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OT: "I'm a brain scientist and I let my son play football"

ashokan

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May 3, 2011
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When the autopsy results for Aaron Hernandez were released the media and its various "experts" were quick to blame football for the deposition of tau proteins in the frontal lobes of AH's brain. It was never mentioned that drugs can also affect the tau proteins that gets blamed for CTE. Hernandez was a prodigious drug user (lots of PCP) and failed many tests since hs started using heavy in 2006.

The constant misrepresentation of the tau situation is mentioned in this excellent CTE article

"I'm a brain scientist and I let my son play football"

By Dr. Peter Cummings

My name is Peter Cummings. I am a forensic pathologist and a neuropathologist, which means I study brain trauma for a living. I am also a football coach and I let my 11-year-old son play football. I may be the only neuropathologist on Earth who lets his kid play football.

Coming to this decision was a serious undertaking and the result of many hours spent pouring over medical journals and football rulebooks.

Before I began this journey, football was banned in my house. I wouldn’t even watch it on TV because I didn’t want my son to see it and develop a desire to play. Despite my efforts, he discovered football via a video game. He immediately fell in love with the sport and I was forced to do some serious soul searching: Should I allow him to pursue his interest and play?

Honestly, I was scared of CTE.

CTE stands for “chronic traumatic encephalopathy”; in real words it means damage to the brain caused by repetitive injury. The hallmark of CTE is the deposition of a protein called ‘tau’ in the brain. Tau has a number of functions, including stabilizing the structure of nerve cells. When nerves are injured, tau builds up and can cause problems.

You may have a read about a recently published paper reporting the presence of CTE in the brains of 99 percent of former National Football League players examined. The findings of this study sent the media into a frenzy and produced a lot of negative press toward football. As a result of the media attention, people are now saying there should be no more youth football; there are even people who are insinuating I am abusing my son by allowing him to play football.

People are coming away from the constant media barrage with the belief that concussions are the sole and direct cause of CTE, most or all football players have CTE, and CTE has led football players to become violent, commit suicide or develop dementia.

I had the same impression before I decided to look a little deeper. But when I dove into the published literature regarding CTE, I discovered the scientific evidence to support the media’s narrative was lacking; in fact, I found bodies of evidence to the contrary and a whole other side to the science that is largely ignored.

I’m not alone. A number of members of the medical and research communities are also voicing serious doubts about the current state of the science linking concussion and CTE.

In fact, it’s not entirely clear if CTE is unique to traumatic brain injury. CTE-like pathology has also been seen in the brains of people who’ve died of epilepsy, without any history of head trauma. There are also cases of opioid overdose deaths where the brains show signs of early aging, including tau accumulation. This might suggest other mitigating factors make some people more prone to developing CTE than others.

Replication and independent verification are two crucial steps in the scientific process. Yet many findings associated with CTE haven’t passed these tests. Contrary to what appears in the headlines, multiple researchers have found no significant relationship between playing football and increased risk of violence, suicide and dementia in the general football playing population. In fact, studies have shown a lower rate of death due to violence and suicide in NFL players as compared to the general population.

None of these studies make headlines, let alone even footnotes in most media reports. So when headlines state “CTE found in 99% of brains from deceased NFL players,” it only fuels people’s fear of CTE. They are assuming, like I did at first, that 99 percent of football players will get CTE.

But one has to be careful about interpreting the headlines, and I will tell you why:

The study population in the most recent CTE paper represents a biased sample, as stated by the authors themselves. This means only the brains of self-selecting people who displayed neurological symptoms while living were studied. This is important because this sample was not a reflection of the general football population. The study was based on 202 brains out of the millions of people who’ve played football – 111 of which are former NFL players.

So, when you hear “99 percent of football players had CTE,” that doesn’t mean that almost every football player will get CTE, and it doesn’t mean your child has a 99-percent chance of developing CTE if he or she plays football. It means 99 percent of a specifically selected study sample had some degree of CTE; not 99 percent of the general football population. This is an important distinction....

