Heather Anderson, an AFLW player who died last year, has been named as the first known professional female athlete to be diagnosed with the degenerative brain disease CTE.
Anderson, who played for the Adelaide Crows in the AFLW premiership retired at the end of 2017. She took her own life in November 2022 at the age of 28.
The Australian Sports Brain Bank diagnosed Anderson as having had low-stage CTE and three lesions in her brain, according to the ABC.
We went to a Kiwi neurology expert to find out more about what CTE is and what researchers know about the condition.
What does CTE stand for?
CTE is a degenerative brain condition called chronic traumatic encephalopathy, which causes specific parts of the brain to degrade over time. Symptoms may not be noticeable at first but can include mood changes, personality changes and behaviour changes, according to the NHS. As the condition gets worse, one may have more noticeable problems with thinking and memory.
How is it diagnosed?
Dr Rosamund Hill is an Auckland based neurologist with a particular interest in brain injuries. She says CTE can only be diagnosed after a patient has died.
“It’s very tricky to diagnose… you have to look at the brain to be able to see the changes, the degeneration because it’s in certain specific places, and you won’t see it unless you particularly do a post mortem looking for it, so a standard post mortem won’t pick it up either,” she said.
The disease resulted in a mixture of cognitive trouble as well as issues with mood and behaviour, but it was not specific.
“You can get those problems from other conditions but when you see these characteristic changes in certain locations in the brain then you can make the diagnosis.”
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AFLW athlete Heather Anderson was diagnosed with CTE after she took her own life in November 2022. (File photo)
How does it happen?
The disease appeared to be found in people who had received a number of concussions or blows to the head across a variety of sports, Dr Hill said.
“That’s why people are very anxious as to what are the risks, because we don’t know how many knocks to the head, how severe do they have to be and how close together in order to put you at risk of getting this condition.”
More research was required to understand why certain people affected by concussions and head trauma developed the disease while others escaped relatively unscathed, she said.
“Not everybody who has had this level of injury gets CTE, so why do some people get it and some people don’t? We don’t know that, but what that tells you logically is there’s more to it than just how many blows to the head you’ve had,” she said.
Other genetic factors like alcohol, medications and performance enhancing drugs could all play a part in the disease, but this was not known to be a fact, she said.
Is it any more common in men than women?
The understanding of how women were affected by CTE was limited as very few female brains had been donated for research.
While the disease was unlikely to affect women differently to men, the concern was around whether women were at greater risk of developing the condition, Hill said.
“The difference is whether women are more vulnerable to the effects of concussion and that is the concern, the condition itself would likely look the same.”
Hill said there was plenty of concern about whether women were more at risk of concussion than men, due to factors such as women’s neck muscles not being as strong as men’s.
123rf/Supplied
Identifying CTE requires a specific post-mortem can not be identified in a brain scan while a person is alive. (File photo)
What sort of research is being done?
While research into CTE was underway, it was made difficult not just by the nature of the disease, but also the long term studies it required.
Much of the existing research had focused primarily on men, Hill said.
“It’s probably been overlooked or underrepresented, if you look at most of the research studies they’ve been specifically in men or put everyone together, so I do think it’s really important that research is done to answer the questions are women at greater risk of multiple concussions for long term consequences.”
Hill said researchers wanted to develop so-called “bio-markers” which would develop tests to indicate whether someone was at risk of developing the disease or another long term brain issue.
This would allow medical professionals to advise people to withdraw from playing contact sport before the damage became permanent, she said.
In the long term, Hill said there were hopes that the degeneration of the brain caused by CTE could be reversed with appropriate drugs.
What’s the risk to me?
Although CTE was linked to contact sports, it was important that people were not panicked into avoiding sport, Hill said.
“It is very rare, partly it might be rare because we’re not looking at everybody, but even so it still is a very uncommon condition.
“It should drive us to be careful about concussion and manage it well, rather than panicking about there being an epidemic of people with CTE because I think that’s probably not going to be the case,” she said.
It was encouraging to see that sport had gradual shifted from the “harden up” mentality to a greater focus on player welfare as many sports entered the professional era, she said.
“What’s unusual about her is that she was very young, she was in her late twenties, typically we consider this condition your at greatest risk if you’ve had a lot of blows to the head over a fairly long period of time but obviously there are some young people who’ve not had a lot of trauma to the head who have been diagnosed with it.”
Where to get help
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Depression.org.nz 0800 111 757 or text 4202
Lifeline 0800 543 354
Mental Health Foundation 09 623 4812, click here to access its free resource and information service.
Rural Support Trust 0800 787 254
Samaritans 0800 726 666
Suicide Crisis Helpline 0508 828 865 (0508 TAUTOKO)
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thelowdown.co.nz Web chat, email chat or free text 5626
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