CTE

Thoughts on everything we are hearing and will see: An opinion

Dustin Fink9 Comments

Certainly we are nearing a “too much” point in terms of concussion for most of the country. For others this is just the continuation of what we have been doing for years. From a personal perspective I do like the attention that the discovery process is getting. I am all for people getting all the info possible to make informed decisions.

I want to take this particular space in this post to assert that I am not – nor have I ever – been against any sport including football. I am, transparently, supporting flag and non-tackle football until high school. Yes, no scientific evidence proves this helps/hurts, but in all my work and research I am of the opinion that less dosage of repetitive brain trauma is better for humans.

That is where we stand, the issue really is one of repetitive brain trauma (RBT), not of sports or accidents or leisure activities. As Dr. Omalu clearly stated in his interview with Matt Chaney in 2011 and again today with Mike & Mike (hour 4); the brain does not heal itself. Damaging it, even on the microscopic level can and will leave a lasting impact. This is not just assumption, it is noted in many different studies regarding brain health after activities (see Purdue).

I am confident that with proper healing time and avoidance of re-injury the brain will find a way to function at or even better (proper learning and congnitive functioning) as people get older. The management of not only the “gross” injury of concussion and TBI is one that is getting better and as we get more research the management of the subconcussive hits and exposure, that too will be satisfactory.

What we all must do is take off the “emotional pants” and wade through the muck to find out what is important for us to make decisions for those that are not capable or even legal. Part of this is discourse and discussion (civil would be best). Everyone will be challenged intellectually and morally with this – it’s OK.

I noticed an article written by Irv Muchnick yesterday Continue reading →

Eleanor Perfetto, PhD – Video

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Been on a video binge lately…  Look for more, but for today please take a listen to Eleanor Perfetto.  There are some points that some may (including me) not agree with entirely, but she has earned the right to be heard!  Not only is she a pharmaceutical epidemiologist, she is the widow of Ralph Wenzel.

Look for more video tomorrow…

Series from the Pittsburgh Post Gazette on CTE

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Mark Roth of the Pittsburgh Post-Gaette put together an informational series on chronic traumatic encephalopathy; “a brain disease that afflicts athletes”.

In the first part that came out this past Sunday, Roth took a look at the global perception of CTE through the examples of Chris Henry and the possible case of still living Fred McNeill;

Chris Henry was a fleet wide receiver for the Cincinnati Bengals. During his five seasons with the team, he developed a reputation as a talented athlete on the field but a bad boy off it, even though those who knew him well say he was typically quiet and respectful. […]

Fred McNeill played 12 seasons for the Minnesota Vikings in the ’70s and ’80s. After retiring, he finished law school and became a successful attorney in Minneapolis, helping to win major class-action lawsuits.

Henry would end up dead after an accident that was predicated with some unusual actions by him, McNeill now has full-time care takers as dementia has stripped him of everything he worked hard for.

Roth begins the second piece with those that can be easily called the experts in this area, Bennet Omalu and Ann McKee; Continue reading →

Limiting Head Trauma is Logical

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The research is starting to come in; the problem is that results and conclusions bring more questions that should be answered.  Naturally some will look at early evidence and make a 180 degree change on their attitudes about certain things.  We are talking about concussions and the research associated with it.  Unfortunately there is plenty of anecdotal and observational cases that sear into our memory, this perhaps shape our thought process.  Along with that there is gathering evidence that supports some sort of process change in how we handle this particular injury.

The need to make change is upon us, that cannot be debated; what can be debated is how or what the changes should be.  I recently read an article where Micky Collins of UPMC said something to the effect of current concussion concern is like a pendulum that has swung all the way to the other side.  Although the changes in sports and activities has certainly not taken that full swing the other way, the pendulum is on the way.  His feelings, like mine is that there is no evidence to suggest that a full swing to the other side is warranted, rather there needs to be competent and complete understanding of what we are facing.  Rather than making full sweeping changes that would be akin to digging up your backyard to rid your self of a mole; when placing traps and poisons and maybe only having to dig up a small section would fix the problem.

