Twenty-two-year-old Ohio State football player Kosta Karageorge had a history of concussions. Though we don’t know the inciting event that resulted in his suicide, research suggests that athletes who sustain concussions are more likely to develop depression, disorientation, and suicide. How so? You might ask. Chronic traumatic encephalopathy (CTE), a degenerative disease of the brain, originally called “punch-drunk” syndrome in boxers, is seen in any athlete who sustains repeated head trauma, especially football players. It’s not unreasonable to assume that Karageorge was a victim of this mysterious disease, which can only be diagnosed on autopsy. “I am sorry if I am an embarrassment but these concussions have my head all f***ed up,” Karageorge said three days before he shot himself (www.washingtonpost.com/football-player-kosta-karageorge).  According to his sister, Karageorge experienced confusion and mood swings, symptoms, which, in addition to aggression and gait disturbances, are not uncommon in those with CTE (www.marquettewire.org/karageorges-death-shows-concussion).

Though football players of any age may suffer from CTE, younger athletes are particularly vulnerable. Because their brains are not fully developed, they are at risk for second impact syndrome, a potentially fatal condition that occurs when a player sustains a concussion then returns to the game and suffers a subsequent concussion before the first one has had time to heal (www.usatoday.com/highschool football deaths). More sad news: the prevalence of depression among teenagers who sustain concussions is three times higher (http://www.ncbi.nlm.nih.gov/pubmed/24355628).

If you haven’t been following the news about brain trauma in football players, you might, or might not, be surprised to learn that, out of one hundred twenty-eight deceased players, as many as one hundred one had CTE (www.pbs.org/concussion). What steps are being taken to prevent football players from these unnecessary and brutal deaths? Both the National Football League and the National Collegiate Athletic Association settled class-action lawsuits in 2013 challenging concussion protocols. But, finally, this past November, a former football player, who sustained concussions playing the game, filed the first class action lawsuit against the Illinois State High Athletics Association.

Another young football player has also come out about his history of concussions, and subsequent plunge into depression. Though heartbreaking, his story will leave you more than informed; it will make you pause and think twice before you enroll your child in high-school football (www.huffingtonpost.com/football-concussions).

Let’s take a moment of silence for the others who chose to end their lives because of football (www.ajc.com/football-suicide):

Owen Thomas: The first, and youngest, collegiate player diagnosed with CTE.

Terry Long: An offensive lineman for the Steelers. Shot himself on June 7, 2005. Age forty-five.

Andre Waters: Played for the Steelers and the Cardinals. Shot himself on Nov. 20, 2006, at age forty-four.

Shane Dronett: A defensive lineman in the NFL. On Jan. 21, 2009, shot himself. Age forty-eight.

Dave Duerson: Played for the Bears, Giants and Cardinals. On Feb. 17, 2011, he shot himself in the chest. Age fifty.

Ray Easterling: Played for the Falcons. On April 19, 2012. Shot himself in his Richmond, Va., home. Age sixty-two.

Junior Seau: A linebacker for the Chargers, Dolphins and Patriots. On May 2, 2012, shot himself in the chest. Age forty-three.

Jovan Belcher: A linebacker for the Kansas City Chiefs. Shot and killed his girlfriend, then shot and killed himself. He was twenty-five.

Paul Oliver: Played for the University of Georgia, then the Chargers. Shot and killed himself on Sept. 24, 2013. Age twenty-nine.

If you’re looking for a holiday gift for a football fan, or a non-fan, check out Steve Almond’s Book, Against Football.  An entire chapter is devoted to football and traumatic brain injuries. The research is both startling, and disturbing.

You might have suffered a concussion playing football as a high school or college student, and because you felt nauseous and dizzy, you rested for a few days, just as your doctor advised. Those few days passed and you felt like your old self again, ready to return to the field.

Fifty years later, your family is concerned about your memory: you don’t know what month it is, and you can’t recall the conversation you had with your son two hours earlier. Your wife eventually takes you to a neurologist, who diagnosis you with Alzheimer’s disease. You’re surprised. After all, you have no family history of Alzheimer’s, and you’ve worked hard to keep your brain sharp: you’ve been an avid reader and crossword puzzle fanatic for years. The neurologist must be wrong, you think. Or maybe you haven’t considered the concussion you sustained half a century earlier.

A brain injury is a risk factor for Alzheimer’s. It’s possible that all it takes is one concussion. On autopsy, an Alzheimer’s brain reveals beta amyloid deposits – proteins that collect between nerve cells. Tau, tangled fibers of proteins, collects within the cells. As we age, it’s not unusual to expect protein build up within our brains, but in Alzheimer’s, they accrue in greater amounts, impeding communication between nerve cells, causing memory impairment and personality changes.

In autopsy studies of those who have died in the acute phase of a traumatic brain injury, researchers have found amyloid deposits in thirty percent of people, including children, and increased tau levels in the spinal fluid of those who died of a severe traumatic brain injury.

But studies have proven that amyloid is a mysterious protein as it relates to head trauma. Researchers have learned that individuals with mild cognitive deficits, who reported a history of brain trauma, showed brain changes consistent with Alzheimer’s. But those with no cognitive impairment, who also reported a history of brain trauma, did not show any changes.

So, at least there is hope – if you have suffered a brain injury, maybe you’ll be among the lucky and will escape the sticky plaques and fibrous tangles.

http://www.medscape.com/viewarticle/818376 http://depts.washington.edu/adrcweb/research-101/traumatic-brain-injury/