Study finds 99% of donated brains have CTE

[PatsGuy]

My 14 year old little girl plays varsity as an 8th grader and like she's Rodney Harrison on the soccer field . Scares the crap out of Mrs RW and I.

Shes had a concussion and I'm sure it won't be her last.

Yeah it those headers n 50/50 balls Skulls hitting each other can be unavoidable

 

[Nikolai]

How about heading the ball in soccer?

Guy I know got a pretty wicked concussion playing a league game a couple years back when he tried a header and hit someone's shoulder.

 

[RobertWeathers]

Yeah it those headers n 50/50 balls Skulls hitting each other can be unavoidable

She got hers via a knee to the head on a slide tackle.

She just had to give up Barbies.....

 

[primetime]

I got a concussion playing high school basketball, and also when I was weed whacking a lawn and walked into a sign. Still normal! Ish.

The odd concussion isn't the actual problem per se. CTE is the result of repeated blows to the head, and the danger is increased dramatically when those blows are introduced at a young age. It's exactly why as soon as I knew my kid (who's big) would be pigeonholed as an offensive lineman, I said nope and looked for alternatives. Fortunately, I hit on one he absolutely loves (two, if you count judo).

That's fair. I don't think it's entirely definitive what causes CTE, but it's clearly some combination of major head trauma and that sort of minor, day to day smashing that happens over and over again. And single concussions probably don't do enough to qualify; it's likely some of those brains in the non-contact sports group of that one study had suffered concussions because they do happen outside of sports, but none had CTE.

In the end, the kids will probably just want to do theater anyways!

 

[patfanken]

I think football is dead. Just doesn't know it yet.
Fortunately, brain imaging tech is advancing rapidly. Hopefully we will be able to diagnose CTE, alzheimers, etc.
I think closer to 10 years rather than 50 is a more realistic timeframe for football insignificance.

Well it will be if people continue to spin VERY narrow studies like this one into omnibus pronouncements. Questions:

1. Wasn't there just a recent study where they found that there was NO connection found in HS players and CTE (I think it was a Wisconsin study) And minimal risk for college players.

2. So that leaves the question, does another 5-10+ years of even more violent hits in the NFL increase the risk of CTE. Well of COURSE it does. But I would suggest the impact is not NEARLY as big as these inflammitory headlines suggest. Literally hundreds of thousands of men have played in the NFL over the last 50 years. If CTE were THAT prevelent we'd be seeing tens of thousands of former players affected.

This was a study of former players who showed signs of dementia before they gave their brains to science. If we took a pool of the general populous the same size as the number of former football players, don't you think we'd be able to find 111 people who developed dementia?

Now that being said, just today I noticed my inspection sticker has been expired since April, and to make matters worse when I went to renew it, my registration had expired in FEBRUARY. So I might not be the right person to be discussing this right now. Maybe the 4 years of HS ball, 4 years of college ball, 3 years beyond that, and 20+ years of competitive LaCrosse on defense have instigated the start of my own CTE issues. I'm not sure, but I wasn't above using it as an excuse at the registry today.

 

[PatsWickedPissah]

They only studied 111

 

[primetime]

Well it will be if people continue to spin VERY narrow studies like this one into omnibus pronouncements. Questions:

1. Wasn't there just a recent study where they found that there was NO connection found in HS players and CTE (I think it was a Wisconsin study) And minimal risk for college players.

2. So that leaves the question, does another 5-10+ years of even more violent hits in the NFL increase the risk of CTE. Well of COURSE it does. But I would suggest the impact is not NEARLY as big as these inflammitory headlines suggest. Literally hundreds of thousands of men have played in the NFL over the last 50 years. If CTE were THAT prevelent we'd be seeing tens of thousands of former players affected.

This was a study of former players who showed signs of dementia before they gave their brains to science. If we took a pool of the general populous the same size as the number of former football players, don't you think we'd be able to find 111 people who developed dementia?

Now that being said, just today I noticed my inspection sticker has been expired since April, and to make matters worse when I went to renew it, my registration had expired in FEBRUARY. So I might not be the right person to be discussing this right now. Maybe the 4 years of HS ball, 4 years of college ball, 3 years beyond that, and 20+ years of competitive LaCrosse on defense have instigated the start of my own CTE issues. I'm not sure, but I wasn't above using it as an excuse at the registry today.

Dementia and CTE aren't the same. They're different pathologies, albeit with the same protein.

