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In recent years, some scientists and advocates have warned that playing contact sports like football and hockey may increase the risk of brain diseases like Alzheimer’s disease or chronic traumatic encephalopathy (CTE) due to a buildup of a specific protein in the brain.

But a new Northwestern Medicine study of 174 donated brains, including some from former high school and college football players, pumps the brakes on that theory. 

The long and short of it is no, this protein in this specific brain region is not increased in people who played football at the amateur level. It throws a little bit of cold water on the current CTE narrative.”

Dr. Rudolph Castellani, corresponding author, professor of pathology at Northwestern University Feinberg School of Medicine and a Northwestern Medicine neuropathologist

The study was recently published in the Journal of Alzheimer’s Disease. It raises important questions about how scientists interpret subtle brain changes associated with aging, Alzheimer’s disease and repetitive head impacts.

How the study worked

The study analyzed brain tissue from the Lieber Institute for Brain Development, which collects brain donations from people who had psychiatric conditions (e.g. schizophrenia, major depression, general anxiety, substance use disorder, etc.) throughout their life. Of the 174 samples collected from older adult men (with a median age of 65 at death), 48 men participated in football in high school or college while 126 had no history of playing a contact or collision sport. 

The study did not include brains from professional athletes. 

The scientists focused on a small memory-related brain region called CA2, part of the hippocampus. This region has been shown to accumulate phosphorylated tau (p-tau) protein – which is often present in neurodegenerative disease – in a variety of contexts, including normal aging, Alzheimer’s disease and in individuals with a history of repetitive head impacts.

But the findings suggest p-tau buildup in CA2 isn’t specific to contact sports. The scientists found no over-representation of CA2 p-tau in individuals with a history of youth football participation. Instead, the presence of p-tau in this region was statistically associated with age.

“What’s novel here is a return to the null hypothesis – that there may be no link between repeated head injuries and p-tau buildup in this location,” said Castellani, who also is the neuropathology core director of the Northwestern University Alzheimer’s Disease Research Center. “Rather than assuming p-tau in CA2 is inherently pathological, we’re asking whether it might be part of normal aging or a non-specific response to environmental factors.”

The study also highlights broader challenges in the field of neurodegeneration research. In particular, the authors point to the difficulty of assigning clinical meaning to subtle pathological findings. The paper’s section, “Knowledge gaps and implications for future research,” underscores how even expert consensus groups struggle to define CTE in clinically meaningful terms.

“Modern studies on CTE may be expanding the boundaries of what’s considered normal variability in the human brain,” Castellani said. “This work reminds us to be cautious in interpreting pathology without clear clinical correlation.”

The authors call for larger studies to better understand how p-tau relates to aging and head injuries, while urging the scientific community to critically evaluate assumptions about what constitutes neurodegenerative disease.

The study is titled “Postmortem tau in the CA2 region of the hippocampus in older adult men who participated in youth amateur American-style football.” 

One in three adults in the U.S. has three or more risk factors for a newly recognized but increasingly common condition: cardiovascular-kidney-metabolic (CKM) syndrome. First recognized by the American Heart Association (AHA) in a 2023 presidential advisory, CKM connects heart and metabolic health with kidney function as intertwined drivers of cardiovascular disease (CVD). 

Long before CKM was defined, millions of Americans were unknowingly progressing through the condition’s dangerous stages. 

In a first-of-its-kind analysis, Tarang Parekh, assistant professor of epidemiology at the University of Delaware College of Health Sciences, and colleagues at Houston Methodist Hospital and Harvard Medical School, examined the state-level prevalence of CKM syndrome, using self-reported data from the Centers for Disease Control’s Behavioral Risk Factors Surveillance System from 2011 to 2023. 

Parekh’s analysis, recently published in the journal JAAC: Advances, found that 80% of the population has some form of CKM syndrome. Over the past 12 years, not a single state saw a decline in CKM rates. 

West Virginia had the highest prevalence, with nearly 87% of residents affected by 2023. Delaware wasn’t far behind, with rates climbing from 76% to 83% over the same period. Colorado reported the lowest rate, with nearly 72% of the population impacted. Overall, CKM rates were highest in the Midwest and the South.

“This is an alarming trend that’s a result of our fragmented healthcare system,” Parekh said.

CKM, like many chronic diseases, progresses in stages. Stage zero means no disease is present. At Stage 1, individuals are obese or prediabetic. Stages 2 and 3 involve kidney disease, hypertension, high cholesterol, diabetes or a combination of risk factors that dramatically raise their risk for CVD. Stage 4 is dire.

That’s where we see a clinical CVD diagnosis, including heart failure, stroke or coronary heart disease, or kidney failure.”

Tarang Parekh, assistant professor of epidemiology, University of Delaware College of Health Sciences

Parekh’s analysis found nearly 50% of states saw an increased prevalence of CKM in stages 1 through 3. While Stage 4 rates declined steadily nationwide, Minnesota was an exception, seeing significant increases in the most dangerous stage of the condition.

