A recent study of retired NFL players by Johns Hopkins medical researchers adds to growing evidence linking football with brain damage.

The study published last month in the journal Neurobiology of Disease focused on nine retired NFL players, but the results add to a growing body of research and anecdotal accounts associating brain disease with the blows to the head that are a common part of football and other sports.

Using an improved brain-imaging technique, Hopkins researchers found evidence of brain injury and repair in the former NFL players while it did not appear in a control group of nine healthy men had who never played professional football.

Because of the small number of subjects and lack of consistent results, however, the retired players' cognitive performance tests did not present clear evidence of mental impairment, said the researcher who conducted that part of the study. The sample was also too small to correlate the results of another element of the study, eight cognition tests including measures of word memory, verbal fluency and attention with the images showing damage chiefly in three parts of the brain, the report said.

Dr. Jennifer M. Coughlin, the lead project researcher, said the study is a step toward bridging knowledge gaps on the association between playing violent sports such as football with mental decline and mood disorders later in the player's life. She was one of 19 co-authors of the study, 17 of whom are with the Johns Hopkins Medical Institutions.

"Ultimately, I'm really hoping that someday we're able to answer the questions from the players and their family members of whether football really caused brain injury," said Coughlin, an assistant professor of psychiatry and behavioral science at the Johns Hopkins University School of Medicine. "We don't have these answers for family members yet."

The new imaging technology developed in about the past seven years promises a way to study how brain injury develops over time in living people, Coughlin said.

The study included 11 former players, nine of whom took part in both the imaging and the cognitive test portion of the study. The former players, 57 to 74 years old, played a variety of positions, though there was no former quarterback in the group. When the research was done, the men had been out of the NFL for 24 to 42 years.

The nine reported a range of experiences with concussion as defined by the American Academy of Neurology. Concussion does not necessarily mean that the victim loses consciousness, but early symptoms can include headache, dizziness, lack of awareness of surroundings, and nausea or vomiting. Later symptoms can include persistent headache, poor attention and memory loss.

Of the nine players who took part in both parts of the study, one reported 11 concussions, one said he'd had none. Most reported two to five.

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Imaging study looks at brain injury in former NFL players