Football players suffer brain injuries even without concussions

MINNEAPOLIS — College football players show signs of injury deep within the portion of the brain that helps control thinking and emotion, including those who haven’t suffered concussions, researchers found.

The greatest damage occurred in players who started young and suffered repeated concussions, a traumatic brain injury that typically stems from a blow to the head or violent shaking. The findings published Tuesday in the Journal of the American Medical Association add to the body of evidence that even mild contact can cause real and lasting brain damage.

Health officials have targeted concussions with outreach programs designed to increase awareness and cut injury rates, particularly in youth sports where there was little attention to the potential harm to the brain from collisions. Studies have shown abnormalities in the brains of former National Football League players and preventable deaths in younger athletes who stayed on the field after taking violent hits.

“The key take-home message, especially for parents, is when in doubt, get it checked out,” said Patrick Bellgowan, director of cognitive neuroscience at the Laureate Institute for Brain Research in Tulsa, Oklahoma, and senior author of the study. “It’s a real injury. Parents basically think once the symptoms are gone their kids are better, and that’s not necessarily true.”

The researchers compared high-resolution brain images for 25 college football players with a history of concussions, 25 athletes who hadn’t suffered traumatic brain injuries and 25 matches with people who weren’t players. They also tested cognitive function and took into account the number of years the men played football.

The results were a surprise, researchers said. Both sets of players had significantly smaller volume in their hippocampus, a region of the brain that’s responsible for memory and emotion, rather than just the men who had suffered repeat concussions. While their memories and thinking weren’t impaired, it took longer to answer questions and their reaction times were slower, the study found.

“The smaller volume may be a precursor, the first stage,” Bellgowan said. “What hasn’t come out may be the functional consequence of that. These guys are on average only 20 years old. They aren’t done with neurodevelopment yet.”

It’s also possible that the study wasn’t large enough to find a difference, the method used to measure cognitive performance wasn’t effective or a difference just isn’t there, he said in a telephone interview.

A separate study also released today found the increased attention has led to a jump in hospital visits for traumatic brain injuries. In 2010, emergency room visits for head trauma increased 29 percent to 2.5 million from 2006. The number of total ER visits during the period increased 3.6 percent, said the researchers led by Jennifer Marin, from the University of Pittsburgh School of Medicine’s department of pediatrics.

The researchers analyzed the Nationwide Emergency Department Sample database that tracks 25 million to 50 million emergency room visits at more than 950 hospitals a year, or about one in five across the U.S. The largest increases were seen in children younger than age 3 and adults ages 60 and older, with most injuries stemming from falls.

“The concussion laws and helmet laws and all the campaigns have been targeted at young adults and teenagers, not the very young and the elderly,” Marin said. “The very young and the very old may not have benefited from those interventions.”

Traumatic brain injury can carry significant complications, with 40 percent of survivors suffering physical or psychological harm in the following year, she said in a telephone interview.

“When we see these dramatic increases, it begs the question of why,” she said. “We need to figure out how to ameliorate it, how to reverse the trend.”