Understanding CTE: The Hidden Danger in Sports

today i want to talk with you all about a serious topic one that is starting to really take

headlines in the world of sports and that is something called cte which stands for chronic traumatic

encephalopathy it has recently come out that spencer fisher a retired ufc fighter

is suffering from multiple cognitive issues mood disorders and behavioral problems

which is thought to be due to the repetitive head trauma faced during a seven year career

fighting in ufc for those who don't know me my name is sonam and i'm a resident doctor specializing in sports and

exercise medicine be sure to subscribe to my channel if you want to stay up to date on latest

videos and content for now let's get back to talking about cte in more detail

if any of you have watched the movie concussion or have have been in the news recently around kind of more deceased ns

nfl players and their autopsy results we're starting to learn about this new diagnosis called

cte which stands for chronic traumatic encephalopathy so what is chronic traumatic encephalopathy or cte for

short essentially it's a progressive neurodegenerative disorder

so if any of you have had parents or grandparents suffer from alzheimer's dementia it's essentially

that type of disorder but in a younger healthier person due to chronic repetitive years of head

trauma in terms of the the pathology or how this develops in the brain we think it's actually due to

the accumulation of proteins called tau proteins around blood vessels

that progresses the degeneration within the brain these similar proteins are also found in

patients with alzheimer's dementia so it can lead to why the symptoms are very

similar so what are the main symptoms of cte there are three main categories of symptoms

one is cognitive impairment so we're thinking memory dysfunction and changes in executive function what

does that mean it essentially means that they're no longer able to inhibit inappropriate actions so for example you

know urinating outside swearing at someone when it's not appropriate to do so and this is why you

see those personality changes in an athlete suffering from cte like diagnoses

two behavioral problems these include aggression paranoia or impulsivity and three

mood disorders these include depression anxiety ptsd paranoia again and unfortunately

as we discussed before if any of you have had anybody suffer from dementia in your family they

present very similarly to these symptoms and what's so sad about cte

is these patients are presenting in their 20s and 30s and 40s with these pretty serious cognitive disturbances

they have young children they have spouses who were not expecting to be caregivers for 30 to 40 years

and unfortunately it develops things like caregiver burnout the actual athlete being on disability

pretty much for the rest of their lives not being able to remember their friends or family not being able to remember

you know the great career they had beforehand and that is why it's so serious

so what are the risk factors that put you at risk for getting cte number one is the years that you play a

sport that puts you at risk for repetitive head trauma so you're thinking total years right so

in inspection in fisher's case he had had seven full years of ufc fighting and ufc is pretty

intense for those of you that are worried if one or two concussions can cause this

researchers have actually shown it's not a single concussion that puts you at risk for cte

but the repetitive micro trauma so just imagine for example all those small hits to your head which

didn't make you daisy didn't make you concussed but were enough to start creating

changes in your brain now add them over a career of 10 to 15 years and that is what changes

the brain on a molecular level to cause symptoms like cte the second risk factor is the age that

you start playing competitive sports which put you at risk for head trauma so this is why we try to keep kids away

from tackle football until they're in their older teenage years

some research has shown for example that kids who engage in tackle football at earlier ages prior to the age of 14

are 10 times higher risk of getting cte than those who wait until they're after 14.

that is insane that correlation is actually more serious than lung cancer and smoking

so this is something that we need to be taking extremely seriously the last thing is actually

genetic predisposition so recently if anyone has been reading the news april e has been implicated in whether

or not you could be at risk for cte we don't know too too much more about it but if you hear about something called

apoe just know that it's something being researched to know whether or not unfortunate

people have higher genetic risk of getting these types of diagnoses so some of the sports that we're worried

about when it comes to cte include tackle football ufc boxing soccer even military vets for example

anything where you can hit your head so you're suspecting a diagnosis of cte in a patient

or you're a family member or an athlete how do you diagnose it so this is the sad part you can't the

diagnosis of cte is made of pathological examination of the brain tissue

so it's actually a post-mortem diagnosis they look at the brain tissue and i'll put up a picture here that shows a

normal brain and a brain with cte and you'll see that the white and gray matter

have significantly shrunk and then when they look at it under a microscope that's when they see these abnormal

congregation of these tau proteins which can cause all of these cognitive symptoms that we're

