Youth Football Players Have Brain Changes After One Season

 Another study finding brain changes from playing tackle football - this time measurable brain changes were found in boys 8 to 13 years old after just one season of playing football. None of the boys had received a concussion diagnosis during the season. The changes in the white matter of the brain (and detected with magnetic resonance imaging (MRI) were from the cumulative subconcussive head impacts that occur in football - the result of repetitive hits to the head during games and practices.

No one knows if the brains of football players fully recover after the football season. But these findings are worrisome. Especially because last year researchers found that NFL players who had begun playing  football before age 12 had a higher risk of altered brain development, as compared to players who started later (see post). Currently nearly 3 million students participate in youth tackle football programs across the United States. Some are calling for young players to only play flag or touch football, and to only play tackle football starting with the teenage years. From Science Daily:

Brain changes seen in youth football players without concussion

Researchers have found measurable brain changes in children after a single season of playing youth football, even without a concussion diagnosis, according to a new study published online in the journal Radiology.

"Most investigators believe that concussions are bad for the brain, but what about the hundreds of head impacts during a season of football that don't lead to a clinically diagnosed concussion? We wanted to see if cumulative sub-concussive head impacts have any effects on the developing brain," said the study's lead author, Christopher T. Whitlow, M.D., Ph.D., M.H.A., associate professor and chief of neuroradiology at Wake Forest School of Medicine in Winston-Salem, N.C.

The research team studied 25 male youth football players between the ages of 8 and 13. Head impact data were recorded using the Head Impact Telemetry System (HITs), which has been used in other studies of high school and collegiate football to assess the frequency and severity of helmet impacts....The study participants underwent pre- and post-season evaluation with multimodal neuroimaging, including diffusion tensor imaging (DTI) of the brain. DTI is an advanced MRI technique, which identifies microstructural changes in the brain's white matter. 

The brain's white matter is composed of millions of nerve fibers called axons that act like communication cables connecting various regions of the brain. Diffusion tensor imaging produces a measurement, called fractional anisotropy (FA), of the movement of water molecules in the brain and along axons. In healthy white matter, the direction of water movement is fairly uniform and measures high in FA. When water movement is more random, FA values decrease, which has been associated with brain abnormalities in some studies.

The results showed a significant relationship between head impacts and decreased FA in specific white matter tracts and tract terminals, where white and gray matters meet. "We found that these young players who experienced more cumulative head impact exposure had more changes in brain white matter, specifically decreased FA, in specific parts of the brain," Dr. Whitlow said. "These decreases in FA caught our attention, because similar changes in FA have been reported in the setting of mild TBI."

It is important to note that none of the players had any signs or symptoms of concussion."We do not know if there are important functional changes related to these findings, or if these effects will be associated with any negative long-term outcomes," Dr. Whitlow said. "Football is a physical sport, and players may have many physical changes after a season of play that completely resolve. These changes in the brain may also simply resolve with little consequence. However, more research is needed to understand the meaning of these changes to the long-term health of our youngest athletes." [Original study]

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