Profile of Self-Reported Problems with Executive Functioning in College and Professional Football Players

Abstract

Repetitive mild traumatic brain injury (mTBI), such as that experienced by contact-sport athletes, has been associated with the development of chronic traumatic encephalopathy (CTE). Executive dysfunction is believed to be among the earliest symptoms of CTE, with these symptoms presenting in the fourth or fifth decade of life. The present study used a well-validated self-report measure to study executive functioning in football players, compared to healthy adults. Sixty-four college and professional football players were administered the Behavior Rating Inventory of Executive Function, adult version (BRIEF-A) to evaluate nine areas of executive functioning. Scores on the BRIEF-A were compared to published age-corrected normative scores for healthy adults Relative to healthy adults, the football players indicated significantly more problems overall and on seven of the nine clinical scales, including Inhibit, Shift, Emotional Control, Initiate, Working Memory, Plan/Organize, and Task Monitor. These symptoms were greater in athletes 40 and older, relative to younger players. In sum, football players reported more-frequent problems with executive functioning and these symptoms may develop or worsen in the fifth decade of life. The findings are in accord with a growing body of evidence that participation in football is associated with the development of cognitive changes and dementia as observed in CTE.

Thinner Cortex in Collegiate Football Players With, but not Without, a Self-Reported History of Concussion

“…45 The ventromedial frontal cortex is associated with several behavioral and cognitive domains, including decision-making and emotional regulation, 46,47 which overlap common symptoms reported by both active and retired athletes with a history of concussion. 40,48 Thinner cortex in the medial frontal regions in football athletes with a selfreported history of concussion relative to healthy controls, but not other football athletes, suggests that this may be due to a combination of previous concussions and high exposure to repetitive head hits associated with football.…”

Everyday Executive Functioning in Chronic Pain

“…This particular pattern of deficits may be unique to chronic pain. The BRIEF-A has been used to characterise executive function impairments in other conditions, including Mild Cognitive Impairment [48], depression [49,50], schizophrenia [51], Attention Deficit Hyperactivity Disorder [30,52], and sports-related concussions [53], among many others [26]. To our knowledge, it has never before been applied to a chronic pain population, and indeed, the profile we obtained from our pain sample is different to any pattern of responses in other clinical cohorts published thus far.…”

Determinants of Coach Communication About Concussion Safety in US Collegiate Sport

“…Athletes who sustain concussions are at risk of acute and prolonged neurologic consequences [4][5][6][7][8]. These consequences may be magnified if the athlete sustains multiple concussions [4][5][6][7][8][9] and even more so if they sustain an additional impact when the brain is in a period of metabolic vulnerability while recovering from the initial injury [10,11], making secondary prevention a critical form of risk reduction.…”