In other words, we do not have a complete picture of what causes CTE, how common CTE is, or what the chance of getting CTE may be for anyone, or even what symptoms, if any, CTE causes.

Most of the published CTE cases are from former NFL players. How football might affect the brains of our youngest players, including my son, is a question the research hasn’t answered yet.

Despite the lack of cases and evidence, some in the concussion research field have stated children shouldn’t play tackle football until high school. Some people are even calling for the end of youth football all together.

They have bolstered their opinion with a paper published in 2015 concluding former NFL players who began playing tackle football before the age of 12 were more likely to experience long-term neurocognitive problems. However, a more recent study of retired NFL players published last year by a different group at Vanderbilt University found no association between age of first exposure to football and subsequent adverse neurological outcomes.

Other research groups have not found a significant link between playing high school football and an increased risk of later-in-life cognitive deficits.

Two separate papers from the Mayo Clinic failed to show an increase in dementia among former high school football players as compared to other athletes and non-athletes who attended high school between 1946-1956. Another study, released in late August, also failed to show cognitive deficits in former Wisconsin high school football players from the 1950’s...

Concussions are not unique to football; they are seen in hockey, rugby, soccer, water polo and even synchronized swimming. By focusing so much attention on football, other athletes who may be at risk are slipping through the cracks, including girls. Current data suggest in sports in which both boys and girls participate (such as soccer and basketball), girls have twice as many concussions as boys. No one knows why.

The surprising gender discrepancy and the lack of adequate representation of athletes from other sports in the current research makes me wonder if the debate is more about an aversion to football than it is about concussions...

I am not paid from a grant studying CTE; I have no association with the NFL. I have one motivating factor: my son. I whole-heartedly support the ongoing CTE research. Although I have no affiliation with any CTE research labs, I have directed the families of deceased athletes to CTE studies. I also directed a friend of mine, who is a female rugby player with post-concussion issues, to a CTE study. I decided to coach so I could stay informed about the constantly evolving rules changes in football. I made the decision to allow my son to play football after long deliberation over all the facts. To suggest this decision is child abuse is preposterous. I am a forensic pathologist, a neuropathologist, and a dad, and I let my son play football. That should speak volumes.

[Editor’s Note: Yahoo Sports reached out to Boston University to offer Dr. Ann McKee, director of the Boston University CTE Center, a platform to reply to the points specifically raised in this op-ed. Boston University did not provide an answer.]

Dr. Peter Cummings is board certified by that American of Pathology in anatomic pathology, forensic pathology and neuropathology. He is an Assistant Professor of Anatomy and Neurobiology at Boston University School of Medicine. He has been recognized as a medical expert by courts of 24 States and six different countries. He is the author of two forensic pathology textbooks. He lives outside of Boston with his wife, son and dog.

https://sports.yahoo.com/im-brain-s...l-135727314.html?soc_src=social-sh&soc_trk=fb
 
"Cognitive impairment is a recognized effect of drug misuse, including the use of opiates. The pathological basis for this is unknown but the temporal and frontal cortices have been implicated. We have shown previously that deposits of hyperphosphorylated tau in drug user brains exceed those seen in age-matched controls."

Heroin abuse exaggerates age-related deposition of hyperphosphorylated tau and p62-positive inclusions
https://www.ncbi.nlm.nih.gov/pubmed/21126996
 
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The problem with any early research in a field like this is getting a grip on the samples used, and trying to extrapolate meaningful epidemiological estimates. The NFL study is a classic example of sample bias. Only players who had demonstrated mental problems had donated their brains post mortem for study.

The two Mayo clinic studies done retrospectively on high school students show little in the way of increased risk for CTE, but the samples are pretty small. Their methodology seems pretty interesting to me. Using HS yearbooks to see who played what 40 years ago, and then tracking those folks down.

The section on how many brains studied and how many players in the NFL, etc., in this blog is, however. way stupid. This guy is the classic example of "...a little knowledge...."