The study you reference published in JAMA Neurology earlier this month using the Wisconsin Longitudinal Study found no statistically discernible difference in cognitive impairment or incidence of clinical depression at age 65 between those who played high school football (in the 1950s) and those who did not. The authors draw a link between football in the 1950s and other contact sports today, which seems like a fair comparison.

However, note the important thing here. The sample studied is men who survived to age 65, so it's already removed from the cohort anyone who may have died earlier due to effects of CTE, which is really the most alarming thing about CTE in any case rather than late-life effects.

Once we get past that, it's also studying cognitive impairment and depression writ large, and at age 65 you're likely going to end up with Alzheimer's and senile dementia playing a role, so CTE blends together with other degenerative cognitive impairment. And at age 65, not over the lifespan. It's an odd methodological choice, perhaps dictated by the data; I don't know the dataset well enough to comment.

They also curiously use a 97.5% confidence interval as opposed to 95%, which sends up a red flag for me (an explanation here may be a single tail, fair enough). And indeed the confidence interval comes very close to showing a statistically discernible effect on impairment (–0.14 to 0.05, it contains 0 so it's not statistically significant, but would it contain 0 if it was a 95% confidence interval?).

This study was done by a Wharton professor and his grad students, not epidemiologists, which similarly raises red flags. Business doctoral students? Who funded this? Did his name start with R and end with ell?

I'm a social scientist and tear apart garbage research for a living, and I've seen it all. This one stinks a bit to me, at least in terms of the wide-ranging conclusions that it claims. Sure, participation in high school football in the 1950s may not have increased the likelihood of cognitive impairment at age 65 for those who survived to age 65 (though see that point about the confidence interval above), which is the very specific claim being made, but that's also almost entirely beside the point.

It's written just abstractly enough that the NFL can wield it to make a point (though it hardly requires such a corporate conspiracy either, these big findings are how academics make a name for themselves after all) as it's almost ensured its conclusions will be overblown and generalized in a particular way. The dishonest "football doesn't cause cognitive impairment, study finds" headlines write themselves. (Incidentally, the accompanying JAMA editorial warns against this very interpretation, though I sincerely doubt anyone read it.)

 

[neali]

How about heading the ball in soccer?

Heading the ball in soccer is like head butting someone in a fight. The act of accelerating your head forward moves your brain to the back of the skull and all the cerebrospinal fluid to the front of the skull. When the impact occurs, the fluid is present as a cushion. That is why the head buttee is knocked for a loop while the head butter is fine.

Not to mention it is a collision with a 2.5 lb. ball rather than a 310 pound DL.

Edit: unless you hit someone else's head.

 

[SEA_Pat]

Literally hundreds of thousands of men have played in the NFL over the last 50 years. If CTE were THAT prevelent we'd be seeing tens of thousands of former players affected.

Actually, it seems the number of people who have played in the NFL between 1920 and 2014 is approximately 25,000. It's quite likely that we've managed to miss the majority of those players before the 1960's because we didn't even know CTE was a thing, and if they had it they'd likely have died by now (a rookie in 1960 would be almost 80 now). So let's cut half of that number out as being outside of the study population. That leaves us around 12,500 former and current players. Even with the small sample who have undergone the study, we're at statistically significant prevalence levels. If we were to test the entire population, I'd not be surprised if there were immediate actions taken to stop the game.

Hate to say it but saw this coming a long way back and suggested that we were going to see major changes to the game to make it more along the lines of rugby. I'd suggested at that time that the thing they probably needed to start with was to remove the helmets. Naturally the NFL has taken a retrogressive stance and opted to try to ride it out for as long as they can, something that will enable them to continue to line their pockets in the short-term, but which may well kill the golden goose in the long-term.

 

[deroc5050]

I would like to see a report from random people and a report from random NFL players in the future.

How many people will develop CTE that did not play in the NFL. I really would need that information so we could have a better informative discussion about the reality and the risks involved playing Pro Football.

2 of my grand parents and some great ancestors were known to have dementia in there late 70's and got worse into there 80's.

I have seen Dementia and alzheimer's develop right in front of me over an 8 year period. My ancestors did not play pro football.

Obviously NFL players are at higher risk of brain injury but degenerative diseases can happen to anyone.

As long as the NFL keeps raking in the money, there is no way the game will be stopped or altered in a way to severely cripple the product on the field. Steps might be taken but it will be the players signing a contract knowing that they are at risk. And just about every player already knows this.

 

[Tony2046]

I would like to see a report from random people and a report from random NFL players in the future.