There are definitely things we can do as parents, players, coaches, researchers, doctors and concerned people in general to make a dent in the issue.  If we find that the changes are not working then taking another aggressive step may be necessary.  I guess the reason for the above rant is to reinforce the need for changes, but the right changes.  (As I wrote the last sentence I realized how do we know if the changes are the “right” ones; I guess we don’t but certainly what is happening now needs attention).

One of the small changes that can be made is very obvious to me; Continue reading →

Concussion Article Links – MUST READ

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Since the tragic and untimely death of Junior Seau the concussion issue has begun to fester like a three-day old pimple on a 13 year-old’s greasy face.  It is ready to pop and keeping up with all of the pertinent articles and “specials” has been very trying.  In this post I will attempt to link up and highlight as many as I can (surely I will miss many, however Concerned Mom in the comment section will have more).

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Lets begin with ESPN and the Outside the Lines week-long look at concussions.  I have found this to be must see, my DVR is a testament to this; using previous stories and bringing in commentators on the subject have provided information and even fireworks.  Yesterday Merril Hoge and Matt Chaney did just that – provide information and create fireworks.  You can find the podcast here (panelists begin about 7:30 mark).

Hoge drew my ire earlier this week with his admonishing of Kurt Warner’s statement of being a father, however yesterday he did have a very valid point about the management of concussions.  I have said is ad nausea here: the elephant in the room is the management of concussions, however Hoge sounded a bit “underconcerned” about the actual injury.  Which is where Chaney had very valid points about the exposure of concussions to the youth.  They are both right in my estimation; the management is the larger issue but we are seeing too many too young people being effected by concussions.  There needs to be work in both areas and remember this is not just a football issue.

We have the duty to protect our kids and if that means flag football for 5-13 year-olds then I am cool with that.  If we find after making such a drastic change that has not been enough then we can take it further if needed.  I feel that a change like this will allow a few things: 1) more time to let the brain develop and thus allowing research to catch up to what we know.  2) employ more medical providers in a position to find, assess and manage concussions (see athletic trainers). And 3) begin a culture shift about the seriousness of concussions, after all this is a brain injury.

As Chaney later told me; Continue reading →

Review: Graduate Study Article on CTE

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During this tragic time the inbox has been besieged by many stories, questions and information.  One such email came in on Wednesday night;

In light of Junior’s death, which dovetails with the Saints bounty fallout, I thought I’d pass along this paper I wrote in grad school last year about the long-term risks associated with concussions in professional football. Its something of a review article, that covers the development of CTE and physiology of concussions. I played football in high school and “sucking it up,” as you know, is part of the gridiron culture, but we need to education players, parents, and trainers about the difference between having your bell rung and developing a neurological disorder. This paper hasn’t been peer-reviewed by anyone except my professor, who was a medical writer, not a neurologist but I stand by the science. I started this article by asking for advice from Dr. Robert Stern, the chairman of the Center For The Study of Traumatic Encephalopathy at Boston University. I drew on their research and many of their articles and they do excellent work.

I also wanted to thank you all for following this issue, which is becoming a major concern for athletes, fans, and families.

The author of the email and of the paper is Doug Taylor and I feel it is a very good piece for all to read.  Although, as Doug notes, the paper is not “peer-reviewed” it does not mean there isn’t valuable information for everyone to read and think about.  I would like to thank Doug for sharing this.

Long Term Effects of Concussions – Doug Taylor

Sports-related concussions are one of the most common injuries sustained by professional football players. The acute symptoms that follow a mild traumatic brain injury are well established, with many instances of headaches, confusion, dizziness, and short spells of amnesia. The long-term effects of these injuries are less comprehensively understood. Continue reading →

CTE Insight from the Bostonia: but take time to remember the real pioneer

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Shortly before this blog began in September of 2010 there was a brilliant article written in Bostonia regarding the work that Boston University was doing.  This article did not fall into my lap until yesterday during the Junior Seau reporting, it was found tweeted out by none other than Will Carroll, @injuryexpert.

