Ex-football players with medical and mental health conditions at higher odds of receiving premature CTE diagnosis

Former professional American football players who have medical and mental health conditions including depression, anxiety or sleep apnea are more likely to receive an unverified diagnosis of chronic traumatic encephalopathy, or CTE, compared to those without those conditions, report researchers from the University of Pittsburgh School of Medicine, Harvard University and Vanderbilt University Medical Center in Sports Medicine today.

Receiving a CTE diagnosis that cannot be verified until after death could further exacerbate mental health conditions in former players due to the current lack of treatments for the disease, the experts caution.

"We agree that CTE neuropathology is real, yet the current narrative about CTE and health after football, in general, is incomplete," said co-lead author Shawn Eagle, Ph.D., research assistant professor of neurological surgery at Pitt. "Currently, a definitive causal link between brain health issues experienced in life and CTE-associated brain changes seen in autopsies has yet to be established."

CTE is a neurodegenerative disease associated with a history of repetitive head impacts and is characterized by the presence of toxic protein aggregates and brain tissue degeneration seen at autopsy. By definition, it is impossible to confirm a CTE diagnosis in a living individual, yet prior research by co-lead author Rachel Grashow, Ph.D., M.S., and colleagues from the Football Players Health Study (FPHS) at Harvard University showed that 3 in every 100 former football players report being diagnosed with CTE by a medical professional.

"It is important for the next generation of players to know the long-term health risks they may face, and that is the ultimate goal of CTE research," said Eagle. "There is still a lot to be learned, and, in the meantime, we want people to receive proven treatments for conditions that may mimic CTE, such as hypertension, sleep apnea, depression and anxiety, among others."

Other authors of the study are David Okonkwo, M.D., Ph.D., of Pitt; Douglas Terry, Ph.D., of Vanderbilt University Medical Center; Rachel Grashow, Ph.D., M.S., Heather DiGregorio, B.S., Aaron Baggish, M.D., Marc Weisskopf, Ph.D., Sc.D., and Ross Zafonte, D.O., all of Harvard University.