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A recent study published in the Neurology journal has revealed that individuals with chronic traumatic encephalopathy (CTE) who also have a family history of mental illness may face a heightened risk of aggressive behavior in middle age. The research, released on November 27, 2024, highlights the importance of considering both genetic and environmental factors when evaluating the risks associated with CTE, a neurodegenerative disease commonly linked to repeated head injuries seen in athletes and military personnel.
CTE, which is known to lead to cognitive decline, mood changes, and dementia, is a significant concern for those who have sustained multiple concussions or sub-concussive blows. However, this study, led by Dr. Jesse Mez of Boston University Chobanian & Avedisian School of Medicine, uncovers a critical interaction between CTE and family mental health history that may increase the likelihood of aggression.
“This appears to be a case where together these risk factors add up to a greater risk for aggression than they each do on their own,” Dr. Mez explained. “People with CTE and a family history of mental illness are much more likely to display aggressive behavior than those with either factor alone.”
The study involved 845 men, many of whom were exposed to repetitive head impacts through contact sports or military service. Among the participants, 329 had played professional football, and all donated their brains to research after death, with an average age of 60 at the time of their passing. Of the group, 70% had CTE, and 45% had a family history of mental illness.
Researchers gathered information from family members or spouses regarding the participants’ aggressive behaviors, such as arguments and physical confrontations. They also inquired about any diagnoses of mental illnesses such as depression, anxiety, bipolar disorder, or post-traumatic stress disorder in the participants’ families. If a family member had been diagnosed with any of these conditions, the individual was categorized as having a family history of mental illness.
Participants were divided into four groups for analysis:
- 30% with CTE and a family history of mental illness
- 40% with CTE and no family history of mental illness
- 15% with no CTE but with a family history of mental illness
- 15% with neither CTE nor a family history of mental illness
Results showed that individuals with both CTE and a family history of mental illness exhibited a higher average aggression score (19) compared to those with only CTE (17). This difference was especially noticeable among those who died between the ages of 40 and 59, with those possessing both CTE and a family history of mental illness scoring 0.64 standard deviations higher on aggression scales, even after adjusting for factors like years spent in contact sports or military service.
Dr. Mez suggested that the increased aggression could be linked to both genetic predispositions and shared environmental factors, such as family dynamics and childhood experiences. He noted that identifying those at higher risk for aggression could help predict the potential consequences of CTE and guide treatment decisions.
Interestingly, for individuals without CTE, a family history of mental illness did not seem to elevate the risk of aggression.
While the findings are compelling, the study does come with limitations. The data relied on the recollections of family members and spouses, which may not always be accurate, leading to potential biases in the reporting of aggressive behaviors.
The research was funded by the National Institutes of Health, the Department of Veterans Affairs, and the Nick and Lynn Buoniconti Foundation. The study offers new insights into the multifaceted nature of CTE and suggests that both medical and family histories should be taken into account when considering the risks of aggression in affected individuals.
