CTE Found in 99% of Former NFL Players in New Study

Submitted by FauxMo on

New research found CTE in virtually every former NFL player included in the study, 110 of 111 or 99%, to be exact. It was found in 87% of players at all levels studied. 

 

Here is a brief article from CNN: http://www.cnn.com/2017/07/25/health/cte-nfl-players-brains-study/index…

Here is the actual research from JAMA: http://jamanetwork.com/journals/jama/fullarticle/2645104

 

Now, the article mentions right up front that this is a "convenience sample." For those not familiar with research methods, that means the authors studied what they had on hand to study, and did not randomize their sample. CTE can only be identified during autopsies, and thus they are doing autopsies of brains that have been donated for study. Those donating their brains (or their families) are, in most cases, suspicious that the player had CTE or some other neurological disease, and they donate the player's brain to confirm this. Therefore, these results may not (and probably do not) generalize to the broader football playing population.

That being said, this is really horrifying. If even a substantial percentage of NFLers develop CTE - far short of 99% - how long can the sport last in its current form? I love football, but as I tell others, I won't let my son play, and he desperately wants to. I've told him when he's in high school and "old enough" to make his own adult decision, he can. But not now (he's only 11). 

P.S. This is not OT. This applies to every football player and program at every level. 

NRK

July 25th, 2017 at 12:52 PM ^

There is no doubt that football is the most significant sport when it comes to CTE and CTE research - especially in the US - and I agree that the subconcussive impacts are also something that should be (and are being) focused on more.

But, soccer does have a good amount of collisions and should not be downplayed.  I don't say this to scare anybody, but I also feel people too quickly jump to the conclusion that football is the only sport that puts you at such risks. (For note, I played football for a short period of time before college, and soccer for most of my life up until college.) There's been a lot more studies around soccer, and subconcussive actions recently. Some noted below.

 

EDIT: And to be clear, there's still WAY more research needed on all of these issues and sports to really have a better understanding of it. I fully suspect my views on this will change as more research is conducted.

 

Cortical thinning in former professional soccer players

https://link.springer.com/article/10.1007/s11682-015-9442-0

 

Cortical thinning was associated with lower cognitive performance as well as with estimated exposure to repetitive subconcussive head impact. Neurocognitive evaluation revealed decreased memory performance in the soccer players compared to controls. The association of cortical thinning and decreased cognitive performance, as well as exposure to repetitive subconcussive head impact, further supports the hypothesis that repetitive subconcussive head impact may play a role in early cognitive decline in soccer players.

 

The neuropathology of Sport

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4255282/

Soccer

There have been reports in the lay press about soccer players with CTE [] and early changes of CTE were by noted by Geddes in an amateur soccer player []. We have also confirmed CTE-MND in a 29-year-old semi-professional soccer player (Fig. 6). In soccer players, it is unclear what role heading of the ball and cervical spine injury play in the development of CTE and MND; this determination has considerable importance, as heading is considered a feature of soccer potentially amenable to restriction or elimination. Recently, soccer players who head the ball more than 1,800 times per year were found to have microstructural abnormalities in the temporo-occipital white matter on DTI that correlated with poorer memory scores []. ALS incidence and mortality are also reported to be unusually high among professional soccer players in Italy []. The 29-year-old soccer player with CTE-MND in our series played soccer since the age of 3 and frequently headed the ball; at autopsy, PHF-tau neu-rofibrillary changes were extensive in both the frontal and posterior temporo-occipital regions. The demonstration of CTE- MND in a young soccer player, college and professional football players, and boxers raises the possibility that the neuropathological substrate of MND in some athletes might be CTE-MND.

 

 

See also:

https://www.ncbi.nlm.nih.gov/pubmed/23757503/

http://nymag.com/scienceofus/2015/09/does-soccer-have-a-brain-trauma-pr…

http://www.cnn.com/2017/02/14/health/brain-damage-dementia-cte-soccer-f…;

 

swoosh

July 25th, 2017 at 11:42 AM ^

Can you give one good reason to play football that out ways the negatives or can't get elsewhere from another sport?  I played, but I would never play knowing what I know now.  There is no way in hell my son will play.  The risk is too high and the payoff is too little.