How many people will develop CTE that did not play in the NFL. I really would need that information so we could have a better informative discussion about the reality and the risks involved playing Pro Football.

2 of my grand parents and some great ancestors were known to have dementia in there late 70's and got worse into there 80's.

I have seen Dementia and alzheimer's develop right in front of me over an 8 year period. My ancestors did not play pro football.

Obviously NFL players are at higher risk of brain injury but degenerative diseases can happen to anyone.

As long as the NFL keeps raking in the money, there is no way the game will be stopped or altered in a way to severely cripple the product on the field. Steps might be taken but it will be the players signing a contract knowing that they are at risk. And just about every player already knows this.

Well I'm not sure how old you are but when I was a kid, back in the 70's and 80's, there were kids playing pee wee football everywhere. Now it's all soccer, baseball and flag football. There is still contact football at the middle and high school level but for the younger kids it has basically disappeared.

I do agree though that the game will continue on but I doubt it will be the same game in ten or twenty years.

The real key will be when CTE scanning becomes available. My kid isn't playing contact football until I have some way of monitoring his health.

 

[primetime]

The "dementia and Alzheimer's happen, so let kids play football" argument is kind of like saying "well all sorts of cancer happen eventually, what's the harm in smoking?"

 

[Galeb]

Won't be long before Exponent finds that the act of donating the brains is the cause of CTE.

 

[BlacknGold77]

Won't be long before Exponent finds that the act of donating the brains is the cause of CTE.

while i get you were making a joke, that point does have some merit in terms of this study.

they have a strong sample bias because it was a study of donated brains. So these were all people that showed symptoms of CTE and thought themselves they had it. So it stands to reason you would see such a high rate of CTE in the studied brains.

what you need is a random sample of all football players with a fairly even distribution across years played in, # of years played and position. You would also need a control sample from the non football playing population with similar diversity (different regions, races, gender and ages). Then you can do a true comparison and make valid conclusions about the link between football and CTE.

it's the same thing as me doing a study on favorite football teams and only choosing a sample from New England. My results will tell me the Patriots are the favorite team of 90+% of the sample, but I can't then use that result to say 90% of all football fans are Patriots fans.

 

[PatriotsReign]

Well I'm not sure how old you are but when I was a kid, back in the 70's and 80's, there were kids playing pee wee football everywhere. Now it's all soccer, baseball and flag football. There is still contact football at the middle and high school level but for the younger kids it has basically disappeared.

I do agree though that the game will continue on but I doubt it will be the same game in ten or twenty years.

The real key will be when CTE scanning becomes available. My kid isn't playing contact football until I have some way of monitoring his health.

The strange things is signs of CTE and ADHD are almost identical.

I was diagnosed with ADD about 15 years ago

10 Symptoms of Adult ADHD

Chronic traumatic encephalopathy: Prevention is key

 

[primetime]

while i get you were making a joke, that point does have some merit in terms of this study.

they have a strong sample bias because it was a study of donated brains. So these were all people that showed symptoms of CTE and thought themselves they had it. So it stands to reason you would see such a high rate of CTE in the studied brains.

what you need is a random sample of all football players with a fairly even distribution across years played in, # of years played and position. You would also need a control sample from the non football playing population with similar diversity (different regions, races, gender and ages). Then you can do a true comparison and make valid conclusions about the link between football and CTE.

it's the same thing as me doing a study on favorite football teams and only choosing a sample from New England. My results will tell me the Patriots are the favorite team of 90+% of the sample, but I can't then use that result to say 90% of all football fans are Patriots fans.

That's not an entirely fair comparison, because the selection bias tells us something useful here. All of these brains were donated by families who noticed symptoms similar to CTE, but CTE symptoms are not unique. They overlap with many other forms of cognitive impairment or mood disorders. That the sample was so large (over 100 former NFL players out of some 15,000 NFL players in the last 40 or so years were so cognitively impaired that their families donated their brains to this bank to be studied for CTE after their deaths, which had to have happened in the last 9 years at most since CTE hasn't been a diagnosis for very long) and that of that sample all but one showed CTE pathology seems pretty damning to me.

So, just to be clear, the population from which this sample was drawn for the study in the OP is not all NFL players, 1920-2017. It's all NFL players who died between maybe 2010 and 2017 — a much smaller group, probably numbering less than 1,000, of which over 100 brains is quite a large statistical sample.

