The concussion discussion: 2018 could be a watershed
More brain injury headlines could be on the way in 2018, writes Wayne Scanlan.
At the first Grey Cup Player’s Health Summit in Ottawa in late November, a Queen’s University neurologist was asked about new therapies for concussion treatment. “To date there is no evidence-based treatment for concussion that is available,” he replied. “All we have is our best guess.”
A case could be made that 2017 was the Year of the Concussion Discussion.
But the topic will hardly be resolved with the completion of the calendar. Given the scientific breakthroughs on the horizon combined with class-action lawsuits and personal stories related to concussions from sport participants, 2018 could make a bigger splash.
At the first Grey Cup Player’s Health Summit in Ottawa in late November, Queen’s University neurologist Dr. D.J. Cook was asked about new therapies for concussion treatment.
“That’s the trillion-dollar question,” Cook said. “To date there is no evidence-based treatment for concussion that is available. All we have is our best guess. Active recovery is what we do right now.”
Cook was the doctor who operated on Gord Downie of The Tragically Hip when it was discovered Downie was suffering from glioblastoma, a form of brain cancer.
“Are there things burgeoning, are there things in the pipeline? Yes there are things that are very close,” Cook said, elaborating on the complex nature of brain trauma.
“It’s more than just an injury of the brain. It’s an injury of the entire nervous system, both inputs and outputs, and as a systemic disease we have a lot to learn. And a lot we can do for it.”
CTE REPORTS
In the past couple of years, concussion news has tended to trickle down from the NFL and NHL and cause ripples in amateur sport.
Data from a Journal of the American Medical Association (JAMA) release caused a stir when it was learned that 110 of 111 deceased NFL players’ brains studied showed evidence of chronic traumatic encephalopathy (CTE).
The degenerative brain disease is associated with repeated head trauma. It’s important to note the brain samples studied were not random, as they were promised to the Boston University CTE Center, either by concerned players prior to their death or by families who recognized changes in mood and behaviour from the ex-player.
A total of 202 brains of former football players were studied by July 2017. This included entries from the NFL, college, CFL and even a few high school samples. The results — 177 brains, 87 per cent, showed signs of CTE. Forty-eight of 53 college players showed signs, while seven of eight CFL players and nine of 14 semi-pro players also showed signs of CTE.
The CTE levels ranged in severity from Level 1 (low) to Level 4 (extreme).
Former New England Patriots tight end Aaron Hernandez, a convicted murderer, was found to have extreme levels of CTE when his brain was studied following his suicide at age 27.
Daniel Daneshvar, a neuroscientist at the Boston University Research CTE Center, told this newspaper that even the experts at the university were taken aback by the findings.
“We’ve been studying CTE for eight years and it’s been in the literature since 1928,” Daneshvar said in an interview. “We knew CTE was related to repetitive head trauma, what was surprising to us was the sheer number of athletes we found that had CTE over a relatively short time period of study.
“To find 110 players (out of 111) at the NFL level was pretty surprising.”
Daneshvar believes professional sport leagues have to get out in front of this ongoing issue.
“To a certain extent I can understand why leagues are reluctant, but the longer they choose to sit on the sidelines when it comes to making decisions to protect their players, the more likely they are to face an existential threat as we become more aware of the specific types of hits that are responsible for the development of CTE,” Daneshvar said.
“If they keep waiting to do anything, people are going to be less forgiving.”
NFL PAYOUTS
The NFL has been lauded for taking a position on the concussion story, admitting a link between football and brain trauma while providing a settlement of $1 billion for former players. Yet, there have been numerous reports suggesting the money offered in the settlement does not measure up to those initial headlines about a future payout. In November, data indicated that of the 1,400 claims submitted by ex-players, only 10 per cent had been approved.
Others have complained that the compensation was dramatically lower than expected and the system has been fraught with delays and red tape to make it difficult for those in need to get their settlement money.
CFL DENIES LINK
The CFL also faces a classaction lawsuit and hasn’t reached the point of settling with former players or even agreeing that CTE is caused by football contact.
“We know there are football players that have had CTE,” said CFL commissioner Randy Ambrosie during his state-ofthe-league media conference during Grey Cup week in Ottawa. “It’s a terrible thing that we’re not going to dispute.”
But Ambrosie added, “we have to follow the science and the science ... is inconclusive. The cause and effect is unclear, it just simply is.”
It’s an injury of the entire nervous system, both inputs and outputs, and as a systemic disease we have a lot to learn. And a lot we can do for it.