MotownGoBlue

July 25th, 2017 at 12:29 PM ^

I think it's easier for some people to quit smoking than it is to quit playing football. Personal choices. And I still don't see how the benefits of smoking outweigh the long term health effects. I smoked and quit, and know many others that have done the same. A habit for some, a "physical addiction" for others. But it can be stopped.

UMGoRoss

July 25th, 2017 at 1:20 PM ^

I think you'd be hard pressed to find parents steering their kids towards smoking at young ages, which is more of the issue here. The death of football isn't going to come from curretn players retiring early, it's going to come as parents stop letting their children play youth football and the future stars of tomorrow wind up playing basketball, baseball or soccer.

 

There's too much money at Power 5 schools, but I wouldn't be surprised if you see some of the D2, 3 or even FCS may consider cancelling their programs in the hear future.

Caille33

July 25th, 2017 at 12:29 PM ^

I am with you 100% on this!  I played in high school and had one concussion but luckily I was playing QB (although not very well lol) and had a great O-Line so I only got hit twice all year.  I enjoyed my time playing football for sure but if I knew this info when I was 16 I never would have played!

I have a 5 year old son and my wife and I have already said there is no way in hell we are letting him play football.  I don't understand how any parent can consciously allow their child to start playing at a young age with all the information that is available now.  I do understand that when they get to high school your hands may be tied and they may do it anyways but I am hoping he enjoys golf or baseball or whatever else more by then!

I think a big misconception, that I've heard when talking to people, is unless they are good enough to play professionally they wouldn't have to worry about this.  That is incredibly inaccurate as I'm sure most people here are aware.  I believe it was the high school QB in NJ that died a couple years (please correct me if I am wrong) that had his brain tested and they found level 3 or 4 CTE.  That means the CTE would have started developing at the end of his PeeWee football days or his early high school years.  That is terrifying!

Caille33

July 25th, 2017 at 12:47 PM ^

I can assure you I am not judging anyone.  I said "i don't understand" because in my mind there is no conceivable way.  However, I have had many conversations with people who said when their kids are old enough to play PeeWee football they are going to allow them.  I will always defend my stance but I do not judge or berate those people for their parenting decisions.  

chunkums

July 25th, 2017 at 11:43 AM ^

Honestly, I don't see how there can be a solution to this. People focus on the concussions, but it's really about the constant small impacts that accumulate over time. The sport (which I love to watch but am feeling guilty about more every day) is predicated on colliding with people all the time, so it seems like that problem will still exist even with new (or old) tech. 

BursleysFinest

July 25th, 2017 at 11:43 AM ^

So Devil's Advocate, Is this really new information?  This puts (some very scary) numbers on it, true.  But the fact that football is a barbaric and dangerous sport to play is a known thing And won't stop me from watching every Michigan football game this fall.  

For me the rising costs of enjoying a college/NFL game is phasing me out as a fan more than the quantifying of the injury risks.

MotownGoBlue

July 25th, 2017 at 11:44 AM ^

Bah, just follow the methods of big tobacco, alcohol, heavy machinery, ATV manufacturers, etc., and put warning labels on all sports equipment and read a disclaimer prior to allowing anyone to play. Problem solved.

TheDirtyD

July 25th, 2017 at 11:44 AM ^

This is surpising to people?

Did you really think having constant head impacts was okay for the body?

Theres no way in hell its good for the body. These are full aged adults making decisions this is a consequence of them. No one is forcing them to play. I don't get why this is such a huge deal. People have been turning their back to this for ages. Just because a doctor comes out and says its bad doesnt mean its going to stop people from playing football, hockey, or any other activity in which you could hurt your brain. 

chunkums

July 25th, 2017 at 11:49 AM ^

You don't start playing football when you're a full-aged adult. By that point, you've lived a life where football has been your entire life and you know little else. If those same adults had focused on a different sport at an early age, society wouldn't be any worse off. 