We have come to understand a bit more about chronic traumatic encephalopathy (CTE) though the work of those in Boston.  It would be an absolute shame to not mention the person who first found this brain issue, Dr. Bennet Omalu.  Dr. Omalu found it but then was unceremoniously Continue reading →

CTE Threshold?

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Charles Bernik, MD of the Cleveland Clinic thinks that there may be a correlation to repeated head trauma and a threshold of when degenerative brain disease begins, like CTE.  An article appearing in Science Daily last week discusses this;

A new study suggests there may be a starting point at which blows to the head or other head trauma suffered in combat sports start to affect memory and thinking abilities and can lead to chronic traumatic encephalopathy, or CTE, in the brain.

The study looked at 78 “fighters” and split them based on their years of experience, in this study the split was nine years.  Those that Continue reading →

Kevin Turner Interview

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We have written about Kevin Turner before; a former NFL player and Alabama stud who is now dealing with the effects of ALS (Lou Gehrig’s Disease).  Turner has started a foundation in his name where they are raising money and awareness about ALS and the workings of the Sports Legacy Institute (SLI) as it relates to CTE.

Yesterday Rachel Baribeau, on her show Barbo & Scarbo (Kevin Scarbinsky), interviewed Kevin Turner on 97.3 The Zone out of Birmingham.  It is such a profound interview that I encourage everyone to take a listen.  You can CLICK HERE for the podcast.

The perseverance of Kevin Turner is and SHOULD be Continue reading →

White Paper

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Sometime today Sports Legacy Institute (SLI), headed by Dr. Robert Cantu and Chris Nowinski are going to release a “white paper” that will “plan to spread successful NFL policy changes to all youth sports,”  this according to Irvin Muchnick via his blog Concussion Inc.

What is a white paper?  Glad you asked it is important for context (via Wikipedia);

A white paper is an authoritative report or guide that helps solve a problem. White papers are used to educate readers and help people make decisions, and may be a consultation as to the details of new legislation. The publishing of a white paper signifies a clear intention on the part of a government to pass new law. White Papers are a ” … tool of participatory democracy … not [an] unalterable policy commitment.[1] “White Papers have tried to perform the dual role of presenting firm government policies while at the same time inviting opinions upon them.”

It is mentioned that along with SLI, Boston University’s Center for the Study of Chronic Traumatic Encephelopathy (headed by Dr. Ann McKee) will be in the white paper as well.

I will be interested to see what exactly they are Continue reading →

Ken Dryden via Grantland

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Ken Dryden was an amazing goalie in the NHL, and has been around long enough to see the transformation of the sport.  Hockey is a very exciting game to watch and really many are missing out on its action.  I continue to tell everyone that there is nothing like a NHL game in the stands, probably the best event one can go to (unless you score a Game 7 ticket in the playoffs).  The issue that Dryden is taking on is one that I have been clamoring for – for a long time – remove shots to the head.  Dryden wrote his article for Grantland and is calling on the NHL and NFL to start playing “head smart”;

This is a difficult time for the NHL, for its commissioner, Gary Bettman, and for hockey. It’s no less difficult for the NFL, for its commissioner, Roger Goodell, for the NCAA, and for football. Head injuries have become an overwhelming fact of life in sports. The immensity of the number, the prominence of the names, the life-altering impact on their lives, and, more disturbing, if that’s possible, the now sheer routineness of their occurrence. The Crosby hit didn’t seem like much. If it hadn’t been Crosby, the clip of the incident would never have made the highlight reel. And if so much can happen out of so little, where is all this going? Who else? How many more? How bad might this get? Careers and lives of players, we know now, have been shortened, diminished, snuffed out by head injuries. What once had seemed debatable, deniable, spin-able, now is not. What once had been ignored now is obvious. Not just contact or collision sports, hockey and football are dangerous sports.

