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1 Chronic Traumatic Encephalopathy in Football The Effects of Technology and Rule Changes in Reducing Concussions and Chronic Traumatic Encephalopathy Anthony Montelione Kean University

2 Chronic Traumatic Encephalopathy in Football Introduction This paper will explore the rate of concussions within the National Football League (NFL) and the long-term consequences that can come with repeated blows to the head causing concussions to the player. In the United States football is an extremely popular sport. Concussions in football have also become an extremely hot topic as more and more people show concern for players and if they are properly protected against concussions while playing football. While awareness is very important and one of the first steps in preventing head injury, new rule changes and technology also come into play are these being used to their full potential to protect players from concussions? These factors as well as the newest data, and neurological factors will be reviewed. Literature Review The Physical Effects: Concussions by definition is described as a mild traumatic brain injury that alters the way the brain functions (Ferry & DeCastro 2022). Concussions are caused by a blow or impact which causes the brain to swell. Symptoms of a concussion include irritability, change in mood, confusion, fogginess, headache, dizziness, visual changes and sleeping pattern disturbances (Ferry et al. 2022). According to Teramoto, Cross, and Willick (2015) article which discussed whether a determination can be made if the style of play with in defensive and offensive positions led to an increase in the concussion rates in players (Teramoto et al. 2015). Over a three-year span there were 437 concussions reported in the NFL regular season. It was reported out if all the players most of them that were in positions that involved in passing plays were at a higher risk for getting a concussion (Teramoto et al. 2015). Once determined that the

3 Chronic Traumatic Encephalopathy in Football style of play increases the risk for concussion, we must now look at the physical effects that the brain will sustain during the duration of the concussion. The player may or may not be immediately affected by the impact and continue to play the game, but once his adrenaline wears off the symptoms may start to appear. Research and Studying of Chronic Traumatic Encephalopathy: By definition Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease associated with repeated head trauma (Teramoto et al. 2015). Research on CTE unfortunately has been limited due to the lack of data in presenting evidence that the risk of developing CTE is due to playing a contact sport (Teramoto et al. 2015). In the article “Is There Chronic Brain Damage in Retired NFL Players” Casson et al (2014) he studied 45 retired NFL players and concluded that chronic brain damage is known to be a frequent result of a long career in the NFL (Casson et al. 2014.) The study was in depth and examined players ranging in age of 30-60. Players who were retired reported 6.9 concussions during their career. In 2017 a larger study done and published by JAMA. The findings were from 2013 in which neuropathologist Ann C. McKee of Boston University and her colleagues published a post mortem report which highlighted 68 male athletes with CTE. In McKees report it associated two distinctive clinical symptoms involving behavior and mood disturbances. These disturbances can be seen in the athletes at their younger age as well as when they were older (Costandi, 2017). The research also involved the study of 202 deceased football players of the 202 brains studied they were able to conclude that 177 were diagnosed with CTE based off of pathological characteristics. These players had a minimum of 15 years playing the game of football. Behavioral and mood symptoms seemed to be a common thread in all of the former NFL players who were diagnosed with CTE (Costandi, 2017).

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