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Former NFL Players Who Played Tackle Football Before Age 12 at Increased Risk of Memory and Thinking Problems Later
Former National Football League (NFL) players who participated in tackle football before the age of 12 were more likely to have memory and thinking problems in adulthood, according to a new study published in the January 28, 2015, online issue ofNeurology®, the medical journal of the American Academy of Neurology.
For the study, researchers tested 42 former NFL players with an average age of 52. All of the participants had experienced memory and thinking problems for at least six months. Half of the players participated in tackle football before the age of 12 and half did not. The number of concussions sustained was similar between the two groups.
The study found that compared with former NFL players who started football at age 12 or later, former players who started before age 12 performed significantly worse on all test measures, even after researchers took into account the total number of years of football played and the age of the players at the time of the tests. For example, those who played before age 12 recalled fewer words from a list they had learned 15 minutes earlier, and made more repetitive errors on a test of mental flexibility, compared with those who started playing at age 12 or later. The differences between the two groups represented approximately a 20-percent difference in level of current functioning on several measures. Study author Robert Stern, PhD, with Boston University School of Medicine said that both groups scored below average on many of the tests.
“Our study suggests that there may be a critical window of brain development during which repeated head impacts can lead to thinking and memory difficulties later in life,” said Stern. “If larger studies confirm this association, there may be a need to consider safety changes in youth sports.”
“Football has the highest injury rate among team sports,” said Christopher M. Filley, MD, with the University of Colorado School of Medicine in Aurora, CO, in an accompanying editorial. Filley is a Fellow with the American Academy of Neurology. “Given that 70 percent of all football players in the United States are under the age of 14, and every child ages nine to 12 can be exposed to 240 head impacts during a single football season, a better understanding of how these impacts may affect children’s brains is urgently needed.”
Stern said that because the study focused on NFL players, the results may not be applicable to the general public and more research is needed before policy changes are implemented. “There are tremendous benefits of participating in youth team sports. The goal is to make them safer.”
“While the researchers did take into account the total years of football played, they were unable to assess the total number of head impacts. So it’s possible that the number of impacts is responsible for the reported results rather than the early age of exposure to football,” said Filley.
Wake Forest Baptist Medical Center has received a $3.8 million, five-year grant from the National Institute for Neurological Disorders and Stroke (NINDS), part of the National Institutes of Health, to continue studying the effects of head impacts in youth league football.
“While there has been increasing interest in football head injuries at the professional, collegiate and high school levels, little data is available for children who play in youth leagues,” said Joseph Maldjian, M.D., professor of radiology at Wake Forest Baptist and principal investigator of the study. “Our goal is to help make youth football a safer activity for millions of children by having a better understanding of how repeated hits to the head affect a child’s brain.”
The Imaging Telemetry and Kinematic Modeling in Youth Football (iTAKL) study will use a three-pronged approach employing imaging, cognitive testing and biomechanical data to increase understanding of pediatric mild traumatic brain injury.
This project builds on recent research conducted at Wake Forest Baptist and integrates neuroinformatics work and computational modeling techniques developed by Maldjian and Joel Stitzel, Ph.D., chair of biomedical engineering at Wake Forest Baptist and co-principal investigator of the NINDS-funded study.
Maldjian said the study is expected to enroll 100 to 130 children ages 8 to 12 who play organized football in the Winston-Salem area. Sensors placed inside players’ helmets will measure head impacts during all practices and games throughout a full season.
Study participants will undergo pre- and post-season cognitive testing and imaging with MRI and magnetoencephalography (MEG), a non-invasive technique that maps brain activity by measuring the magnetic fields generated by the brain’s neurons. If a player experiences a clinical concussion during the season, the same testing and imaging will be conducted as soon as possible after the diagnosis, Maldjian said.
The Wake Forest Baptist researchers have partnered with Gerard Gioia, Ph.D., division chief of neuropsychology at Children’s National Health System in Washington, D.C., for analysis of the cognitive data.
The research team hopes that the long-term benefit of the iTAKL study will be objective data that will help equipment designers, researchers and clinicians better prevent, mitigate, identify and treat head injuries.
Partial support for the initial study, which collected data from 50 youth league players during the 2012 season, was provided by the Childress Institute for Pediatric Trauma.
The NFL has announced that more than 140 former NFL players will serve as Master Trainers and Ambassadors to teach and reinforce USA Football’s Heads Up Football program to youth leagues and high schools nationwide during the 2014 season.
Elaborating on that point, the league noted that of USA Football’s 78 Master Trainers, 17 played in the NFL, “bringing knowledge and insight gained from competing at the sport’s highest level. Master Trainers lead full-day instructional sessions for high school and youth programs nationwide, teaching Heads Up Football’s curriculum to high school- and youth league-appointed Player Safety Coaches.”
The NFL also noted that another 127 former NFL players serve as Heads Up Football Ambassadors, “visiting practices and games of teams that participate within the program. Ambassadors strengthen awareness and reinforce Heads Up Football’s messages and standards.”
To Master Trainer Ruben Brown, a nine-time Pro Bowl selection at guard for the Buffalo Bills and Chicago Bears (1995-2007), the responsibility seems personal.
“I’m a father – nothing is more important to me than the health of our kids,” he said. “Heads Up Football is changing for the better how coaches are prepared, players are taught and safety is addressed, and it’s exciting to see so many other former players share this commitment.”