First known CTE brain disease diagnosis for a female athlete

Australian researchers have diagnosed what is believed to be the first professional woman athlete with the degenerative brain disease chronic traumatic encephalopathy (CTE). 

Scientists at the Australian Sports Brain Bank (ASBB) in Sydney said they had identified low-stage CTE in the brain of a former Australian rules football player Heather Anderson, who died eight months ago, aged 28. 

Her family had donated her body to medical science, hoping to learn more about her health before her death. The cause of death is subject to an ongoing investigation but is believed to have been suicide.

What is CTE? 

Chronic traumatic encephalopathy is a degenerative brain disease whose most common cause is thought to be repeated head injuries or concussions. A major collaborative study last year said it had found "conclusive evidence" of this hypothesis.

Encephalopathy combines the two ancient Greek words for "brain damage," traumatic denotes that the condition is trauma- or injury-related, and chronic denotes that it is a long-term condition.

Its effects can range from comparatively mild to extremely debilitating, and it's most commonly known for cases involving professional athletes in contact sports like boxing, American football, rugby, or Australian rules football. It's also fairly common in military veterans exposed to repeated explosions.

Conclusive diagnosis is not possible while a person is still alive. It can only be identified by studying samples of a person's brain under a microscope at autopsy.

Although it can't be reliably diagnosed while a person lives, it can cause an array of symptoms from cognitive impairment to short term memory problems, issues controlling mood and temper, depression, tremors, speech impairment, loss of coordination, and increased aggression.

Some 300 cases have been identified in American football players alone.

Why is Anderson thought to be first female athlete diagnosis? 

Few scientists really doubted that CTE was likely or possible in women who frequently play contact sports, as it has proven to be with men.

Indeed, some studies have suggested women might be more susceptible to concussion than men and require longer to recover safely.

But unlike with concussion, opportunities to investigate CTE only come post-mortem, and most such tests had been carried out on male athletes, who remain statistically more likely to compete in contact sports over prolonged periods.

"She is the first female athlete diagnosed with CTE, but she will not be the last," researchers wrote. 

ASBB director Michel Buckland said that to his knowledge, Anderson was the first female athlete — and one of only a few women — to undergo tests for the condition after death. 

"There were multiple CTE lesions as well as abnormalities nearly everywhere I looked in her cortex," Buckland said. "It was indistinguishable from the dozens of male cases I've seen."

Buckland said he wanted to thank the Anderson family for donating her brain and said he hoped "more families follow in their footsteps so we can advance the science to help future athletes." 

Buckland also told the BBC in a separate interview that Anderson's family had told him that "in some ways" the findings "made a lot of sense." 

Former army medic involved in contact sports since childhood

Andersen died eight months ago aged 28. The former army medic had played contact sports since she was 5. 

She was a top level women's player of Australian rules football — perhaps most simply described as a distant cousin of rugby and American football — until 2017. 

Andersen was a talented defensive player, but her career in the top division was cut very short by injury. She also played rugby league.

She played just eight games in Australia's top AFL Women's division with the Adelaide Crows, winning the championship in 2017 and then retiring in her early 20s.

Her career included at least one case of concussion and she was known for playing in pink protective headgear.

Doctors first identified CTE-like symptoms in seasoned boxers as early as the 1920s, first calling it "punch drunk syndrome," but only 50 cases were definitively confirmed in the next 75 years. The research has advanced rapidly this century.

Research into CTE has caused serious soul searching in several sports including American football, rugby, boxing, ice hockey and even soccer — with scientists concerned in particular about the effects of heading the ball, particularly for younger players in that somewhat less physical game.

msh/jcg (AFP, Reuters)