FauxMo

July 25th, 2017 at 12:05 PM ^

And the alternatives are...

1. Soliciting brains from the families of all deceased NFL players, which would be incredibly sensitive and difficult;

2. Taking the brains through some form of coercion (make NFL players (past and present) agree to participate as a pre-condition for their pension?);

3. Kill living NFL players to study their brains. 

In human studies, convenience samples are sometimes the best you can do. 

mGrowOld

July 25th, 2017 at 11:49 AM ^

I dont think the NFL is going away anytime soon but be prepared for very interesting contract language to be introduced soon.   "In exchange for these millions of dollars today you agree to not sue us later when you cant remember to pull down your zipper before you pee later in life."

That's what's coming.   Acknowledgement of the issue and waivers against litigation.  And just big tobacco survived (even though everybody knows smoking kills you) football will too because their will be no shortage of people willing to trade riches today against brain damage tomorrow IMO.  And just like I smoked for over 25 years know full well how stupid it was they will regret the decision later when it's too late to do anything about it.

NRK

July 25th, 2017 at 1:11 PM ^

The NFL has already started doing this through education pieces that help their assumption of risk:

 

https://www.playsmartplaysafe.com/

 

http://operations.nfl.com/football-ops/nfl-ops-honoring-the-game/health…

 

If they're smart they'll continue to take it to the next logical step and talk not just about concussions but also a career in football, but they'll likely walk a fine line there (it's better PR for them to talk about concussions as spectacular plays than repetitive hits that are difficult or impossible to avoid).

trueblueintexas

July 25th, 2017 at 11:49 AM ^

It will be interesting to see how the sport evolves. Short of moving to two hand touch, it's going to be really dififcult to fix this via rules. CTE is not simply about the one big hit in a game. It's about the repeated hits through practice and games. They already track steroid use pretty close at the NFL level basically leaving equipment options as the solution.

I do wonder if making the equipment less protective for the rest of of the body would have an impact. In essence, would the greater likelihood of a broken bone or severe contusion cause players cut back on the speed, force, and aggression with which they attack. Not sure it would make a difference in the trenches, but it might for the rest of the players.

PopeLando

July 25th, 2017 at 12:00 PM ^

I'm always concerned about people who advocate LESS protection as a potential solution for injury issues. It only partially solves the incentive problem, as there is still the possibility of inflicting major damage - and the financial rewards therein. And, of course, it means that some poor player will be seriously maimed before the consequences hit home for people. I only see three real solutions here: new rules, new equipment, or age restrictions on when you can start playing football.

maize-blue

July 25th, 2017 at 11:54 AM ^

I wonder what these studies would say regarding hockey players, boxers, mma or other contact sport athletes.

KungFury

July 25th, 2017 at 11:55 AM ^

But how could they have no controls? No mixed set of brain samples with no known football status. Yes, they had a few lower level football samples, but come on. With such subjective analysis you have to have controls. Histology is hard to interpret. Just leaving the stain on a few extra seconds can make your sample darker. You need to have several mixed in controls to show what not CTE looks like before you can say what CTE looks like. I don't doubt NFL players get CTE at a much higher rate than a normal population. But if you're going to publish something so damning, present good data to back it up.

One Inch Woody…

July 25th, 2017 at 12:20 PM ^

This is true, the headline should read "99% of 202 ex-NFL players with severe mental issues were diagnosed with CTE"

Not only that, but the median age of death for those with mild CTE was 44 years while median age of death for those with severe CTE was 71 years. So what, does CTE extend your life by 30 whole years? Obviously that's a ridiculous statement, so I would really doubt the power that this data set has. What it does do, undeniably, is demonstrate that for the low percentage of individuals with psychologial issues, there is a link between their trauma and pychological state.

