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Wednesday, September 22, 2010

College Football, Suicide and Brain Damage


Dr. Roy Benaroch is a general pediatrician, author, and educator at Emory University. He has written two books for parents and contributes to several parenting and medical web sites and print journals.

A realistic worry, or just media fear-mongering? That’s a good question to ask after widespread news reports about a college football player’s recent suicide. Stories about this tragedy seemed to blame his death on football. Is it time to rethink high school and college athletics?

Owen Thomas, a junior lineman at the University of Pennsylvania, committed suicide after an abrupt change in personality and mood. An autopsy revealed early stages of brain damage, called chronic traumatic encephalopathy (CTE), that had previously been linked to depression, impulse control problems and suicide in professional athletes.

In the past, it was believed that CTE was caused by repeated concussions, a traumatic brain injury following a sudden blow to the head. More severe concussions cause an immediate loss of consciousness, while milder concussions cause a period of confusion, sleepiness, trouble with balance, or a severe headache. In any case, concussions were always thought to cause symptoms immediately after the injury — so a football player who is “knocked out” or “knocked silly” is known to have a concussion, and has to come out of the game for evaluation and treatment to prevent further injury. A sharp blow to the head not accompanied by any symptoms — the kind that happens thousands of times a day on sports fields all over the world — was not thought to be something to worry about.

What makes this recent story concerning is that Thomas had no previous history of concussions. Now, it could be that he was having concussions, and just not telling his coach. If that was the case, the lesson here is that athletes need to learn about the importance of the symptoms of concussions and need to tell their coaches, even if it means missing time on the field.

But what if Thomas’ history is correct? What if brain injury — we’re talking serious brain injury, the kind that causes changes in personality and mood that can drive a young man to suicide — can be caused by the ordinary blows football players sustain every day?

It not clear at all that the autopsy findings are definitely diagnostic of CTE. This article points out that even if there is some risk of football, suicides like this are very rare. The risk is much smaller than risks that families take every day, like the risk of driving a car, or the risks of an unhealthy diet leading to the serious health consequences of obesity. The actual risk of suicide from brain damage caused by football, if it exists, is probably far outweighed by the considerable health benefits of physical activity.

Stories like these have a strong and emotional impact. A dramatic and senseless death in an otherwise-healthy college student captures your attention, and makes us wonder about what should have been done differently. But a little perspective is needed: millions of young athletes play football, and we’re not seeing anything close to an epidemic of symptoms of CTE. Coaches do need to improve their recognition and treatment of athletes with concussion, and further study is needed into a possible link between CTE and non-concussive brain injuries. But now is not the time to pull the rug out from sports participation.

Posted by: WebMD Blogs at 8:47 pm

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