Former Pro Football Players Show Troubling Brain Changes

Head injuries related to football might be tied to markers of dementia like brain shrinkage and decreased blood flow to the brain, a new study of former pro and college players reports.

The study looked at signs of injury to the brain’s white matter, called white matter hyperintensities.

These are caused by reduced blood flow to white matter, which functions as the information highway connecting different parts of the brain.

“Studies have shown that athletes exposed to repetitive head impacts can have increased white matter hyperintensity burden in their brains,” said researcher Michael Alosco, a neuropsychologist at Boston University Chobanian & Avedisian School of Medicine.

“White matter hyperintensities are easily seen on MRI as markers of injury of various causes,” he continued in a news release. “We know these markers are more common as people age and with medical conditions such as high blood pressure, but these results provide initial insight that they may be related to multiple aspects of brain damage from repetitive head impacts.”

For the study, Alosco’s team compared brain scans of 120 former pro football players and 60 former college players against 60 men who never played football and had no history of concussion.

They found that the relationship between white matter hyperintensities and stroke risk was more than 11 times stronger in former football players than in those who never played.

They also found that these signs of brain damage were 2.5 times more strongly related to elevated p-tau proteins in football players than in non-players. P-tau protein levels are associated with damage caused by Alzheimer’s and other brain diseases.

On one measure of white matter integrity, the relationship was nearly 4 times stronger in former football players, the study showed.

White matter hyperintensities also were associated with more brain shrinkage and less blood flow to the brain, results show.

Finding ways to treat white matter damage will be important to help players manage their risk of cognitive problems, Alosco said.

“While our research previously showed that former football players still have elevated white matter hyperintensity burden after controlling for sleep apnea, alcohol use and high cholesterol, it is still important to consider working on modifying these risk factors due to their effects on cognitive problems and other symptoms,” he said.

The study was published Dec. 20 in the journal Neurology.

More information

The Cleveland Clinic has more about white matter disease.

SOURCE: American Academy of Neurology, news release, Dec. 20, 2023