experiencing now unfortunately what is the prognosis for cte this is where it gets pretty

sad these athletes are just going to continue to get worse so if you imagine your grandparents with dementia

if any of you have seen the timeline and the progression it's very similar and that's why they become completely

disabled completely dependent on on help and their family and no longer able to really engage in the world after

having such an amazing sporting career and i know many of you will ask what are the treatments for cte so right now

we don't have any treatments to reverse the diagnoses as with a lot of cognitive disorders we we have

medications that can help stabilize things so you know if your mood is an issue we can

help with mood mood medication and antipsychotics antidepressants if behavior is an issue we talk about

therapy psychotherapy behavioral inhibition training and if headaches are an issue we can help

address the headaches by using prophylactic medications but there is no single one treatment for

cte and that's where this becomes a little bit more heart-wrenching especially as a doctor because not being

able to treat something like this and watching your patients decline can be pretty sad now if any of you've

been following the news about spencer fisher and his recent diagnosis you know that

dana white the head of the ufc has been talking about psychedelics and been trying to talk

with the center for psychedelic research at john hopkins university so i actually looked into this a little bit

and over the last few years john hopkins has actually created a research program and i will link the program in the

description so you guys can take a look at it looking at psychedelics for depression

alcohol use disorder ptsd pretty much a lot of other mental health disorders

so i did a little bit of digging to see whether or not psychedelics can be used in

something like cte they're really pushing it but they actually don't have much research on it right now

unfortunately people like dana white are noticing that this is gonna be more and more prevalent as your younger fighters

are going to start retiring and you will start seeing the effects of this in the future

much like fisher's case but we know that psychedelics will essentially induce a state of

wakefulness and increase brain connectivity which during the administration of these

medications can help people rewire their brain slightly and increase for example their mood help

with smoking cessation help with alcohol use disorder now when i am saying psychedelics i'm

talking about psilocybin and that's the one that's commonly referred to in these research trials

they looked at the use of psilocybin in disorders of consciousness what does that mean

people in vegetative states people in semi-vegetative states people who aren't responding appropriately

and people with cte could be lumped into this category so what they found was psychedelics

increased brain complexity and conscious awareness now the research is still trying to figure

out the mechanisms by this but they're thinking that potentially if you can increase conscious awareness

this is a medication that may be able to help alleviate some of the symptoms of something like ct

or dementia the john hopkins psychedelic center for research is actually looking at the use of psilocybin

and alzheimer's disease so quite simply if it presents very similar cte they can actually use that and look at

research in that regard now this is really new but i thought it was an interesting

thing to really put on out there because unfortunately like with time we're gonna see that

you know certain drugs and medications that we hadn't really used in the past could be used as treatments you know one

of the famous examples was aspirin is was willow bark and now we use it to prevent heart attacks in millions and

millions of people around the world so cte is a pretty significant diagnosis and i mean a lot of athletes

really have to sit down and think is the risk of cte worth it do you want to continually hit your head

and and predispose yourself to early onset dementia behavioral problems we have actually seen this diagnosis in

the likes of chris benoit aaron hernandez jr sao and joven belcher and unfortunately some of these athletes

took their own lives and took the lives of others prior to doing so and on autopsy was found that they had

symptoms of cte so this is a scary diagnosis and we're now starting to understand it

enough where sports medicine doctors were trying to create policies where we're pulling people out when

we're suspecting concussions or brain injuries we're asking kids not to play tackle football we're trying to

take that out of this the schooling system to protect kids and their brains for as long as possible and then we get

into more of the controversial topics of whether or not ufc may become legally liable for these

athletes afterwards if we now know that repetitive head trauma can cause these symptoms

at the end of the day patients and athletes have the ability to consent to certain

risks like i can't prevent someone from doing something that i don't agree with if

they know the benefits and risks of doing so so this is going to bring out a really

interesting area of sports medicine and that these athletes will have to be educated on these risks and whether or

not the organization such as the nfl or ufc may be legally liable for these outcomes later on in the future

i don't know the answer to these questions they're simply questions i'm posing

i'd be interested to hear any comments or questions down below this is an interesting topic i'm definitely going

to do videos on this in the future and i'd love to hear your thoughts if you like this video please click on the

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that's all