Study Points to ‘Significant,’ Potentially Long-Lasting Brain Damage to Football Players

Best-selling author Malcolm Gladwell made news earlier this month when he called football a “moral abomination” due to the debilitating brain injuries impacting a significant percentage of players.

A new study released Monday by an Israeli university appeared to bolster Gladwell’s assertions on the serious and potentially long-lasting medical impact on some athletes.

Researchers at Israel’s Ben-Gurion University found that brains of certain football players experienced “significant” damage following concussions that were so mild that they were never reported. So significant in fact that even those mild concussions could lead to brain damage years later.

A university press release sent to reporters Monday stated that the researchers used new and enhanced MRI diagnostics that identified “significant damage to the blood-brain barrier (BBB) of professional football players following ‘unreported’ trauma or mild concussions.”

Researchers contended that their findings could “improve decision making on when an athlete should ‘return to play.’”

“Generally, players return to the game long before the brain’s physical healing is complete, which could exacerbate the possibility of brain damage later in life,” said Dr. Alon Friedman of the Ben-Gurion University Brain Imaging Research Center and one of the authors of the study.

The “pathological” Blood-Brain Barrier (BBB) brain images compared with the "intact." (Photo: Ben-Gurion University)

Friedman further observed that “until now, there wasn’t a diagnostic capability to identify mild brain injury early after the trauma. In the NFL, other professional sports and especially school sports, concern has grown about the long-term neuropsychiatric consequences of repeated mild Traumatic Brain Injury (mTBI) and specifically sports-related concussive and sub-concussive head impacts.”

Researchers at Ben-Gurion and at the Soroka University Medical Center in Beersheba used a new MRI diagnostic technique to detect the “blood-brain barrier breakdown in football players.”

“Specifically, it generates more detailed brain maps showing brain regions with abnormal vasculature, or a ‘leaky BBB,’” the university said of the diagnostic approach.

The study authors examined 16 players from the Israeli Football League team, the Black Swarm of Beersheba. Thirteen track and field athletes from the university were the control group.

“The DCE-MRIs were given between games during the season and revealed significant damage. Forty percent of the examined football players with unreported concussions had evidence of ‘leaky BBB’ compared to 8.3 percent of the control athletes,” the researchers reported.

“This showed a clear association between football and increased risk for BBB pathology that we couldn’t see before. In addition, high-BBB permeability was found in six players and in only one athlete from the control group,” Friedman said.

Friedman noted that not all players had signs of harm.

The study appears as a research letter in this month’s issue of JAMA Neurology which is published by the American Medical Association. JAMA's website notes that while research letters are far shorter than full articles, they are peer-reviewed and undergo "stringent editorial review."