Even at this point, in the absence of studies that need to be done, it's a good early conclusion to say that repeated head trauma causes CTE. And the more you play, the more you are at risk for repeated head trauma. And the higher level you play at, with its increased violence, the more you are at risk for really serious repeated head trauma.

The fact that other things might also cause CTE is irrelevant. Radon causes lung cancer. Doesn't mean you should smoke.
I would probably let my kid play football if he really wanted to, but if he were good enough to play at the college level, we'd have a real discussion about it.

Having a President encouraging more brain injury in football is, well, dotard.

I'm glad I gave the game up when I did.

And btw, near research out of BU indicates that they've found a way to test for CTE in folks who are still alive. This could actually be a boon for football.
 
The human brain was not meant to play football. Or the knees, neck, ankles, shoulders, spine, etc. My son loved football and played throughout HS. I can tell you I was glad when his HS career ended last fall, as he escaped without serious injury, other than a broken collarbone and one concussion. Other kids on his team were not so fortunate.

He was recruited to play football and baseball in college but chose to play baseball. I'm very thankful for that.
 
Silly article. He as way too biased when he said you can get concussions playing other sports too. None of them have even slightly close to the repetitive head banging that football has.
 
Who was the poster years ago who famously claimed there was no connection between smoking and lung cancer? Anyone remember that or who it was?
 
HS Girls soccer and basketball has a much higher rate of concussions then football.
Can't necessarily compare boys sports with girls. For reasons no one is sure of girls seem to get concussions at a higher rate. It may be as simple as they report it more frequently, or something else.
 
CTE is real. CTE and concussions are way overblown. The NFL and their equipment counterparts need to spend millions on research and improving equipment. That being said, they also need to spend millions educating parents that their third grader isn't going to get CTE. There is so much bad info out there and parents are "learning" this stuff from The View and Oprah.
 
I still suspect that football players underreport concussions. Well, we know they do because they've admitted as much. However my fear about HS football is more about injuries in general. In my HS plenty of kids got injured in all the sports, but the only ones that got MANGLED were playing football.
your school must not have had gymnastics
 
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I still suspect that football players underreport concussions. Well, we know they do because they've admitted as much. However my fear about HS football is more about injuries in general. In my HS plenty of kids got injured in all the sports, but the only ones that got MANGLED were playing football.
But from a concussion standpoint wrestling and soccer are worse. And they under report because they think they are playing in a "safe" sport.
 
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HS Girls soccer and basketball has a much higher rate of concussions then football.

Careful not more concussions but a higher percent of the concussions in girls soccer and basketball were severe concussions as opposed to football. Football still had more per 100,000 participants but were less likely to be a sever concussion.
 
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Wow -
"Before I began this journey, football was banned in my house. I wouldn’t even watch it on TV because I didn’t want my son to see it and develop a desire to play."

gee, ya think you might have just heightened the kid's appetite for the forbidden fruit? A total embargo on football? - gosh doctor, go back to your classes in human behavior and think about how this was likely to turn out ... and ask yourself why on earth you thought you could control his interests and desires by attempting to control his world.

There is an old joke - "what is the difference between God and a Doctor?" ....- God never thinks he is a Doctor
 
Careful not more concussions but a higher percent of the concussions in girls soccer and basketball were severe concussions as opposed to football. Football still had more per 100,000 participants but were less likely to be a sever concussion.
Yes more as a percent and at much larger %.
The story I posted is very clear that its results are a %. Still football isnt the most dangerous sport concussion wise.
 
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Try banging any other body part repeatedly for years and years. There will be permanent damage. Why would the brain be any different? Our skulls and brains were not shaped by evolution for such activity. Other animals, like bighorn sheep and woodpeckers have been molded by millions of years of natural selection for such activity. We ain't them. Our ancestors on the African savannah didn't play football, nor was there any survival or reproductive advantage to having the cranial anatomy of a sheep.
 
