(BBC)-Australian scientists say they have made the world’s first diagnosis of chronic traumatic encephalopathy (CTE) in a professional female athlete.
Studies on the degenerative brain disease, linked to contact sports, are usually carried out on male athletes.
The diagnosis was made on the brain of Heather Anderson, an Australian Rules footballer who took her own life last year aged 28.
Scientists say the case could be “the tip of the iceberg” for women in sport.
CTE causes an increased risk of mental illness and has also been linked to dementia, but can only be diagnosed post-mortem. Scientists believe it is caused by repeated head knocks and concussions, with a study by 13 academic institutions last year finding “conclusive evidence”.
Research into the condition has been growing in recent years – with more than 300 cases identified in American football alone.
In Australia, high-profile male Australian Rules footballers Danny Frawley, Shane Tuck and Polly Farmer were diagnosed with CTE, as was rugby league player-turned-coach Paul Green.
But study of CTE in female sports stars has been limited.
Ms Anderson’s family donated her brain to the Australian Sports Brain Bank (ASBB), in the hope of better understanding her death.
She played eight professional games in the top-tier Australian Football League Women’s (AFLW). She suffered several injuries throughout her career including at least one concussion.
A talented defender, she was known for wearing a bright pink helmet during matches before her retirement in 2017.
Prof Michael Buckland, who co-authored the study, said Ms Anderson’s brain had three clear lesions, including in parts of the organ that regulate movement, problem-solving, memory, language, and behaviour.
Prof Buckland told the BBC that people suffering from CTE often experience a wide range of mental health issues, and that Ms Anderson’s family had told him “in some ways” the findings “made a lot of sense”.
“Depression, anxiety, irritability, impulsivity, drug and alcohol use, suicidal thoughts, as well as actions of suicide are common,” he said.
He added that Ms Anderson’s family were grateful for the research and might encourage more studies into how head injuries affect women in sport.
“I think [Ms Anderson] is a sentinel case. There’s certainly a real need for a focus on females in this space,” he said.
It comes as sporting bodies globally are under pressure to improve concussion protocols and protect players.
In Australia, more than 60 former AFL players are suing the league for up to A$1bn (£526,000; $668,000) in compensation for the serious damage concussions have allegedly caused them.
Similar cases have also been launched in the US and the UK, where almost 400 players have joined a class action.