Chronic Traumatic Encephalopathy and the NFL

cheesehead

I haven't seen this discussed on the boards yet.

The long-term impact of head trauma on football players has gained increasing attention.

The recent Dave Duerson (former Bears/Notre Dame player) suicide and his request (via text message prior to shooting himself) that his brain be studied for evidence of Chronic Traumatic Encephalopathy has added to the discussion. Interestingly, Duerson shot himself in the chest, presumingly to preserve his brain for study.

Article on Duerson's death and C.T.E at the link:

http://www.nytimes.com/2011/02/20/sports/football/20duerson.html?_r=1&partner=rss&emc=rss

eagle eye

Head trauma has been discussed here many times. Possibly in the weird and wacky world and I think it was Neil put up a thread about it before too.

Actually just done a search and it was Neil.

tallaghtoutlaws

http://www.boards.ie/vbulletin/showthread.php?t=2055805995&highlight=head+trauma

This is the thread in question there also has been many brief discussions on it in other threads.

To be honest even if they do find 100% that American football is 100% the cause of all said problems the game will never change. The only way they will remove the majority of the injuries that happen later on is to remove the helmet and that wont happen.

Of course the NFL will do something along the lines of trying to bring in more rules in the prevention of serious injury. Like they have with the head contact. Over the next few we may see even more rules to take out some of the bite also. But it is clear the helmets are the major cause and we all know where money is involved nothing will ever change.

Duerson may he rest in peace will just be notched down as a tragic loss to the game and the governing bodies will eventually ignore and move on. The day the money wheel stops turning is the day the sport removes the helmet.

Just found this now: http://www.nfl.com/news/story/09000d5d81e710d9/article/nfl-urging-states-to-pass-youth-football-concussion-laws

cheesehead

Great points Tallaght. While comparing American Football to Rugby isn't completely fair, it gives one an idea of Helmet vs. Non-helmet contact.

I found a couple of studies comparing American Football to Rugby:

One from the British Medical Journal:

Abstract
Objective: To establish injury profile of collegiate rugby union in the USA

Design/setting: 31 men’s and 38 women’s collegiate rugby union teams prospectively recorded injuries during games and practice during the 2005–06 season. Three teams withdrew before data collection. An injury was defined as one: (1) occurring in an organised intercollegiate game or practice; and (2) requiring medical attention during or after the game or practice, or (3) resulting in any restriction of the athletes’ participation for ≥1 day(s) beyond the day of injury, or in a dental injury.

Main outcome measures: In total, 847 injuries (447 in men; 400 in women) during 48 026 practice (24 280 in men; 23 746 in women) and 25 808 game (13 943 in men; 11 865 in women) exposures were recorded.

Results: During games, injury rates of 22.5 (95% CI 20.2 to 25.0) and 22.7 (20.2 to 25.5) per 1000 game athletic exposures or 16.9 (15.1 to 18.9) and 17.1 (15.1 to 19.1) per 1000 player game hours were recorded for men and women, respectively. Over half of all match injuries were of major severity (>7 days’ absence) (men 56%; women 51%) and the tackle was the game event most often associated with injury (men 48%; women 53%).

Conclusions: Collegiate game injury rates for rugby were lower than rates recorded previously in men’s professional club and international rugby and lower than reported by the National Collegiate Athletic Association Injury Surveillance System for American football, but similar to rates reported for men’s and women’s soccer in 2005–06.

Another done at University in New Zealand:

Conclusion: In a 1999 study by Massey University in New Zealand, there were 9.5 concussions per 1000 high school rugby players.

In a 2003 study by Yale University in the States, they found that there was an incidence rate of 53.9 per 1000 high school football players.

Rented Mule

People have to understand that concussions may not be a contributing factor for CTE, but they are not the only factor involved.

Concussions are the easiest to diagnose and easiest to point the finger at, but it is the repetitive sub-concussive hits that are so prevalent in football that appear to be causing the most damage.

The thought that the very nature of the game could be causing this is the most terrifying for those who have played football.

tallaghtoutlaws

Rented Mule wrote: »

People have to understand that concussions may not be a contributing factor for CTE, but they are not the only factor involved.

Concussions are the easiest to diagnose and easiest to point the finger at, but it is the repetitive sub-concussive hits that are so prevalent in football that appear to be causing the most damage.

The thought that the very nature of the game could be causing this is the most terrifying for those who have played football.