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Who was the poster years ago who famously claimed there was no connection between smoking and lung cancer? Anyone remember that or who it was?

Pretty sure it was this guy:

e7b63f4bc82401c56139cb37ff02cdfe--camels-smoke.jpg
 
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Female soccer players suffer the most concussions in high school sports


"High school girls have a significantly higher concussion rate than boys, with female soccer players suffering the most concussions, according to new research presented today at the 2017 Annual Meeting of the American Academy of Orthopaedic Surgeons (AAOS).

"While American football has been both scientifically and colloquially associated with the highest concussion rates, our study found that girls, and especially those who play soccer, may face a higher risk," said Wellington Hsu, MD, professor of orthopaedics at Northwestern University's Feinberg School of Medicine and lead author of the study. "The new knowledge presented in this study can lead to policy and prevention measures to potentially halt these trends...

The study authors hypothesize that girls may face a greater risk of concussions and other injuries in soccer due to a lack of protective gear, an emphasis on in-game contact and the practice of "headers" -- hitting the ball with your head."


https://www.sciencedaily.com/releases/2017/03/170314081533.htm
 
I had a class on research study design during my time at Rutgers. That and quanative methods should be required classes for everyone. It would be helpful for parents to be able to look behind the study and not just listen to sound bites when attempting to make the best choices for your family.

I have respect for science, however if you look at the design of most of these research studies you will see massive flaws in the selection of the sample group that will naturally lead to a pre-determined conclusion. The author here points that out and shows flaws and contradictory findings in other studies. I do feel that he entered this with bias of this own though. His overall point that there should be further research on a larger community of athletes, including female athletes is very valid.
 
CTE is real. CTE and concussions are way overblown. The NFL and their equipment counterparts need to spend millions on research and improving equipment. That being said, they also need to spend millions educating parents that their third grader isn't going to get CTE. There is so much bad info out there and parents are "learning" this stuff from The View and Oprah.

Sounds a little like "Man-caused global warming hysteria".
 
Where did you even hear that and why would you think it's true if you did? Do you actually watch these sports? For those of you silly enough to "like" the post...

http://www.headcasecompany.com/concussion_info/stats_on_concussions_sports

That site is selling "detection sensors".

They hype a new concussion 'epidemic" ("CDC reports show that the amount of reported concussions has doubled in the last 10 years". ) without revealing that the criteria for "diagnosing" a concussion have been greatly watered down. There used to be "grades" of concussion related injury but those went out window, A local high school near me has 1100 students and one fall 100 of them were diagnosed with concussions with many pulled from sports. Almost anything can be called a concussion today.


MDs decry concussion 'hype'

"Dr. Neil Craton and Dr. Oliver Leslie — who practise out of Legacy Sport Medicine in St. Vital — co-authored a provocative editorial that appears in the current edition of the Clinical Journal of Sports Medicine.

The physicians, who specialize in muscle and skeletal injuries, say the world is unnecessarily in crisis mode regarding concussions, traumatic brain injuries that are thought to alter brain function.

Contributing to the problem, say Craton and Leslie, are exaggerated media headlines about high-profile, concussed athletes as well as researchers who "catastrophize" the condition.

"It's a good-prognosis condition. There's very little evidence of a bad prognosis for this condition. We need not fear. It's like, relax. Take the tone down a little bit."

At the centre of Craton and Leslie's criticisms are the Zurich Guidelines, the rules physicians follow when caring for concussed patients. The guidelines contain a checklist of concussion symptoms including headaches, depression and irritability...

Craton and Leslie say the diagnostic criteria in the Zurich Guidelines are "absurd" considering most people, even if they were uninjured by concussion, would test positive for the brain injury under its recommendations.

He said he sees patients who suffer from serious anxiety related to believing they are concussed, even when they aren't.

"What I'm saying is that what's being diagnosed as only a brain injury is often not a brain injury," said Craton. "It could be a neck injury. It could be an inner-ear injury. It could be a person who is sad or depressed."


