College football players in the United States endure over 1000 head hits every season. Although many don’t produce symptoms such as dizziness or blurred vision that often accompany frank concussion, these “clinically silent” hits are associated with the same type of brain damage as concussion, according to a recent Science Advances study. The Problem Previous work has suggested that participation in American football may be related to later development of chronic traumatic encephalopathy (CTE)—a progressive neurodegenerative disorder that can only be diagnosed postmortem. The condition likely is caused in part by repetitive traumatic brain injury (TBI), including concussion, which accounts for more than 80% of all TBI cases. To ensure player safety, the National Football League’s Head, Neck and Spine Committee developed removal-from-play and return-to-play protocols largely based on the presentation and resolution of concussive symptoms such as ...
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", language="en", issn="0098-7484", doi="10.1001/jama.2019.15361", url="http://dx.doi.org/10.1001/jama.2019.15361" }