence of mild cognitive impairment, a pre-Alzheimer’s state, was "slightly higher," according to the paper.
One surprising finding, according to the researchers, was the number of players with depression.
Most of the eight former players with the condition weren’t diagnosed prior to the study because they didn’t have the low moods many people typically associate with depression, such as feeling sad and crying. Instead, they had decreased energy levels, problems with sleep, weight and appetite, and difficulty initiating things, Hart said.
Brain scans taken of 26 of the former players detected differences in blood flow to areas of the brain associated with memory and word finding. The scans also showed for the first time a correlation between cognitive impairment and abnormalities in white matter.
"When you shake or move the brain, you can tear or damage the white matter," Hart said. "It doesn’t necessarily always have to be the point of developing symptoms. We need better and more sophisticated ways of identifying things that lead to these symptoms."
The study involved 34 former National Football League players living in northern Texas. They were recruited at a local gathering of retired NFL players and through word of mouth. Daryl Johnston, a Dallas Cowboys fullback from 1989 to 1999 and member of three Super Bowl winning teams, helped the researchers recruit others for the study.
"Having played 11 years in the NFL and taken countless hits, I’ve heard about the struggles of the players who came before me and the challenges regarding their quality of life," Johnston said in a press release.
"Through the Center for BrainHealth, former players can find out if there is an issue," he said. "If you catch it early or late, there are things you can do to improve your condition. The brain is regenerative for life, and we can restore faculties that just a few years ago were thought to be lost forever."
One potential culprit is a condition called chronic traumatic encephalopathy or CTE.
The disease is a result of repeated blows to the head that can cause changes to the brain, leading to degeneration. It was initially discovered in boxers in the 1920s, according to the website of the Boston University Center for the Study of Traumatic Encephalopathy.
Behavioral symptoms include memory loss, confusion, aggression, depression, and dementia. The findings may provide hints on what to look for when researchers try to characterize the condition, Arrastia and Perl wrote.