Director of CTE Center Explains Disease’s Link to MMA

Although there is only one definitively diagnosed case of CTE in MMA there are many suspected cases (which can only be certainly diagnosed with brain autopsy upon death).

Today, Dr. Ann McKee, a neurologist and Director of the CTE Center at the Boston University School of Medicine gave sobering testimony to Congressional Subcommittee on Commerce, Manufacturing, and Trade om the reality of the disease’s link to MMA (along with other contact sports).

The testimony arose in the context of studying the Muhammad Ali Expansion Act (legislation that is more concerned with disparity of power between promoters and fighters than safety).  In any event the subcommittee wished to hear about safety aspects and this and Dr. McKee’s testimony provided the following highlights reminding fighters and trainers that this is a disease of ‘mileage’.

In sports like MMA, the risk for CTE is not directly related to the number of concussions – rather the risk for CTE is related to the cumulative exposure to subconcussions that occur with every blow to the head. The longer you play contact sports, the higher your exposure to repetitive head impacts, and the higher the risk for CTE. Starting a contact sport at a young age often leads to a longer playing career and greater exposure to head trauma, but another factor that contributes to enhanced risk for young athletes is that the developing brain is more susceptible to damage from repetitive head trauma.

The other misinformation about CTE is that it is very rare, because it has only been diagnosed in a few hundred people and there are millions of people who have played contact sports. But CTE is not rare, we would not be able to find 218 cases of CTE in 291 athletes ranging in age from 18 to 98 years over the past 8 years if it were rare. If you don’t look for something, don’t know how to look for something, and don’t find it that does not mean that that something is rare; it means it is under recognized. You have to know how to look for CTE in order to find it. We have found CTE in 75% of brains of athletes donated to our brain bank, and while that does not represent the percentage of living athletes with CTE, it does indicate the disease is much more common than we previously thought. Recent brain bank studies looking for previously unrecognized CTE have found changes of CTE in 5% of the general autopsy population and in 1/3 of contact sport athletes in a neurodegenerative disease brain bank. 

If you were to ask me how we limit risk for CTE in MMA, I would say:

1. Don’t allow children and young adults to participate in full contact with head strikes

2. Educate fighters so they learn their greatest opportunity to limit exposure is to not allow head strikes in training and sparring exercises

3. Limit the number of head strikes in a match

4. Reduce the number of full-contact matches per season

CTE is a big problem for contact sports, and what we know today is very likely only the tip of the iceberg. While we recognize the importance of contact sports to an athlete’s physical and psychological well-being, CTE is a known and preventable consequence. There is great urgency for more funding for research on CTE and the risks for CTE associated with sports like MMA, football, boxing, and ice hockey, and military service. We need to dedicate significantly more resources to understanding and treating this preventable disease. We need to bring hope to the players and Veterans who are in the beginning stages of this disease and showing signs of memory loss, behavioral changes and depression. We need to develop effective interventions and treatments so that all individuals can continue to participate in the sports they love, but also live long, healthy, productive lives

You can find Dr.McKee’s full testimony here.

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