Australian researchers have for the first time diagnosed a female athlete with chronic traumatic encephalopathy (CTE), a progressive degenerative brain disease caused by repeated head injuries, in a finding which will have major implications for women’s sport.
The Australian rules footballer and Adelaide premiership player Heather Anderson died in November 2022 at the age of 28, with her unexpected death the subject of an ongoing coronial investigation.
Anderson, who was also a medic in the Australian defence force, played rugby league and then Australian rules football during her contact sports career, which began at age five and spanned 18 years.
Her mother insisted that she wear a helmet during games due to the risk of concussions.
“She hated watching me get smashed,” Anderson told media outlet Mamamia in 2017.
Anderson’s family donated her brain to the Australian Sports Brain Bank hoping to better understand why she died. The findings from the ASBB researchers, published on Tuesday in the medical journal Acta Neuropathologica, describe the examination of her brain and neuropathological findings that fulfils current diagnostic criteria for low-stage CTE.
A piece by the authors of the paper, published by The Conversation, said: “She is the first female athlete diagnosed with CTE, but she will not be the last.
“Although Australian women have historically been excluded from the sports most associated with repeated head injuries, this is changing,” the authors wrote. “In 2022, there were almost one million women and girls playing some form of contact sport in Australia. As women’s participation in contact sport continues to grow, so too does their risk of repetitive brain trauma.”
Due to the circumstances surrounding Anderson’s death, her father wrote in a Facebook post at the time that it is suspected she died by suicide. “The response to the news of Heather taking her own life has shown us that she had friends, teammates, and fellow soldiers all across the country,” he wrote.
The study of her brain was led by associate professor Catherine Suter, the ASBB chief scientist. In the research paper, she and her co-authors wrote: “While there are insufficient data to draw conclusions on any association between CTE and manner of death, suicide deaths are not uncommon in the cohorts where CTE is sought at autopsy.”
Paper co-author Dr Michael Buckland said there were “multiple CTE lesions as well as abnormalities nearly everywhere I looked in her cortex”.
“It was indistinguishable from the dozens of male cases I’ve seen,” he said. “I want to thank the Anderson family for generously donating Heather’s brain and hope more families follow in their footsteps so we can advance the science to help future athletes.”
To date, there have only been a handful of CTE cases reported in women, and none have been former athletes.
Dr. Chris Nowinski, the CEO of the Concussion Legacy Foundation which co-founded the ASBB, said; “The first case of CTE in a female athlete should be a wakeup call for women’s sports.
“We can prevent CTE by preventing repeated impacts to the head, and we must begin a dialogue with leaders in women’s sports today so we can save future generations of female athletes from suffering.”
He said as women’s participation in contact sports grows, and as former contact sports athletes age, researchers anticipate more female athletes will be diagnosed with CTE.
Readers seeking support and information about suicide prevention can contact Lifeline on 13 11 14; Suicide Call Back Service 1300 659 467; or for information about CTE support visit CLFHelpline.org.