Dementias beyond CTE including Alzheimer's and Parkinson's linked to sport, study finds

Jeremy Wilson, Chief Sports Reporter    July 31, 2019

A range of dementias beyond CTE have been linked to sport in a new study CREDIT:GETTY IMAGES

The link between contact sports and dementia extends beyond chronic traumatic encephalopathy (CTE) to a much wider range of neurological diseases, according to new studies of the brains of former football and rugby players.

Although there has been an enormous focus on CTE following the neurological problems facing American footballers, the evolving weight of research, including the groundbreaking work at the University of Glasgow, is finding a mixture of brain disease among those participants with a long history of head trauma.

A new review of international scientific evidence has also reinforced a study in Italy which showed that footballers were more than six times more likely to suffer from motor neurone disease (MND).

Don Revie was among the higher profile former footballers diagnosed with motor neurone disease CREDIT: HULTON ARCHIVE

Don Revie, Jimmy Johnstone, Fernando Ricksen, Len Johnrose and Stephen Darby are among the higher profile former footballers to have been diagnosed with MND. 

Patrick Grange, the former Major League Soccer player whose brain was examined at Boston University in 2012, was found to have MND as well as CTE.

And in 2014, Brazilian footballer Bellini was posthumously diagnosed with CTE. Bellini, along with Pelé, led Brazil to World Cup victories in 1958 and 1962.

CTE is the type of dementia that is most commonly linked to head trauma and was still found in around three-quarters of the 11 former footballers and rugby players with dementia in the Glasgow study.

Most striking, however, was the prevalence of other dementias and neurological diseases within individual brains, including Alzheimer’s, Parkinson’s disease, chronic cerebrovascular disease and dementia with Lewy bodies. 

The findings have led researchers at Glasgow to use the term 'Traumatic Brain Injury-related neurodegeneration' or simply ‘TReND’, within which CTE might be just one variant.

All of those studied had played football or rugby over a significant period of time, ranging from 11 to 32 years, and were not regularly exposed to other contact sports. The vast majority first showed dementia symptoms in their fifties or sixties and died before the age of 80.

“The focus has been too narrow on CTE, which we show might be a ‘passenger’ pathology, and not the primary driver of dementia,” said Dr Willie Stewart, the lead investigator at Glasgow. “If doctors treating former footballers or rugby players or boxers with dementia assume that CTE is the only problem, then they may be falsely assuming that the patient’s Alzheimer’s or Parkinson’s etc. is nothing to do with sport.

“What is striking is the degree of mixed pathologies. This is something that we are increasingly aware of in wider dementias, but typically found in ‘very old’ patients. Typically these former footballers and rugby players are not ‘very old’, and so it does raise a question why they have such complex pathology.”

Dr Bennet Omalu, the doctor who was credited with identifying some of the first CTE cases in American football, is aware of the Glasgow research and also believes that there should now be new terminology to describe a wider range of neurological diseases that are linked to brain trauma.

“I have been following the research,” he said. “We need to begin to move away from the monolithic way of thinking. CTE is not the only type of brain damage you suffer. It is one of a spectrum. We now call it the Traumatic Encephalopathy Syndromes. TES. This includes dementias, Parkinson’s, Alzheimer’s, Lewy body dementia and others. We shouldn’t become myopic and focus on CTE alone. It is one of many diseases in this spectrum. 

“Brain trauma increases your risk of suffering a variety of brain diseases. There is a need for greater research. It was very Hollywood, how CTE was discovered, it was an unfortunate consequence. It is a spectrum of diseases.”

https://www.telegraph.co.uk/sport/2019/07/31/dementias-beyond-cte-including-alzheimers-parkinsons-linked/