Stopping disease progression

Routine health screenings are key to slowing the progression of CKM and reducing CVD. However, work to get physicians to assess these conditions in an interconnected manner is only just beginning.

“We must educate the public about the intersection of these conditions, so they realize CKM syndrome is more than just taking care of obesity, diabetes, or CVD in isolation,” said Parekh. “Without lifestyle and behavioral changes, one risk factor can snowball into several.”

Significant variation in state-level programs also complicates the matter.

“Some programs only tackle diabetes self-management. We must expand those programs to include other risk factors for CVD to reduce CKM syndrome progression,” Parekh added.

Parekh also emphasized that individuals must take charge of their health.

“People need to know their weight, blood pressure, and BMI,” said Parekh. “Routine point-of-care testing during wellness visits is essential. But often, if a measure is borderline, we tend to ignore it – that needs to stop.”

A new initiative

To combat rising CKM rates, the AHA has launched a pilot preventive health initiative focused on improving care for people in select cities and regions, including Atlanta, San Diego, Baton Rouge, Louisiana, Washington, D.C, Maryland, and Ohio, including the Cincinnati metro area and parts of Kentucky. These locations were selected due to disease prevalence, health system infrastructure and community characteristics. 

The AHA plans to expand the CKM Health Initiative to 15 geographic regions nationwide, ultimately reaching 250,000 Americans at 150 existing healthcare sites. 

“The pilot brings together providers across various specialties, from primary care physicians to cardiologists and nephrologists, to take a more holistic approach to care,” Parekh said.

Looking ahead, Parekh plans to analyze clinical data using electronic health records (EHRs) to conduct a more detailed understanding of CKM. He also hopes to develop a machine-learning risk model to predict and, ultimately, slow CKM progression.

Mothers experiencing depression have considerable challenges across multiple parenting domains, according to a global systematic review published in the July issue of Harvard Review of Psychiatry, part of the Lippincott portfolio from Wolters Kluwer. Maternal depression is defined as major depressive disorder (MDD) that occurs during pregnancy or emerges within 4 to 30 weeks after birth.

Tiago N. Munhoz, PhD, a psychologist at Federal University of Pelotas, Pelotas, Brazil, and colleagues found that 97% of observational studies published in the past decade demonstrated an association between maternal depression and negative parenting practices. “Understanding this relationship is crucial for developing effective psychological methods and interventions,” they emphasize.

Updated review was global and had no language restrictions

Until now, the most recent systematic review to explore the association between maternal depression and parenting only included data collected up to 2013 and was limited to English-language reports. To find more recent evidence, Dr. Munhoz’s team searched the MEDLINE/PubMed, SciELO, BVS, LILACS, Embase, Web of Science, and PsycInfo databases for articles published from November 2013 through 2023. They included observational studies in which mothers were diagnosed with MDD or were screened for depressive symptoms postpartum or in their child’s youth or adolescence.

The researchers looked for studies on parenting practices-specific behaviors directed toward children-and excluded those pertaining to parenting styles (e.g., authoritarian, permissive, or neglectful). They selected 29 articles for data extraction: 27 published in English and two in Portuguese. Of these, 10 studies were conducted in Europe/Central Asia, six in East Asia/the Pacific, six in Latin America/the Caribbean, five in North America, and two in the Middle East/Africa. Eight studies were conducted in middle-income countries and one in a low-income country. Some studies involved videotaping interactions between mothers and children.

Maternal depression was linked to impaired mother-baby bonding and reduced sensitivity

Fourteen studies investigated mother-baby bonding, and all found that maternal depression impaired this bond. In studies that used both the Edinburgh Postnatal Depression Scale and the Postpartum Bonding Questionnaire, higher depression scale scores indicated more damage to the bond. Four studies showed that women who did not manifest depressive symptoms bonded more closely with their babies than women who were depressed or experienced depressive symptoms throughout their lives.

Maternal depression was also associated with:

• Low sensitivity (recognizing and responding to a child’s needs)
• Reduced involvement (participating in daily interactions and activities)
• Diminished commitment (fulfilling childcare responsibilities)
• Less smiling at, touching, or interacting with the baby
• Decreased pleasure in interacting with the child
• Heightened negative emotions
• Increased hostility
• Inconsistent punishment
• Relaxed discipline

One study found no significant associations between maternal depression (during pregnancy and postpartum) and sensitivity or positive regard for the child. That study was conducted in the US and involved 36 low-income mother-child dyads.

“[E]xisting literature suggests that depression-alleviating interventions based on cognitive behavioral therapy and mindfulness improve parent–child relationships and reduce negative parenting behaviors,” the authors remind their colleagues. “Such tactics benefit maternal well-being and the overall family dynamic.”