Well there is debate over whether or not concussions are one of the main factors. Some believe they are and some believe they are not. The Brain is one complicated part of the body and unfortunately it may go down to one of these things that can never truly be defined. When I was looking into the other day I found a couple of different articles, this one here was a very informative piece. This guy sees links between concussions, PTSD and depression.

http://www.stripes.com/news/doctors-study-link-between-combat-and-brain-disease-1.98394

Another one about Owen Thomas with the University of Penn who committed suicide due to CTE.

http://www.paisano-online.com/news/concussions-linked-to-cte-1.1685722

You are right though sub-concussive hit most definitely don't help either but the all lead down the same garden path. The head taking excessive amount of hits whether its full on concussions or a string of cumulative sub-concussive head impacts.

Either way making better awareness of concussions and making sure the lessen the amount of direct head contact can only be a good thing down the path of trying to fully diagnose CTE.

Just think its taken the best of 70 years for the NFL and NCAA and other Football bodies to start taking concussions and head impact serious. Just look at the amount of players that sat out of games as precaution. Long time coming.

tallaghtoutlaws

The one case that blows up all of the theories is Chris Henry:

http://www.blackheartgoldpants.com/2010/6/29/1541234/chris-henry-had-cte-before-death

As the football world has come to better understand the causes and effects of brain damage in its sport, three general assumptions about Chronic Traumatic Encephalopathy (CTE) started to take hold:

* It is a result of concussions, particularly multiple concussions
* It happens to people with long, contact-filled careers
* Its onset happens later in life

Basically, the general consensus was that Mike Webster was the poster child for CTE.

And then Chris Henry died, and now there's evidence that blows up all three of those assumptions. And that is just about the worst news possible for the sport of football.

Star-divide

In fact, not only does Henry satisfy none of those three conditions, he doesn't even come close. Down the line:

It is a result of concussions, especially multiple concussions: If Henry ever suffered a concussion, it was news to his teams; Henry never missed a game to head injury during his career at West Virginia or Cincinnati.

It happens to people with long, contact-filled careers Chris Henry spent four years at West Virginia, then five in the NFL. But even those numbers are both somewhat inflated; Henry redshirted one of those four years at WVU, declaring for the draft after his junior year. Once in the NFL, Henry was suspended for half a year due to arrests--some of which included erratic, violent behavior. So of those nine seasons after high school, Henry was actually playing for just 7 and a half.

Further, Henry played wide receiver, one of the least contact-intensive positions in sport. Yes, Colin Sandeman can surely attest to how violent the worst hits can be for wideouts. But the repetitious, incessant helmet contact that we've been led to believe (and not unfairly) causes CTE and that linemen, linebackers, and safeties face just isn't there.

Its onset happens later in life Henry died at 26. And not only did he exhibit classic signs of CTE, his brain was already in advanced stages of decay:

Finding CTE in a current pro football player wouldn't surprise Robert Cantu, whose Boston University research group has received funding from the NFL.

"It also wouldn't surprise me that somebody as young as 26 would have it, either," Dr. Cantu said of Mr. Henry. "What would be a big surprise is if the amount of Tau protein. ... would be as excessive as it is in people who had much more lengthy careers and died at a much later age."

"It didn't look like the brain of a 26-year-old," said Dr. Omalu, a former Allegheny County pathologist who first found CTE in an autopsy of Mr. Long in September 2005.

A picture of the tissue study of Henry's frontal cortex, compared to that of a normal brain, is here. As one researcher put it, "you should never see" the red stainings evident in Henry's brain. One would expect them in an Alzheimer's patient.

cheesehead

Interesting conversation.

A couple of additional points to add:

Bill Simpson, the guru of motor racing helmets, is now working with the NFL on helmet design. Drivers wearing Simpson's racing helmets walk away from 200 mph contact with concrete walls. He feels confident he can design a helmet that will withstand football collisions. Whether that helps mitigate the repetitive, sub-concussive hits impact - I don't know.

Also, as Tallaght notes above, the NFL appears to be much more pro-active the last season or so in sitting players out as precaution. In years past the coach would say things such as: "He got his bell rung, but he's good to go for the second half". Now we have The American College of Neurology putting out consensus statements taking it to a new level: A player shouldn't return to competition "unless cleared by a neurologist or a physician with proper training"

The ACN full statement at the link:

http://www.aan.com/globals/axon/assets/7913.pdf

cheesehead

Update:

Duerson found to have C.T.E on autopsy. Article in today's (5/2/11) New York Times at the link:

http://www.nytimes.com/2011/05/03/sports/football/03duerson.html

Boston University's news release has additional information:

“Mr. Duerson was suffering from moderately advanced CTE; stage 3 of 4. The pathology was severe in areas of the brain that influence impulse control, inhibition, emotion and. Memory,” said Dr. McKee."

Full Report at link: http://www.bu.edu/phpbin/news/releases/display.php?id=2232