But keep in mind and this is very back of the envelope stuff, this study is over a period of 2 years and sampled players who died between the ages of 35-79. This means that these individuals would have played in the NFL anywhere from 1960 to 2014 - given that the total number of NFL players in any given year is 1696, and if every player was different every single year that would give us 91584 players (obviously there are players who stay multiple years, so lets cut that down to 20000 unique players and some would have died for other causes so let's say 10,000). So out of those 10000, 202 were shown to have severe psychological issues. Obviously there are more that wouldn't have been able to participate in the study so lets bump that number up to 500. There are no statistics as to how many football players died in that same timeframe without psychological issues so we can't do a direct comparison, but even with those crappy numbers, CTE is found in a mere 2-5% of NFL players. 

Supposedly their brain bank included those with military service and domestic violence victims, so it would seem that those would present interesting groups to study, if nothing else but to compare if CTE is a result of football.

It does piss me off that this study has no control group - I mean how does this bullshit even get on to JAMA other than because they know they'll get reads and the article will be talked about and misconstrued?

Unsalted

July 25th, 2017 at 12:00 PM ^

I love football, I loved playing football in HS. I wasn't very good or big, but I treasured every minute because there was no way I would play when I got to Michigan. In my brief career I had my lights turned out twice in games (10th grade and 12th grade). In both of those games I continued playing, which was dumb.

With all my head banging, I steered my two sons away from football. I would have let them play if they wanted but I never put them on that path. I told my family, when I die, I want them to cut my brain open to check for CTE before they turn me to ash.

NCBlue22

July 25th, 2017 at 12:00 PM ^

As the OP said the methods are so flawed here.  It's like saying 99% of people in a depression clinic with symptoms of depression have brain chemical changes.  Well, no duh.  Now, I'm not saying there is no link between playing football and CTE as their inherently probably is; but until a longitudinal comparison study comes out we really have no idea.  Just wanted to reiterate that here.  

uncle leo

July 25th, 2017 at 12:05 PM ^

Let's not make it as complicated as it needs to be. Break it down to the simpliest human form.

Heads smash- Impact to brain.

Bigger, strong athletes who launch themselves repeatedly at opponent head- massive impact.

KungFury

July 25th, 2017 at 12:17 PM ^

But you can't claim something as damning as this article with 0 controls in a completely subjective study. We know very little about the brain. Neurological research is decades behind cancer research, and look at how much trouble that continues to cause us. Bashing your head is bad, but it's irresponsible to make huge conclusions on the little data we have.

uncle leo

July 25th, 2017 at 12:21 PM ^

Player upon player reporting to the media that they can't remember things, get lost.

Players taking their own life, and those cases showing CTE in the brain.

There are too many telling pieces that these players have CTE. 

Just think about it logically. You start this physical, brutal game from a young age, constantly smashing into each other's melon. I would be surprised if there WAS NOT a correlation. 

KungFury

July 25th, 2017 at 12:31 PM ^

You can't show a correlation with 1 data point. They have 1 point. It is CTE in football players. They have 0 data that shows a normal population NOT having CTE. Do you understand where these numbers come from? They stain brain samples and then a human says huh, that's enough stain to be CTE, or nope, not enough stain. This is qualitative data they are presenting as quantitative. Without any presentation of normal.

Sopwith

July 25th, 2017 at 12:41 PM ^

as far as the the article itself. It reads simply this:

In a convenience sample of deceased football players who donated their brains for research, a high proportion had neuropathological evidence of CTE, suggesting that CTE may be related to prior participation in football.

UNCWolverine

July 25th, 2017 at 12:03 PM ^

Not sure the OP is allowed to make the OT determination. It's a subjective call by the board majority. That's like telling someone that you don't have bad breath or body odor, not really your call.

Kevin13

July 25th, 2017 at 12:22 PM ^

even done as a convience sample is very startling and something I think more and more people are becoming aware of and steering kids clear of the game. I played football for many years, even had a couple of brief cups of coffee in the NFL. But, if I had a son I would probably try to keep him away from the game. I would push him more towards something like golf.

mi93

July 25th, 2017 at 12:45 PM ^

a 30-second commercial for the Super Bowl is $5M, stadiums (of good teams) are full, and salaries are equivalent to being in the top 1% of the average workforce, there will be people that are willing to take the risk.

