This continuing “Guest Series” is being authored by Terry Ott and will delve into the Canadian Football League and the issues revolving around it and brain injury. His process began nearly a year ago, but Mr. Ott picked up some steam with the release of“League of Denial”. He has since found himself running into dead-ends and basically being ostracized for taking a journalistic angle on this as it pertains to the CFL. We are thankful that we can provide a space for his writings and only hope that someone who is reading this can further his cause. You can read PART 1 HERE and PART 2 HERE and PART 3 HERE.
THE CURIOUSLY TITLED AND ENIGMATIC BRAIN STUDY, AND THE SEEMINGLY RHETORICAL QUESTION OF ’14
“We can’t solve problems by using the same kind of thinking we used when we created them.” –Albert Einstein, who knew a thing or two about brains.
Dr. Tator: Not absent
Dr. Ann McKee, professor of neurology and pathology and co-director of the Center For The Study Of Chronic Traumatic Encephalopathy at Boston University once mused in a television interview that she wondered if most if not all professional football players had some degree of CTE.
After all, the brains of former football players examined by the Center so far has found the existence of CTE was near one hundred percent.
Whether one agrees with the now famous Dr. McKee in totality regarding the prevalence of CTE in former players, her and her team are world-class doctors and researchers who have brought the serious issue of football related brain trauma into the collective consciousness of tens of millions of observers.
Most believe that the BU work on CTE was the main catalyst for the National Football League to eventually in 2009 admit that there was a cause and effect between football play and CTE and was also the key preponderance of the evidence that made for a 765 million dollar settlement between the league and former players who claimed neurological damage from playing football.
Here in the Great White North, Dr. Charles Tator, of the University of Toronto, has been referred to as the grandfather of brain research and sort of the Canuck version of BU-like CTE research.
Dr. Tator, a neurosurgeon, originally specialized in spinal cord injuries, but was leader of a study of the brains of 6 former Canadian Football League players that was published in May, 2013.
Despite the fact that Dr. Tator’s study found a fifty percent incidence of CTE among the subjects, the study was entitled “Absence of chronic traumatic encephalopathy in retired football players with multiple concussions and neurological symptomatically”
The detailed study places much weight on the small number of brains evaluated in the study as well as the role that genetics and per-disposition to brain disease on the subjects has on CTE determination, and in summing up, Dr. Tator overall advised “caution” in preparing a diagnosis of CTE.
Still, there was the fact that half the studied brains indicated CTE, yet it was an “absence of,” situation. Man, I could have a pretty good weekend in Vegas with a 50% chance at the odds.
But after repeated attempts to contact Dr. Tator last October to clarify some of the details of the study,including the “Absence Of” title, and only after an appeal to the University, I received an e-mail from him that did not really address my questions but did say that research on CTE would continue.
And last November, and now just appearing in January 2014 on PubMed.gov, Dr. Tator has produced another study on CTE, entitled in an online abstract “Chronic Traumatic Encephalopathy: How Serious A Sports Problem Is It?” http://www.ncbi.nlm.nih.gov/pubmed/24273309
I urge all interested parties to seek out this coherent and well written new study and read it carefully.
Because the study raises some important and significant questions about CTE including the lack of long-term study results on football concussions and brain degeneration-in plain English, the cause and effect-as well as establishing a classification and universal rating system for CTE.
Yet if Dr. Tator’s new the study is any indication, it would appear that the good doc may still be in the “absence of” and “cautious” and definitely in the “how serious?” camp. Or maybe he just likes provocative, contrarian study titles.
“At present, it is not possible to assess the validity of the proposed methods of classification and grading of the severity of the disease (CTE). Additional studies of large numbers of at-risk athletes are essential, especially prospective longitudinal studies,” the new Tator study states.
The study further proclaims that “It is essential to carefully evaluate the clinical and neuropathological features of CTE in athletes in the last 10 years.”.
And the study also states that it “is apparent that there are many unanswered questions to be answered to determine how big a problem this (CTE) is, especially the percentage of concussed athletes that will develop CTE.”
Dr. Tator also believes that “The fact that most CTE cases worsen clinically over time and the long latency in most cases before florid clinical findings emerge will always mean that cases of pure CTE will be rare…”
Of course I never went to Med school, nor even J-school, but a lay, serious reading of the “Absence Of” study and the new pregnant question study might lead the average observer to deduce that Dr. Tator is far from on the same page as the BU CTE researchers who appeared to have already, as have many medical professionals and other, come to the conclusion that “caution” in a diagnosis of CTE in some former football players may be too cautious in and of itself and the finding that “pure cases of CTE may be rare,” may also be a clinical bridge too far.
In the new study, Dr. Tator also appears to question some conclusions on CTE that Dr. Bennett Omalu-who gained national prominence with his appearance in the documentary League of Denial-has come to, and while this sort of scientific debate among peers is the norm, could it also be a kind of (all in the) family feud?
And if you recall the former CFL linebacker Leo Ezerins featured in the second installment of this series-and whose name is on the “Absence Of” study-was of the opinion that much or even the whole CTE question was a “feedbag” for the less than earnest hopefully rich and famous, one may also wonder just what the hell is going on as earlier uttering of his come to light.
Because while Leo had told me that he had not suffered any ill effects from concussions, in 2012, he sang a quite different tune for a Hamilton, Ontario newspaper.
In the story, predominately about Dr.Tator’s then coming work on CTE and with Tator complaining about how the CFL was not ponying up research bucks, Ezerins was described as “a poster boy” for concussions, as well as noting Leo’s complaint of lingering headaches, memory issues and perhaps half in jest, not being able to find his way to the locker room back in the day after a particularity hard hit.
“I couldn’t figure out the entrance from the locker-room onto the field, and I didn’t remember the entire game after that hit,” Ezerins told the paper, although the game in question was not identified.
You can make your own judgements as to why Leo said one thing about his experience with concussion(s) in 2012 to the paper, and a much different thing in 2013 to me, other than to note that his statements to me came after the publication of Dr.Tator’s “Absence Of” study.
Sadly, Leo told me late last year to get lost, although Dr. Tator did reply that regarding CTE funding,
“Yes, the CFL has been more supportive,” although he did not reveal the amount of support. (Previously, the CFL refused to answer my questions about Dr. Tator’s study.By comparison, BU CTE group received one million dollars in funding for CTE research from the NFL in 2010 but was later criticized by league doctors for their definitive concussions equal brain damage conclusions.)
The efficacy of pro leagues with a dog in the hunt funding research for what has become a controversial and litigated issue is surely a seriously discuss amongst yourselves scenario.
And not to get too pop cosmic on y’all, but the whole thing puts me in mind of the wise and esteemed Todd Rundgren who once sang that, “You know, wishing won’t make it so. Hoping won’t do it, praying won’t do it…the sun and the moon won’t do it And God won’t do it and I certainly won’t do it That leaves you, you’ll have to do it.”
Or in less eloquent words, the question of “absence of CTE” and “how serious a problem” it is-and Dr. Tator et al can certainly call their studies any damn thing they please-might appear to be on the wrong side of the central issue at best, and even maybe just plain wrong about “caution” and CTE at worst. But of course time, and more research, will most likely eventually tell which of the “sides” are the most accurate, and most importantly helpful in treatment and prevention.
Yet hey ladies and gentleman, don’t take my humble word for it, but rather hear it from an individual with first hand knowledge and real life experience:
The Concussion Blog 