CTE, Emotional Regulation, and Racial Disparities in the NFL

    In April 2021, Philip Adams, a former NFL player, shocked the nation when he killed six people before taking his own life. Posthumous examination revealed that Adams suffered from chronic traumatic encephalopathy (CTE), a brain disease linked to repeated head trauma. This tragic event highlights the devastating effects that brain injuries, especially those sustained over the course of a sports career, can have on behavior, mental health, and overall well-being. The strange this is, CTE can't be diagnosed until after death, meaning the fullness of its impact often remains hidden until it's far too late. How is it that such a detrimental brain disease, capable of changing someone's life so drastically and quickly, can go undetected until a person dies?

    This issue ties directly to recent findings in neuroscience research, specifically in Dr. Caitlin M. Hudac and her colleagues’ study, Dynamic Cognitive Inhibition in the Context of Frustration: Increasing Racial Representation of Adolescent Athletes Using Mobile Community-Engaged EEG Methods (Hudac et al., 2023). This study examines how brain injuries like CTE affect cognitive inhibition, the mental process of controlling and suppressing impulsive behavior, and emotional regulation in athletes. The study used mobile EEG technology to measure the brain's electrical activity in real-time, allowing researchers to observe how frustration impairs cognitive control during specific tasks.

    Specifically, the research focused on adolescent athletes, a group vulnerable to brain injuries due to repeated head impacts from contact sports. The study found that athletes with a history of brain injuries showed reduced cognitive inhibition, leading to greater impulsivity, poor decision-making, and emotional dysregulation. These behaviors are incredibly similar to the issues seen in Philip Adams, whose repeated concussions led to damage in the frontal lobe, the region of the brain that is responsible for regulating emotions and controlling impulses. As the study shows, the impaired cognitive inhibition observed in athletes mirrors the behavioral issues that Adams faced, where his brain injuries made it difficult to control his emotional responses and impulses, ultimately contributing to the tragic outcome.

    Additionally, the NFL's use of race-norming in its brain injury compensation program, which adjusted medical test scores based on a person's race or ethnicity, has disproportionately affected Black players. This practice assumed lower cognitive function for Black players, further highlighting racial disparities in concussion treatment and raising important ethical questions about equity in healthcare for athletes of different races. Just as the study calls for more racial representation in research, the NFL's race-norming practice underscores systemic health disparities that impact Black athletes.

    Dr. Hudac's study also emphasizes the importance of racial diversity in neuroscience research. Historically, Black athletes have been underrepresented in studies on concussion and brain injuries, which have contributed to inequalities in diagnosis and treatment. The research argues that without diverse samples, the impact of brain injuries, such as CTE, cannot be fully understood or addressed. The lack of representation intensifies the racial health disparities in both sports and healthcare.

    Ultimately, the case of Philip Adams underscores the critical need for early diagnosis and more inclusive research on brain injuries, especially for disease like CTE, where it can't be discovered until after death. The emotional and cognitive impairments caused by CTE, as illustrated by both the study and Adams' tragic story, highlight the importance of improving concussion care and diagnostic methods for all athletes, particularly those from marginalized groups. The NFL’s history of race-norming reflects the need for equity in healthcare, and by integrating diverse research populations, adopting fairer diagnostic methods, and addressing systemic racial disparities, we can work toward ensuring that all athletes, regardless of race, receive the care and recognition they deserve.

References:

Georgia Public Broadcasting. (2021, December 14). Ex-NFL player who killed 6 people and then himself had CTE, doctors say. https://www.gpb.org/news/2021/12/14/ex-nfl-player-who-killed-6-people-and-then-himself-had-cte-doctors-say

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, 918075. https://doi.org/10.3389/fneur.2022.918075

Palmer, A. (2021). Tackling discrimination in the NFL: How the recent CTE race norming agreement highlights the need to provide broader anti-discrimination protections for NFL players through collective bargaining agreements. William & Mary Business Law Review, 13(2), 405-434. https://scholarship.law.wm.edu/cgi/viewcontent.cgi?article=1252&context=wmblr