Why profile of CTE is so different in NZ and the US
The death of Billy Guyton has sparked concern and confusion, and it is easy to understand why. Analysis by
New Zealand Rugby has understood for decades that concussions could lead to lasting damage to the brain. In a 2002 document to accompany its RugbySmart player welfare course for coaches and officials, it unambiguously states: “Repeated concussions may cause permanent damage to the brain.”
And, in 2024, some within the organisation believe that the entire area of pastoral care for former players can be improved.
It would be understandable, therefore, if the casual sports fan is confused about the relative lack of discussion here about the specific brain disease known as chronic traumatic encephalopathy (CTE), the one found in Billy Guyton post-mortem, compared to the United States.
Even anyone vaguely interested in sport has probably heard of CTE, which is synonymous with the NFL in America, and even featured in the Hollywood movie Concussion.
So, why is much more common in the US discourse, compared to New Zealand?
To understand that, the easiest place to start is a body called the Concussion in Sport Group (CISG).
That group involved scientists from many different codes all over the world, and the group assesses the latest research and puts out a consensus statement on concussion.
The most recent consensus statement was released in 2023, following a conference in Amsterdam in October, 2022, which was attended by NZ Rugby chief scientist Ken Quarrie.
CISG is not the be all and end all for NZ Rugby, which conducts its own research, but it does inform NZ Rugby’s position, so its consensus statement is a significant part of the overall CTE picture in New Zealand.
On CTE, it states: “CTE-NC is not a clinical diagnosis.” In other words, CISG, and NZ Rugby, acknowledge the disease known as CTE in the brain, but does not believe it has been shown that its mere presence in the brain leads to a “specific neurological or psychiatric problems”, or indeed “CTE-NC is inevitably progressive”.
On the issue of the brains of former NFL players showing high rates of CTE, the CISG position is: “These studies of former athletes are not cohort studies that can examine causation or quantify risk and thus were not included in the systematic review.”
So, those studies haven’t even been included in the CISG position because it believes they are flawed by design, and do not meet the standard scientific bar in terms of meeting the burden of proof.
The above statements are presented without prejudice – they are merely an attempt to explain why the CTE debate has been far more prominent in the US than it has been in New Zealand.
As a result, as reported by Dylan Cleaver in the The Spinoff last year, there has only been one successful CTE claim recognised by ACC, that of former All Black Tutekawa Wyllie, and only after a years-long battle waged by his his wife Margaret.
Where does leave the players?
Well, set aside the scientific acronyms and classifications and focus on that warning in New Zealand Rugby’s 2002 RugbySmart manual. “Repeated concussions may cause permanent damage to the brain.”
That means the game has to do everything to protect present and future players, and even more importantly, it needs to better look after the past players who have already taken the head impacts and are living with the consequences. CTE or not, this is real.