Dryden does not suggest to Bettman, rather implores him to make necessary changes; Continue reading →

Corwin Brown

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The former Michigan star and coach for Notre Dame has been hospitalized due to a self-inflicted wound after a stand-off in his Indiana home.  Fox News has the report;

A statement released by Brown’s family said he became suspicious, distant, gloomy, exhausted and depressed after playing eight seasons in the NFL.

“We believe Corwin is suffering from symptoms similar to those experienced by the late Dave Duerson and were caused by the many notable collisions during Corwin’s career in the NFL,” the family said. “For those reasons, Corwin chose to not disclose his symptoms, as he did not want to bring shame to any coach, team, organization or the NFL. Continue reading →

Recent ABC Story

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ABC has run a very extensive story about head injuries in sport (see football) in light of the Duerson suicide.  The article is good but what is striking are the videos associated with it.  Not only the embedded video on the first page, but the sourced videos below it, mainly about Mike Webster (Driven Mad?).

Neuropathologist Bennet Omalu, MD, who was the first to identify the condition, told MedPage Today, “There is no reason, no medical justification, for any child younger than 18 to play football, period.”

As we should know Omalu is the godfather of CTE, he first found it with Webster and subsequently other former NFL’ers, once called a “doctor of Voodoo medicine” Omalu has some of the best perspective on this injury.

“People said then, and still are saying today, that when former athletes deteriorate into depression, drug abuse, and even violence and criminality, it’s because they don’t compete well on the field of life after competing well on the field of football,” Omalu said in an interview with MedPage Today. Continue reading →

Video About Duerson

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Newsy.com, a Multi-source Video Analysis website, has run a video about Duerson and information surrounding his untimely death.

VIDEO LINK HERE

Of note in the Duerson follow-up has been the fact that he shot himself in the chest, and it is being reported that he mentioned to his family that he did that for the explicit reason of not harming his brain.

Tom McHale and CTE

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There is an amazing “Outside the Lines” video on the ESPN.com website.  There is an issue of embedding it here on this site, however I can provide a link (7 minutes).

OTL: Future of Football

The story begins telling us about Tom McHale, former NFL offensive lineman, who had a terrible end to his life at a young age.  What was found posthumously in Tom’s brain was chronic traumatic encephalopathy, an occurrence that is becoming more evident as brains are examined.  Although CTE cannot be directly contributed to his death, CTE can cloud judgment and affect the executive function of the brain, leading to cases like McHale.

The video takes a look at what former players think of the sport, in particular what they are going to do with their own kids; the McHale’s, Eddie Mason and LaVar Arrington.

Take a look and comment back here.

WWE Comes Under Fire

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Irvin Muchnick the author of Chris & Nancy: The true story of the Benoit Murder-Suicide and Pro Wrestling’s Cocktail of Death wrote a blog today about the transparency of the World Wrestling Entertainment business.  It is a fascinating look at the “inside” of the WWE and their current leadership of the medical team.  Muchnick contends that Dr. Bryan Donahue, cardiologist, and Dr. Joseph Maroon, neurosurgeon, both of the University of Pittsburgh Medical Center (UPMC) and WWE’s medical team, may have a conflict of interest when it comes to supplements.

However, this blog also highlights some of the “thought process” behind the WWE and Chronic Traumatic Encephalopathy, and the current “don’t ask, don’t tell” mentality.

In terms of Maroon’s medical specialty of neurology, the matter of closest interest was his response to a study of Benoit’s brain tissue, which showed a large accumulation of tau proteins, the sign of CTE. The examination was conducted by a forensic pathologist, Dr. Bennet Omalu, one of the pioneers of this research, at the behest of the Sports Legacy Institute. SLI had been started by a former WWE performer and Harvard graduate, Chris Nowinski, who retired from the ring as a result of his own concussions.

Much like Maroon and the NFL originally, WWE tried to discredit or downplay CTE research. But the hiring of Maroon to coordinate WWE’s wellness policy coincided with the addition of Maroon’s imPACT testing and of Donohue’s area of expertise, cardiovascular screening. In total, five out of the wellness program’s eight medical professionals listed at the WWE website are from UPMC.

