Head injuries and brain damage should not be taken lightly. During adolescence, brain development shows a disparity between rapid growth in reward-seeking areas and the slower maturation of the prefrontal cortex, which underpins executive functions like memory, attention, and cognitive inhibition. If not addressed properly, repeated head traumas in contact sports may lead to neurological disorders that manifest later in life, including chronic traumatic encephalopathy (CTE) and other neurodegenerative conditions. CTE is a progressive brain condition linked to ongoing head trauma—even when those injuries do not meet the criteria for concussions (Catanese, 2024). Emerging evidence points to emotional dysregulation following brain injuries, partly stemming from disrupted cognitive inhibition—affecting one's ability to manage mood and emotions effectively. Thus, enhancing emotion regulation has become a key focus for interventions related to concussions and brain injuries.
Hudac and her team discovered that their findings suggest a trend indicating that frustrating situations have less impact on athletes with previous concussions or associated symptoms. This aligns with other research showing diminished N2 amplitudes in these athletes, indicating that their cognitive inhibition is less disrupted by emotional challenges. Previous neuroimaging studies provided insights into decreased amygdala activity—a center for emotion processing—during frustration tasks. Researchers also noted that this amygdala activation is influenced by the ventromedial prefrontal cortex (vmPFC), a key brain region that manages emotional regulation and cognitive inhibition (Hudac et al. 2022). Moreover, the findings underscore important developmental considerations, as the prefrontal cortex undergoes significant structural and functional changes throughout childhood and adolescence, often in contrast to shifts within the brain networks tasked with managing reward and mood. They also highlighted that systemic barriers, such as insufficient concussion education and limited access to trained health professionals in many urban and Title I schools, put adolescent athletes at an increased risk of undiagnosed concussions and subsequent serious neurological issues later in life.
Without appropriate treatment or education, the symptoms and effects of CTE can resemble those of other forms of dementia. These include memory loss, difficulties with attention and concentration, mood swings such as anxiety, aggression, and depression, as well as suicidal thoughts and impaired judgment (Meehan et al. 2015). CTE can also take a heavy toll on families. Relatives of individuals diagnosed with CTE have reported noticing significant changes in their loved one's behavior, thinking, and emotions over time. This past spring, a 17-year-old boy tragically took his own life after suffering more than 10 concussions while playing soccer since first grade (Curtis, 2024). The neurological damage became increasingly evident as he grew older. Despite his family taking every precaution and seeking medical advice, the full impact of those concussions remained uncertain. His mother mentioned that he was "more moody" and felt "very compromised personality-wise with his studies," saying, "I think his brain was just on fire." Those close to him recognized that, deep down, he loved his family and friends, yet he seemed to be searching for an escape from the damage within his mind.
One of the final concussions he sustained resulted in persistent migraines, and his mother expressed that "he hasn't been the same since." Many observed that he "lost his light in the last year." Even with their proactive efforts and ongoing testing, the damage from CTE was already irreversible. His story underscores the critical importance of the development of the prefrontal cortex and amygdala—damage to these regions can severely disrupt emotional regulation. Notably, harm to the amygdala can impair the ability to experience fear, potentially leading to extreme behaviors.
References
Catanese, L. (2024, March 28). What is CTE? understanding chronic traumatic encephalopathy. Harvard Health Publishing. https://www.health.harvard.edu/mind-and-mood/what-is-cte-understanding-chronic-traumatic-encephalopathy
Curtis, L. (2024, March 22). “He was beyond fearless”: Cedarburg teen remembered for his love of soccer, his family and his faith. Greater Milwaukee Today. https://www.gmtoday.com/news_graphic/news/he-was-beyond-fearless-cedarburg-teen-remembered-for-his-love-of-soccer-his-family-and/article_206e7ab8-102c-525f-a62b-d0cc85e1422a.html
Hudac, C. M., Wallace, J. S., Ward, V. R., Friedman, N. R., Delfin, D., & Newman, S. D. (2022). Dynamic cognitive inhibition in the context of frustration: Increasing racial representation of adolescent athletes using mobile community-engaged EEG methods. Frontiers in Neurology, 13. https://doi.org/10.3389/fneur.2022.918075
Meehan, W., Mannix, R., Zafonte, R., & Pascual-Leone, A. (2015). Chronic traumatic encephalopathy and athletes. Neurology, 85(17), 1504–1511. https://doi.org/10.1212/wnl.0000000000001893
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