Football will always be tweaked, but I don't see it going anywhere for quite a while.

Sopwith

July 25th, 2017 at 12:56 PM ^

as far as the the article itself. It reads simply this:

In a convenience sample of deceased football players who donated their brains for research, a high proportion had neuropathological evidence of CTE, suggesting that CTE may be related to prior participation in football.

Nevertheless, the tau-protein stains of the brain sections are frightening. People of age-matched cohorts don't have brains that look anything like this.

To see what a typical brain looks like at age 65, look at the picture on the far left of the poster shown below (very few dark regions; that's a 72-year old former boxer on the far right with a 45 year old former football player in the middle). 

PeterKlima

July 25th, 2017 at 1:20 PM ^

I don't really like people "starting conversations" about scientific research.  I THINK the majority of scientists looking at these issues would answer that there are no real conclusions yet, but there may be some day.

So, you get articles like the above based on a self-selecting group of people. Every scientist would have serious concerns about relying on something so flawed in its methods.  But, it makes headlines and will stop the inquiry for most people.

Likewise, there are studies about whether CTE is a disease or not:

CTE is associated with memory issues, speech abnormalities, and behavior and personality changes. The problem is, some scientists still doubt whether or not the disease even exists. A controversial new study from the Journal of the International Neuropsychological Society suggests that it may not be its own unique neurodegenerative disorder, and that the cognitive impairments of football players don't look very different from those experienced by the general population.

Those studies are probably similarly flawed.

There are even studies about the lack of any correlation with HS football and CTE:

http://jamanetwork.com/journals/jamaneurology/article-abstract/2635831

Probably similarly flawed as well.

I SUSPECT there may be some correlation between CTE and playing extensive football.  It is probably based on the same thing others see, massive collisions.  However, I also believe that playing football is overall better for your health than not playing football. 

I am not sure of those ASSUMPTIONS and I will probably reserve judgment until more/better studies come out. Of course, my experience is that the general population is not as concerned with accuracy as they are with confirming their own feelings, so I suspect that others will jump to whatever conclusions they FEEL are appropriate.

IMO - Articles like these are similar quality fodder for message boards as pre-season rankings.  Something to waste time discussing, but not anything to be taken seriously... until more is shown.

cletus318

July 25th, 2017 at 1:27 PM ^

While I'd agree we don't know a ton about CTE, the link between CTE and repetitive brain trauma (not necessarily playing football in and of itself) is supported by about a century of research.

PeterKlima

July 25th, 2017 at 2:12 PM ^

That has been assumed for a long time.  I think the studies started on boxers. People have speculated about the scope of that link, the difference with other physical activities, and the symptoms/reults of that link (whatever scope it may have)  for a long time. 

Those later points are what people are concerned about and jumping to decisions about.

You know that a large number of people will see the headline and simply believe/recount to others that 99% of all football players have concussions. 

Just like lots of people think football players die younger and suffer higher rates of suicide than the general population.  They'll just take the most ridiculous and alarming claims to heart because they feel that way.

Better not to start down that path even if CTEs have some type of link to blows to the head.

drjaws

July 25th, 2017 at 2:29 PM ^

I get the fears, but I wouldn't trade my youth playing football, baseball and hockey for anything.  I mean, "tackle football" was something my brothers and I played in the back yard since we were toddlers.  I was never good enough to go pro but if anyone who is thinks football is in any way safe for any part of your body, not just your brains, is in denial or stupid.

 

In short, I'd rather do what I love and enjoy life until it is no more than try to extend it by avoiding things that make life enjoyable.  Will I get CTE?  Maybe.  But I could also end up like Sean Taylor so . . . .

swoosh

July 25th, 2017 at 2:35 PM ^

Read an article when I was deciding about my son playing football or not.  They put a sensor in a Jr. High player helmet for a week.  The average was 60 sub-concussive hits a day.  The scientist suggested to parents to go bang your head 60 times lightly against the wall.  See how you feel, I tried it, after 3 I was done.  To think I did that for 6 years, some kids today have done that for 12 years before the graduate HS.