Over-diagnosis due to paranoia, say authors of medical journal editorial
https://www.winnipegfreepress.com/local/mds-decry-concussion-hype-254138851.html
 
Did not encourage my boys to play football. Better safe than sorry. Frankly, I think I had my "bell rung" one too many times.
 
  1. That site is selling "detection sensors".
They hype a new concussion 'epidemic" ("CDC reports show that the amount of reported concussions has doubled in the last 10 years". ) without revealing that the criteria for "diagnosing" a concussion have been greatly watered down. There used to be "grades" of concussion related injury but those went out window, A local high school near me has 1100 students and one fall 100 of them were diagnosed with concussions with many pulled from sports. Almost anything can be called a concussion today.


MDs decry concussion 'hype'

"Dr. Neil Craton and Dr. Oliver Leslie — who practise out of Legacy Sport Medicine in St. Vital — co-authored a provocative editorial that appears in the current edition of the Clinical Journal of Sports Medicine.

The physicians, who specialize in muscle and skeletal injuries, say the world is unnecessarily in crisis mode regarding concussions, traumatic brain injuries that are thought to alter brain function.

Contributing to the problem, say Craton and Leslie, are exaggerated media headlines about high-profile, concussed athletes as well as researchers who "catastrophize" the condition.

"It's a good-prognosis condition. There's very little evidence of a bad prognosis for this condition. We need not fear. It's like, relax. Take the tone down a little bit."

At the centre of Craton and Leslie's criticisms are the Zurich Guidelines, the rules physicians follow when caring for concussed patients. The guidelines contain a checklist of concussion symptoms including headaches, depression and irritability...

Craton and Leslie say the diagnostic criteria in the Zurich Guidelines are "absurd" considering most people, even if they were uninjured by concussion, would test positive for the brain injury under its recommendations.

He said he sees patients who suffer from serious anxiety related to believing they are concussed, even when they aren't.

"What I'm saying is that what's being diagnosed as only a brain injury is often not a brain injury," said Craton. "It could be a neck injury. It could be an inner-ear injury. It could be a person who is sad or depressed."


Over-diagnosis due to paranoia, say authors of medical journal editorial
https://www.winnipegfreepress.com/local/mds-decry-concussion-hype-254138851.html
It's too funny that he questions where we got that info and defends his point with a website that is called "Headcasecompany" . [roll]
 
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This guy is not wrong in the sense that most "science" reported by the media is junk science.

Yes yes yes..we live in an age of junk science - scientism. Corporations,marketers, politicians, social engineers etc - anyone can buy any kind of "study" they want. Americans are very vulnerable to suggestions by "experts". Many experts are also wannbe rock stars who see hype as permissible if it leads to their "success"


"Scientism is a term generally used to describe the cosmetic application of science in unwarranted situations not covered by the scientific method. More generally, scientism is often interpreted as science applied "in excess"..

To indicate the improper usage of science or scientific claims.[8] This usage applies equally in contexts where science might not apply,[9] such as when the topic is perceived as beyond the scope of scientific inquiry, and in contexts where there is insufficient empirical evidence to justify a scientific conclusion. It includes an excessive deference to claims made by scientists or an uncritical eagerness to accept any result described as scientific. This can be a counterargument to appeals to scientific authority. It can also address the attempt to apply "hard science" methodology and claims of certainty to the social sciences, which Friedrich Hayek described in The Counter-Revolution of Science (1952) as being impossible, because that methodology involves attempting to eliminate the "human factor", while social sciences (including his own field of economics) center almost purely on human action."
 
Did not encourage my boys to play football. Better safe than sorry. Frankly, I think I had my "bell rung" one too many times.

Locally, we had football teams cut in half practically overnight due to parent fears.

Tellingly - as MSM and politicians say football is too dangerous for boys (Obama said he wouldn't let his son play) - many are saluting the insertion of girls into football. We had one girl play in a local HS game (the event was greatly hyped even though the girl was under 5 ft and could barely run - she just "hovered" around the edges of play). This parallels the move to push women into combat even though thye fail training on massive scale and are much more injury prone. There's more than a little crazy weaving its way through the concussion hysteria.

