Athletes are hard on their bodies – professional athletes even more than others.
Contact sports such as American football, soccer, baseball or rugby, hockey, ice hockey, and lacrosse are examples of high contact sports that often result in concussions or injuries that may affect brain function. Several studies conducted over the past few years on American football players have detected a degenerative brain disease called chronic traumatic encephalopathy, or CTE. The disease is a result of consistent physical trauma to the athletes’ brains due to intense physical contact over time. A study published on July 25, 2017 in the Journal of the American Medical Association has determined that 99 percent of deceased players’ brains show evidence of CTE. These overwhelming results have stimulated medical investigations into the neuroprotectant effects of medical cannabis on the brain.
Who Discovered Chronic Traumatic Encephalopathy in Athletes?
Chronic Traumatic Encephalopathy, or CTE, was discovered in 2002 by Bennet Ifeakandu Omalu, a Nigerian-American forensic pathologist, physician, and neuropathologist at the Allegheny County Coroner’s Office in Pittsburgh, Pennsylvania. Dr. Omalu, the subject of the recent Will Smith film Concussion, discovered that several Pittsburgh Steelers American football team members who were deceased had significant brain damage due to repeated concussions during practice and games. A concussion is a type of traumatic brain injury (TBI) that results from a bump, blow, or jolt of the head causing normal functioning of the brain to be disrupted. Concussions are usually mild, but Dr. Omalu’s findings indicate that repeated concussions may have deleterious effects on the human brain. Severe TBIs can result in memory loss, extended periods of unconsciousness, and brief mental status changes, according to the Centers for Disease Control and Prevention (CDC). The CDC estimated that almost 50,000 people died in 2013 from TBIs.
What is Chronic Traumatic Encephalopathy?
Chronic Traumatic Encephalopathy (CTE) is a complication of concussion, a progressive neurodegenerative disease in which the brain has suffered extreme trauma. CTE patients often lose brain mass, or have enlarged sections of the brain. One of the major issues with studying CTE in contact sport athletes such as American football players is that CTE can only be identified in the brain following the athlete’s death. In the process of diagnosing CTE, the human brain is tested for high levels of defective Tau proteins which build up in the brain over time and cause CTE signs to emerge. Tau proteins’ usual role is as a stabilizer for brain nerve cells, but in CTE the proteins are not fulfilling this task. Post-mortem testing for Tau proteins is conducted using a process called immunostaining.
Symptoms of Chronic Traumatic Encephalopathy
Symptoms of CTE are as follows and may only appear decades after the brain injuries occurred:
- Memory loss
- Difficulty planning, organizing, prioritizing, paying attention, and starting tasks
- Depression or suicidal behavior
- Impulsivity and impaired judgment
- Anger, aggressiveness, and irritability
- Progressive dementia
Some individuals with CTE may also suffer from a more severe form of the disease known as Chronic Traumatic Encephalomyopathy or CTEM, which results in the following symptoms (characteristic of amyotrophic lateral sclerosis or Lou Gehrig’s disease) in addition to those of CTE:
- Profound weakness
- Fasciculation (tics)
The repetitive brain trauma professional athletes such as American football players experience has also been found in military veterans. Parents of children who participate in contact sports at a young age are also concerned that CTE may affect their children’s growing brains. The CDC has provided a helpful guide on how to protect children from TBI, and estimates that 329,290 United States children under the age of 20 were treated for sports and recreation-related injuries and diagnosed with concussion or TBI in 2012 alone.
How Medical Cannabis May Protect the Brains of Athletes
Medical cannabis is excellent at relieving pain, and has been proven to be a neuroprotectant, or to contain compounds which protect the brain from injury and environmental dangers. In a 2000 study, Hampson, Frimaldi, Lolic, Wink, Rosenthal, and Axelrod found that both THC delta 9-tetrahydrocannabinol) and CBD (cannabidiol) reduced neurotoxicities in the brains of rats. Another study in Canada found that cannabinoids stimulated newborn rat neuron growth and reduced anxiety and depressive behavior, as well. They did so because they are naturally-occurring antioxidants and prevent inflammation of the brain.
Ongoing CTE Studies
Currently, researchers are working in the renowned Johns Hopkins University School of Medicine in Baltimore, Maryland, to determine the results of cannabinoid consumption versus opioid consumption on American football players in the National Football League (NFL). The study, conducted by Vandrey, Bonn-Miller, McCann, and Budney is supported by these former NFL football players: Derrick Morgan, Jake Plummer, and Eugene Monroe. The study is wide-ranging, and will be the basis for future medical cannabis and contact sport athlete studies in the future, including injury frequency and intensity measurements; American football players’ intake of prescription opioids, medical cannabis, and other substances to mediate pain from those injuries; and the general health of both former and current American football players.
Researchers at the Pennsylvania Biotechnology Center in Pennsylvania stated that inflammation has an important role in injury, and cannabinoids naturally reduce inflammation. Dr. Tuma and Dr. Ward are studying the feedback cycle of inflammation that makes head injuries like concussions worse, and results in CTE. Tuma and Ward are partnering with a cannabis company to determine if rodent pretreatment with CBD can protect their brains from injury.
Eugene Monroe, a former Baltimore Ravens tackle who recently resigned from the NFL, noted that “We now know that [opioids] are not as safe as doctors thought, causing higher rates of addiction…and we have cannabis, which is far healthier, far less addictive, and quite frankly, can be better in managing pain.” The Johns Hopkins study is meant to measure American NFL football players’ medication intake (including medical and recreational cannabis), injuries, and general health, with the aim of determining which medications are detrimental and which help them with pain, injuries, and other side effects of the contact sport they participate in. Ryan Vandrey and Marcel Bonn-Miller hope the study will inform future studies for athletes and medical cannabis. CTE is not the only degenerative brain disease that athletes and other people suffer from; if medical cannabis can indeed protect the brain from environmental and sports-related injuries, the implications are vast in the world of medicine, and could help those with Alzheimer’s, depression, and other neurogenerative diseases, as well.
[Featured image credit- Medical Marijuana Update]