Muchnick also penned some inconsistencies in regards to CTE information provided by the WWE and what they (medical director, Dr. Maroon) actually knew: Continue reading →

The Sad End of Brad Evans

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YouTube Video Tribute

A promising young athlete struck down in the prime of his life, at his own hands.  Brad Evans of Hobbton High School in North Carolina ended his life with a gunshot.  A seemingly “put together” young man who had no indication of depression or impulse control issues suddenly and without explanation felt compelled to end it.  Brad was going to go to college to play baseball and possibly strive for his ultimate goal of the Major Leagues.

This was to happen after his senior season, including on the gridiron, where all the problems may have begun.  It is very important to say that there is and most likely will not be a link, but Brad suffered three concussion in a month’s time.  He  returned prematurely, and did not get a doctor’s clearance to participate.  His final concussion occurred on October 8th and required a helicopter transport to a regional medical center.

The time line and a very good narrative of what happened to this young man are at the FayObserver.com, written by Greg Barnes.

No one will ever know whether Brad suffered from CTE, or whether the repeated blows to his head altered his thinking and led him to take his own life.

Suicide remains one of the most common causes of death among teenagers.

But a mounting body of evidence – reinforced by the unlikely deaths of three promising young athletes since April – suggests that at least some of those suicides could be linked to repeated hits to the head.

2010 Head Trauma & The Athlete

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On Friday October 1st, this conference was held with 192 in attendance listening to the 11 speakers about how head trauma is affecting sports/athletes in Boston, MA.  More importantly it was being discussed how the young athlete is most susceptible and preventative steps must be taken.

Chris Nowinski, co-director of the Boston University Center for study of CTE, and advisory board member of www.sportsconcussions.org, was to the point about reducing hits to the head of individual athletes,

“We can have a way to reduce the number of hits in the head from 1,000 to 300, tomorrow.”

But a lot needs to be studied and in order to do that more brains are needed.  Thankfully there are some out there that are willing to donate when the time comes.

Some 350 athletes, from all sports and including amateurs, have agreed to donate their brains to the Boston University center since the program’s inception last year; its goal is 750 donations. Meanwhile, six retired pro athletes are participating in a study in which their brains undergo state-of-the-art imaging tests, and they already have produced evidence of lost brain tissue compared to non-athletes.

Next month, the center directors said, 200 retired NFL players of all ages and years of experience will begin a program of neurological, psychiatric and medical study that will include spinal taps, to track potential brain injury and disease and find other ways that they can be diagnosed.

Read the entire story here.

Bob Probert’s Posthumous Donation

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One of the most feared hockey players, Bob Probert, will have his brain donated to Boston University and the research center.  This is the same center that did the research on Owen Thomas’s brain, and is on the forefront of CTE research.  Bettor.com has run a story about the hard decision his family made, for the betterment of hockey and athletes.  Another player who has planned to donate his brain to BU is Keith Primeau, he said in the article;

“There was a period of time where groin injuries were front and centre, and knee injuries were front and centre, but they began to build it into their business model,” he said in 2009. “They accepted the fact that players were going to miss time because of sports hernias. To me, the head is so much different than just a torn abdominal muscle or a torn knee, in that it can be life altering.”

It will be interesting to see the results.

CTE Found as Contributing Factor

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Another post on Owen Thomas and what researchers have found. 

As we discussed previously chronic traumatic encephalopathy was found by Ann McKee at Boston University.  This case is EXTREMELY unique on many levels.  First, Thomas was the first college aged individual to show CTE, secondly he was never diagnosed with a concussion.  However, being a lineman in football he was exposed to thousands of head hits throughout his career.

Here is a video with his mother and the full story found at bu.edu;

This particular topic of concussions will be more on the “front burner” as time goes on.

Chronic Traumatic Encephalopathy

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CTE or Dementia Pugilistica is becoming more and more prevalent as we dive deeper in the realm of concussions.

We ran a story about a mother looking for changes in football after her son’s suicide.  That death was as a result of CTE as found by researchers at Boston University.

CNN.com ran a story on Wednesday about this individual and CTE.