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Experts debate sports brain injuries

Does a progressive brain disease called CTE really exist, and is there any evidence that sports concussions and repeated hits to the head really cause it?

Those were two key parts of a debate that took place Thursday at Renaissance Chicago Downtown Hotel between two of the nation’s top sports concussion experts at the American Academy of Clinical Neuropsychology in Chicago.

The debate — which was similar to a presidential debate with lots of cordial back and forth disagreements — centered around a condition called chronic traumatic encephalopathy (CTE). CTE is said to cause such symptoms as memory loss, aggression, depression and progressive dementia. And the theory is that multiple concussions can lead to people developing the disease, though a lot is unknown.

That was the argument Robert Stern, co-director of the Center for the Study of Traumatic Encephalopathy at Boston University, made to a packed room of conference attendees.

“Just getting your head hit doesn’t mean you’re going to get this [CTE]. What it does mean is that some people, and we don’t know who yet, are at greater risk than others for developing this [disease],” Stern said. “There are multiple risk factors that add to the scenario.”

He cited numerous studies that he said supported his argument that CTE exists and that multiple hits are at least partly to blame, such as a 2013 study led by Dr. Ann McKee, who is also a member of the Study of Traumatic Encephalopathy. The study analyzed post-mortem brains obtained from a cohort of 85 subjects, including 64 athletes, with histories of repetitive mild traumatic brain injury and found evidence of chronic traumatic encephalopathy in 68 subjects.

“The thought leaders in the world don’t question whether CTE exists as a disease and don’t question that repetitive brain trauma is a necessary variable to develop it,” Stern said.

But Christopher Randolph, a professor in the department of neurology at Loyola University Chicago Stritch School of Medicine , for one, isn’t convinced of either.

“There’s a great deal of fear out there that exposure to head trauma can lead to something late in life. And as we stand here now, there’s not one shred of evidence to support that,” Randolph said after the debate. “We have a bunch of case studies where they find something in the brain of uncertain clinical significance…but it’s very poorly controlled science. So, I think people are putting the cart before the horse right now and what we need to do is determine whether or not those repetitive trauma actually increase your risk for anything late in life and then take it from there.”

Even so, Randolph said, “It’s prudent until we know more that [if] you have a concussion while you’re playing a sport that you be held out until your symptoms resolve and we tend to err on the side of caution with that, and that’s a reasonable thing to do as the science is young.”

The disease has gotten more attention since last year when the brains of 14 of 15 former NFL players were found to have it. The brains were studied at the Boston University School of Medicine Center for the Study of Traumatic Encephalopathy.

They included former Chicago Bears safety David Duerson, 50, who shot himself in the chest in February, leaving behind a note requesting that his brain be donated for study.

In recent years, the NFL has tried to strengthen rules that are designed to minimize injured players, such as banning the practice of tackling a player by using his helmet. The move was banned after concluding it commonly resulted in injury.



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