Girls Who Love Football Rush Into Their Own Leagues
http://www.cetusnews.com/sports/Girls-Who-Love-Football-Rush-Into-Their-Own-Leagues.HkxMSWHhtb.html
 
A well-controlled experiment will likely NEVER be possible and, as a result, there likely will NEVER be a definitive answer. That does not negate the correlation between head trauma and altered brain function that is implied by the existing data. For some that is enough to not let their kids play football.

Similarly, I will not start smoking even though it is not clearly understood why smoking correlates with increased cancer. Others will.
 
This guy is a board certified in anatomic pathology, neuropathology and forensic pathology. He is a physician & a scientist & has been a medical examiner - but typically pathologists examine specimens or cadavers - not patients. Their work is not typically 'hands on' with the whole patient - at least not a living 'patient'. That does not diminish his credentials nor his scientific capabilities - but it should be kept in mind .

also - purely an impression - this guy does seem to be a bit all over the place seems to be a bit of a gadfly - wants to be an academic - wants to be a novelist, wants to be a media forensic-historian - wants to cultivate a lucrative "expert witness" consulting practice... (not surprising that he has earned some disdain from within the medical community & a fair amount of harrumphs!)
- if he is not entirely an "attention whore" - maybe he is decidedly "attention-promiscuous"


"Dr Peter Cummings signs copies of his first novel, The Neuropathology of Zombies, at the University Bookstore at his alma mater, The University of Maine."

"50 years later, Beverly forensic pathologist examines JFK" - article on Cummings - Boston Globe November 21, 2013

He also has a private side business, devoted almost exclusively to consulting work for defense lawyers on shaken-baby cases. He has also started a nonprofit dedicated to helping indigent clients facing shaken-baby charges

His scientific work that passes muster should be given its due - his subjective opinions should be taken with a few grains of salt! -
 
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The problem with any early research in a field like this is getting a grip on the samples used, and trying to extrapolate meaningful epidemiological estimates. The NFL study is a classic example of sample bias. Only players who had demonstrated mental problems had donated their brains post mortem for study.

The two Mayo clinic studies done retrospectively on high school students show little in the way of increased risk for CTE, but the samples are pretty small. Their methodology seems pretty interesting to me. Using HS yearbooks to see who played what 40 years ago, and then tracking those folks down.

The section on how many brains studied and how many players in the NFL, etc., in this blog is, however. way stupid. This guy is the classic example of "...a little knowledge...."

Even at this point, in the absence of studies that need to be done, it's a good early conclusion to say that repeated head trauma causes CTE. And the more you play, the more you are at risk for repeated head trauma. And the higher level you play at, with its increased violence, the more you are at risk for really serious repeated head trauma.

The fact that other things might also cause CTE is irrelevant. Radon causes lung cancer. Doesn't mean you should smoke.
I would probably let my kid play football if he really wanted to, but if he were good enough to play at the college level, we'd have a real discussion about it.

Having a President encouraging more brain injury in football is, well, dotard.

I'm glad I gave the game up when I did.

And btw, near research out of BU indicates that they've found a way to test for CTE in folks who are still alive. This could actually be a boon for football.
Obviously, the sample of 110 or so brains that were studies is biased, but it's still part of the general cohort. So as that number grows, it would be hard to deny that a significant portion of pro/college football players suffer from CTE.

As a parent of a daughter, we don't have to worry about football, but I am terrified of my girl really developing a passion for gymnastics.....that's brutal on the body. At her gym, you see the older groups and practically half of them have injuries, braces, boots, wraps, and a few on crutches. She also has a love for swimming, so hopefully she will choose that. Or maybe tennis. At her school, the team sports that are big are lacrosse, field hockey, and basketball. I need to look up data on those! :)
 
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