Literature Review

Does Age of Exposure to Tackle Football Affect CTE Severity?


Younger age of exposure to tackle football is not associated with chronic traumatic encephalopathy (CTE) pathologic severity, Alzheimer’s disease pathology, or Lewy body pathology, according to data published online ahead of print April 30 in Annals of Neurology. Younger age of exposure does appear to predict earlier neurobehavioral symptom onset, however, the authors said.

Michael L. Alosco, PhD

“These findings suggest that exposure to repetitive head impacts from tackle football as a youth may reduce resiliency to diseases, including, but not limited to, CTE, that affect the brain in later life,” said Michael L. Alosco, PhD, Assistant Professor of Neurology at the the Boston University Alzheimer’s Disease and CTE Center. “This study adds to growing research suggesting that incurring repeated head impacts through tackle football in earlier life can lead to both short-term and long-term effects on the brain.”

Repetitive Head Impacts and Neurodevelopment

Previous research has linked younger age of first exposure to tackle football with smaller thalamic volume in former National Football League players. A recent study of 214 former and amateur football players found that age of first exposure to tackle football—before age 12, in particular—predicted increased odds of self-reported neuropsychiatric and executive impairment.

“Youth exposure to repetitive head impacts may disrupt neurodevelopment to lower the threshold for later clinical dysfunction,” said the researchers.

To examine the effect of age of first exposure to tackle football on CTE pathologic severity and age of neurobehavioral symptom onset in tackle football players with neuropathologically confirmed CTE, Dr. Alosco and colleagues analyzed a sample of 246 amateur and professional tackle football players whose brains had been donated to the Veteran’s Affairs–Boston University–Concussion Legacy Foundation Brain Bank. The researchers interviewed informants to ascertain players’ age of first exposure and age of onset of cognitive, behavioral, or mood symptoms. A total of 211 football players were diagnosed with CTE; 35 did not have CTE. Of the 211 participants with CTE, 126 had CTE only, and the other participants had comorbid neurodegenerative diseases.

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