Lindsey Straus Lindsey Straus Brooke de Lench Brooke de Lench   IN: What's New, Top Stories, Effects of Concussion and Repetitive Head Impacts   Tagged:  
  • Lindsey Straus

    Author: Lindsey Straus is an award-winning youth sports journalist, practicing attorney, and has been Senior Editor of SmartTeams since its launch as MomsTEAM in August 2000. She can be reached at lbartonstraus@MomsTEAM.com.

  • Lindsey Straus
  • Brooke de Lench

    Author: Executive Director of MomsTEAM Institute, Founder and Publisher, MomsTEAM.com, Producer of The Smartest Team: Making High School Football Safer. Follow Brooke on Twitter @brookedelench. Email her at delench@MomsTEAM.com.

  • Brooke de Lench

CTE: Media Continues To Be Ahead Of Science

Media divide

On the other side of the media divide in reporting on CTE, not surprisingly, continues to be the New York Times, which, it is widely acknowledged, began the CTE=dementia and CTE= suicide memes ten years ago with the publication on January 18, 2007 of a now famous article about former Philadelphia Eagle André Waters, who, after committing suicide, was diagnosed by trailblazing pathologist Bennet Omalu with CTE. As far as the Times was concerned, Dr. McKee’s new study didn’t add to the debate; it ended it: “It is no longer debatable whether or not there is a problem in football — there is a problem,” Dr. McKee said.

Conspicuously absent from the article, however, was any mention of Dr. McKee’s concessions in the actual study that several other factors besides prior participation in football may influence CTE risk and disease severity, including factors other than cumulative hits to the head. Nor was there any mention of her startling admission that it was even “unclear” whether symptomatic hits (concussions) were “more important” than asymptomatic hits resulting in subconcussive injury” in CTE risk, disease severity, and progression.

If no one, including Dr. McKee, knows whether CTE is caused solely by concussions, solely by repeated blows to the head, or a combination of both, and there is evidence that genetic factors, use of alcohol, drugs (including opioids and PEDs), and pre-existing psychological problems might affect risk, one might reasonably ask why it was that the Times re-stated for the umpteenth time that scientists “believed [CTE] to be caused by repeated blows to the head,” and that what remained to be learned was not whether repeated blows to the head caused C.T.E., but rather “how many blows to the head, and at what levels, must occur for C.T.E. to take hold?” It is hard to draw any conclusion other than that such uncertainty didn’t fit neatly into the Times’ 10-year-old football=dementia meme.

The value of the study in determining the risk of developing CTE also appears to have been greatly exaggerated. While Dr. McKee admitted to the Times that there was a “tremendous selection bias” and that the brains autopsied were far from a random sample, the article nevertheless viewed 110 positives as “significant scientific evidence of an N.F.L. player’s risk of developing C.T.E.”

Most scientists, however, take issue with that assessment, including Dr. Samadani, the University of Minnesota neurosurgeon. “McKee saying that 110 of 111 brains she examined from NFL players have CTE is the equivalent of an emergency medicine doctor saying that 110 of 111 patients presenting to the emergency department with a tibia at right angles to a fibula have a fracture somewhere in the bones: she is seeking disease among those who report being symptomatic from it and therefore [she is not in a position to] estimate prevalence in a general population.”

Samadani also points out that, “totally lost in this debate are studies investigating the benefits of sports for children in particular. The average American 16-year-old boy who plays football has a BMI greater than 26. What sporting options exist for this child who, by virtue of his body build, is already at risk for premature hypertension, obesity, diabetes, cardiovascular disease, stroke, dementia, and 13 types of cancer? In the vast majority of people, the benefits of playing sports outweigh the risks of associated injury.” To Samadani, the focus should be on reducing risk in sports; increasing participation for all children; and understanding benefits.

In his 2017 journal commentary, Carson agrees: if sports governing bodies want to get serious about preventing dementia in their former athletes, he argues that it “might make more sense to follow the existing evidence base for dementia prevention.” Given consistent and robust findings on the value of being physically active into old age, Carson believes that “targeting defined risks rather than speculative ones seems a far better place to start.”

In the meantime, as the Times article reminds us, repairing the disconnect between the science on CTE and the media is a long way off.

__________________________________________________

Brooke de Lench is Founding Executive Director of MomsTEAM Institute, Publisher of MomsTeam.com, producer/director of the PBS documentary, The Smartest Team: Making High School Football Safer, and author of Home Team Advantage: The Critical Role of Mothers in Youth Sports (HarperCollins) and Director of NCAA-DoD grant winning program Smart Teams Play Safe . Follow her @BrookedeLench Contact her at delench@MomsTeam.com

Lindsey Straus, JD has been Senior Editor of MomsTEAM.com since its launch in 2000. In May 2016, Ms. Barton Straus was honored by the American Academy of Orthopaedic Surgeons with its prestigious Media Orthopaedic Excellence (MORE) award for her article, Counting Pitches Can Save Young Players’ Arms But Not Always Used Consistently.

MomsTEAM is a 501(c)(3) non-profit which does not solicit nor accept donations from the National Football League, USA Football, or Pop Warner.

This article was originally published in Medium.com on September 20, 2017.

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