A Third of Former NFL Players Believe They Have CTE

As the 2024 National Football League rushes into the second quarter of the season, a new survey of former players bears news as jarring as it is heartwrenching. One out of three NFL veterans told Harvard researchers that they’re convinced they have CTE.

CTE, shorthand for chronic traumatic encephalopathy, is a neuropathological condition caused by repeated head trauma. Tragically, a diagnosis is only possible during a post-mortem examination.

JAMA Psychiatry published the paper, a Harvard University’s Football Players Health Study product, on Sept. 23.

The players who feared they had CTE reported significantly more cognitive problems, along with a host of other symptoms. Those included higher rates of suppressed testosterone levels, struggles with depression, mood swings, frequent headaches, and chronic pain.

These symptoms – among others – have been past indicators of cognitive issues – even in patients without a history of head injuries.

“As complex human beings, our beliefs can exert a strong impact on our health,” coauthor Ross Zafonte – and president of Spaulding Rehabilitation Network – explained. Zafonte is also a principal investigator of the Football Players Health Study.

“The symptoms that raise CTE concerns are real and CTE concerns are valid, but it’s critical to understand that having persistent fears about this condition can take a toll on mental health,” Zafonte added. “When these concerns discourage former NFL players from receiving effective treatments for other or interrelated conditions related to physical and emotional health, it’s our responsibility to intervene.”

Investigating CTE Connections

The study included researchers from Harvard Medical School, Harvard T.H. Chan School of Public Health, Massachusetts General Hospital, Brigham and Women’s Hospital, and Spaulding Rehabilitation Hospital.

Research has suggested a connection between the diagnosis of an incurable neurodegenerative disease and elevated suicide risk. So the investigators wanted to find out if the perception of CTE produces a similar link.

The researchers included 1,980 former professional football players in this study. Specifically, the researchers wanted to know how many of them thought they had CTE. They also wanted to uncover any commonalities among those NFL veterans, and whether worries about CTE included suicidal thoughts.

The analysis showed that 34 percent of players believed they had CTE.  And about a quarter of the survey respondents who believed they had CTE also reported suicidality. That stands in stark contrast to just 5 percent of participants who didn’t think they had CTE.

While concerns about CTE are legitimate, treating comorbid conditions could help manage other symptoms. It could also help with one’s overall mood, the researchers added.

“A key takeaway from this study is that many conditions are common to former NFL players such as sleep apnea, low testosterone, high blood pressure, and chronic pain, which can be associated with problems in thinking, memory, and concentration,” first author Rachel Grashow of Harvard Chan School and the Football Players Health Study said.

“These efforts may reduce the chances that players will prematurely attribute symptoms to CTE, which may lead to hopelessness and thoughts of self-harm,” she added.

Parsing the Results

“Until clinical guidelines and treatments for CTE become available, former players and their physicians should explore treatment interventions and positive health behavior changes that have been shown to improve cognitive function, overall health, and quality of life,” said senior author Aaron Baggish, HMS associate professor of medicine at Mass General, professor of medicine at the University of Lausanne in Switzerland and senior faculty member of the Football Players Health Study.

“Interventions including weight loss, exercise, improving sleep, and implementing a low-salt diet may improve cognitive function,” Baggish noted.

“Overall, our data support the argument that new, well-intentioned rules adopted every season by the NFL have been proven to be too weak to make the NFL game safer,” the authors of the 2020 study wrote.

Further Reading

Chronic Traumatic Encephalopathy Presenting as Psychogenic Nonepileptic Seizures

Managing Psychiatric Issues in Elite Athletes

Chronic Traumatic Encephalopathy: Football vs Soccer