Connecting the dots, one by one
SCIENCE CLOSE TO DEFINING RISK OF CTE IN CONTACT SPORTS
Aconcussion research paper was published last week that on first glance looks like it could have been produced by the School for the Study of the Right Bleeding Obvious.
The report from the Krembil Neuroscience Centre says for patients showing symptoms of a concussion more than three months after the injury was suffered, the presence of a larger number of symptoms suggests the recovery period will be longer.
So more symptoms is worse than fewer symptoms. You don’t say.
But the reality is that with concussion research, any little bit of scientific advancement helps. Even though it has now been several years since the long-term risks of brain injury became a controversial topic in sports, there remain all kinds of unresolved questions. So a study such as this one, which collected data from more than 100 people with long-term effects from concussions and gives doctors and trainers more information about who might be more likely to take longer to recover, is useful.
But the fact science around concussions is advancing with slow, measured steps is also why those involved with big- time sports can continue to say the links between their games and something like chronic traumatic encephalopathy ( CTE) remain unproven. Whether it has been NHL commissioner Gary Bettman on a number of occasions or CFL boss Jeffrey Orridge just before the Grey Cup, they have insisted the connection between contact sports and CTE has not been proven. This is technically correct as CTE has only ever been discovered in an aut- opsy and as such there is no study that can compare the rate of CTE in a bunch of athletes with the rate of CTE in a group of non- playing controls. The commissioners, whose leagues are dealing with lawsuits from former players that essentially allege concussion negligence, can therefore retreat into the science- isn’t- settled defence and get away with it, even if there’s an ethical question about whether they even believe what they are saying.
But the science won’t necessarily always be unsettled. Dr. Charles Tator, a neurosurgeon at Toronto Western Hospital and one of the authors of the study mentioned above, concedes the work on CTE is not conclusive.
“It is true that we can’t connect all the dots that we’d like to,” he said in a recent interview. “But science is moving in that direction.”
And it’s moving in the direction toward an elevated risk of CTE being flagged as a consequence of multiple concussions, which are more likely to occur in contact sports like football and hockey. ( The NFL’s health and safety director conceded a link between football and CTE l ast spring, which was a stark departure from the league’s previous stance, but commissioner Roger Goodell later said the acknowledgment was consistent with earlier assertions. He has since fallen back on the importance of further study.)
Researchers around the world, including at the Canadian Concussion Centre, which Tator heads at the Krembil Neuroscience Centre, are working on a test that would detect the presence of CTE in a living subject. If they get there, that holds the key to all the unanswered questions: is there a significant increase in the risk of developing CTE associated with all contact sports? And how much does that compare with the general populace? Are there non-athletes who develop CTE, but don’t realize they have it? And if so, is it possible high- risk individuals could be identified before they ever take up a sport that involves high-speed collisions?
If a test for CTE in the living can be developed, Tator says, “it will then be much easier to connect the dots.”
He remains cautious about drawing sweeping connections between contact sports and longterm cognitive brain injury, but only in the present.
“We’re not ready with a conclusion yet,” Dr. Tator says. “But I would say we are going to have this solved in the next few years.”
That’s a statement that holds tremendous implications for professional sports. Even as former football and hockey players have suffered mental illness after their playing days, taken their lives as a result and were then discovered to have had CTE, there has always been an uncertainty about risk that has allowed the billion-dollar leagues to push forward. Players can make vast sums of money in a short time in these sports and with the risk of long- term cognitive impairment not quantifiable, it’s one many remain fine taking.
But the risk remains there, clearly. Just hours after Orridge made his comments about CTE before the Grey Cup, former player Matt Dunigan hosted a town- hall session with fans in a hotel ballroom. With Orridge sitting next to him on the stage, Dunigan joked repeatedly about his foggy memory, about having good days and bad and about the fact that the shadow of concussions still looms over him. For Dunigan and countless others, playing football had a long- term price. It’s not the same for everyone, but the risk exists.
Science may soon determine just how much of one there is for those who take the field or the ice.
And what will t he s ports leagues say then?