Effects of repeated head trauma in young athletes – National Institutes of Health (.gov)

Report on Early Brain Changes from Repetitive Head Impacts and Implications for Sustainable Development Goal 3

Introduction and Alignment with SDG 3: Good Health and Well-being

A study supported by the National Institutes of Health (NIH) provides critical insights into the early-stage neuropathological effects of repetitive head impacts on young to middle-aged athletes. The research reveals significant brain alterations occurring years before the clinical manifestation of chronic traumatic encephalopathy (CTE). These findings directly support the United Nations’ Sustainable Development Goal 3 (SDG 3), which aims to ensure healthy lives and promote well-being for all at all ages. Specifically, this research contributes to Target 3.4, which seeks to reduce premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being, by laying the groundwork for early detection and intervention strategies for a debilitating neurodegenerative condition.

Key Research Findings

The analysis of postmortem brain tissue from athletes, primarily those who played American football, yielded several critical findings that advance the understanding of CTE pathology:

• Early Onset of Cellular Damage: The study identified lasting brain changes in athletes under the age of 51, demonstrating that damage begins long before the development of CTE’s hallmark tau protein pathology.
• Significant Neuronal Loss: Researchers observed a 56% loss of a specific neuron type in a brain region susceptible to impact. This loss was evident even in individuals without tau buildup and correlated directly with the number of years the athlete was exposed to repetitive head impacts.
• Sustained Immune Response: The brain’s immune cells, known as microglia, exhibited increased activation that was proportional to the duration of the athletes’ participation in contact sports, indicating a chronic inflammatory state.
• Vascular and Molecular Changes: The study uncovered molecular changes in the brain’s blood vessels, including gene patterns suggesting immune activity and thickening of small vessels. A novel communication pathway between microglia and blood vessel cells was also identified, which may explain how early cellular issues progress to widespread disease.

Contribution to Global Health and Sustainable Development Goals

This research provides a scientific foundation for public health initiatives aimed at protecting athletes and contributes directly to achieving key SDG targets.

1. Advancing SDG Target 3.4 (Non-Communicable Diseases): By identifying the earliest cellular signatures of brain injury, this work is a crucial first step toward developing preventative measures and treatments for CTE, a non-communicable neurodegenerative disease. Protecting the brain health of young athletes is fundamental to promoting lifelong well-being.
2. Strengthening SDG Target 3.d (Early Warning and Risk Reduction): The findings establish a basis for new diagnostic tools capable of detecting brain damage much earlier than current methods allow. This enhances the capacity for early warning and risk management for a significant global health risk associated with contact sports.
3. Supporting SDG 17 (Partnerships for the Goals): The study exemplifies a successful partnership between government agencies (NIH, U.S. Department of Veterans Affairs) and academic institutions (Boston University CTE Center). This collaboration leverages combined expertise and resources, including technologies from the NIH BRAIN Initiative®, to address a complex health challenge.

Conclusion

The NIH-funded study marks a significant advancement in understanding the pathogenesis of CTE by shifting the focus to the earliest cellular events that precede detectable disease. The identification of neuronal loss, immune activation, and vascular changes as early indicators of damage provides a new framework for research and clinical development. These insights are essential for creating effective strategies to prevent devastating neurodegeneration, directly aligning with the global commitment to SDG 3 to ensure good health and well-being for all populations, including athletes at risk from repetitive head injuries.

1. Which SDGs are addressed or connected to the issues highlighted in the article?

SDG 3: Good Health and Well-being

• The article is centered on medical research aimed at understanding and preventing a neurological disease, Chronic Traumatic Encephalopathy (CTE). This directly aligns with the goal of ensuring healthy lives and promoting well-being. The research, funded by the National Institutes of Health (NIH), seeks to “reduce the burden of neurological disease” and “extend the healthy, active years of life,” which are core tenets of SDG 3.

SDG 17: Partnerships for the Goals

• The article highlights a collaborative effort involving multiple institutions to achieve a common research goal. It mentions research conducted by “Scientists at the Boston University CTE Center, the U.S. Department of Veterans Affairs Boston Healthcare System and collaborating institutions,” with funding from various NIH institutes like NINDS and NIA. This multi-stakeholder partnership between academia and government agencies to advance scientific knowledge for public health exemplifies the spirit of SDG 17.

2. What specific targets under those SDGs can be identified based on the article’s content?

SDG 3: Good Health and Well-being

• Target 3.4: By 2030, reduce by one-third premature mortality from non-communicable diseases through prevention and treatment and promote mental health and well-being.
  • The research focuses on the early detection and prevention of CTE, a non-communicable neurodegenerative disease that can lead to dementia and premature health decline. The article states the work “lays the foundation for new ways to detect brain effects of repetitive head injuries and potentially lead to interventions that could prevent devastating CTE neurodegeneration,” directly contributing to the prevention and treatment aspect of this target.

SDG 17: Partnerships for the Goals

• Target 17.16: Enhance the Global Partnership for Sustainable Development, complemented by multi-stakeholder partnerships that mobilize and share knowledge, expertise, technology and financial resources.
  • The study described is a clear example of such a partnership. It involves academic institutions (Boston University), government healthcare systems (U.S. Department of Veterans Affairs), and federal research agencies (NIH, NINDS, NIA) mobilizing financial resources (evidenced by grant numbers) and sharing expertise and advanced technology (“cutting-edge tools that track gene activity”) to address a significant health issue.

3. Are there any indicators mentioned or implied in the article that can be used to measure progress towards the identified targets?

SDG 3: Good Health and Well-being

• For Target 3.4: While the article does not cite official SDG indicators, it implies several scientific and health-related metrics that can measure progress in understanding and preventing CTE.
  • Implied Indicator: Rate of neuronal loss in specific brain areas. The study explicitly measures this, finding a “striking 56% loss of a specific type of neurons” in young athletes. Tracking this metric can measure the severity of early-stage damage.
  • Implied Indicator: Level of microglia activation. The research observed that these immune cells “became increasingly activated in proportion to the number of years the athletes had played contact sports,” providing a measurable marker for brain inflammation due to head impacts.
  • Implied Indicator: Incidence and prevalence of CTE. The ultimate goal of the research is to prevent CTE, so tracking the rates of this disease in at-risk populations (like former athletes) would be a long-term indicator of the success of preventative interventions developed from this research.

SDG 17: Partnerships for the Goals

• For Target 17.16: The article provides evidence of a partnership in action, which can be seen as a qualitative indicator of progress.
  • Implied Indicator: Number of collaborative research projects between academic, government, and healthcare institutions. The study itself, supported by grants like U19AG068753 and U54NS115266, serves as a concrete example of such a project, indicating that partnerships are being formed and funded.

4. Table of SDGs, Targets, and Indicators

Source: nih.gov