[I may be wrong on this, but my assumptions: I don't think this brain bank has been around that long, only since 2008 or so when the CSTE came into existence, and I imagine donations of deceased NFL players' brains didn't begin in earnest until even more recently when this started becoming a bigger story, and one needs to donate a brain very soon after death.]

Other (albeit convenience) samples of non-football players have not shown nearly that level of prevalence, even though from what I understand all the brains in the "brain bank" are 'neurologically interesting' so to speak (that is, most belonged to people with neurological impairment or disorders). Yes, if the world was perfect, you'd be able to do a large-n randomized control trial, but without the ability to screen living brains, it's an impossible ask.

 

[BlacknGold77]

That's not an entirely fair comparison, because the selection bias tells us something useful here. All of these brains were donated by families who noticed symptoms similar to CTE, but CTE symptoms are not unique. They overlap with many other forms of cognitive impairment or mood disorders. That the sample was so large (over 100 former NFL players out of some 15,000 NFL players in the last 40 or so years were so cognitively impaired that their families donated their brains to this bank to be studied for CTE after their deaths, which had to have happened in the last 9 years at most since CTE hasn't been a diagnosis for very long) and that of that sample all but one showed CTE pathology seems pretty damning to me.

So, just to be clear, the population from which this sample was drawn for the study in the OP is not all NFL players, 1920-2017. It's all NFL players who died between maybe 2010 and 2017 — a much smaller group, probably numbering less than 1,000, of which over 100 brains is quite a large statistical sample.

[I may be wrong on this, but my assumptions: I don't think this brain bank has been around that long, only since 2008 or so when the CSTE came into existence, and I imagine donations of deceased NFL players' brains didn't begin in earnest until even more recently, and one needs to donate a brain very soon after death.]

Other (albeit convenience) samples of non-football players have not shown nearly that level of prevalence, even though from what I understand all the brains in the "brain bank" are 'neurologically interesting' so to speak (that is, most belonged to people with neurological impairment or disorders). Yes, if the world was perfect, you'd be able to do a large-n randomized control trial, but without the ability to screen living brains, it's an impossible ask.

oh, definitely not saying the results are ignored or are completely invalid. And not saying they shouldn't be used. Just trying to pump the breaks on the conclusions of "99% of all people who play football have CTE" is all

Agree with your point about the sample being statistically significant, I was just pointing out that the sample itself is tainted as it was all people who displayed the symptoms of and thought they had CTE vs a true random sample of the 1,000 from 2010-2017 (which as you said, is a nearly impossible task)

 

[primetime]

oh, definitely not saying the results are ignored or are completely invalid. And not saying they shouldn't be used. Just trying to pump the breaks on the conclusions of "99% of all people who play football have CTE" is all

Agree with your point about the sample being statistically significant, I was just pointing out that the sample itself is tainted as it was all people who displayed the symptoms of and thought they had CTE vs a true random sample of the 1,000 from 2010-2017 (which as you said, is a nearly impossible task)

Yeah, it's definitely not 99% in the full NFL population. But it was 111 brains, of which 110 had CTE, and my assumption is that those brains were all donated in the last decade or so. There haven't been that many NFL players (maybe only 25,000 since 1920, and of those several thousand are currently playing), so even 1,000 dying in the last decade is high, but let's stick with it. Even if we assume those 110 were the only ones of that population with CTE, the most conservative estimate possible, that's still an 11% rate of prevalence.

That's obscenely high; there's simply no way it's that high in the general population. I would guess on the high end it's a percentage point or two, even including people who played high school or college football.

(This, of course, only answers the question about NFL players and not players at all levels, too, but the conclusions are excessively alarming).

 

[BlacknGold77]

Yeah, it's definitely not 99% in the full NFL population. But it was 111 brains, of which 110 had CTE, and my assumption is that those brains were all donated in the last decade or so. There haven't been that many NFL players (maybe only 25,000 since 1920, and of those several thousand are currently playing), so even 1,000 dying in the last decade is high, but let's stick with it. Even if we assume those 110 were the only ones of that population with CTE, the most conservative estimate possible, that's still an 11% rate of prevalence.

That's obscenely high; there's simply no way it's that high in the general population. I would guess on the high end it's a percentage point or two, even including people who played high school or college football.

(This, of course, only answers the question about NFL players and not players at all levels, too, but the conclusions are excessively alarming).

definitely agree.

The study certainly has the significance to prove football = higher risk and higher occurrence of CTE.

The extent of that risk is still an unknown. Like you said, we know the floor is 11%. What they need to determine now is the true rate, which given what they need currently to confirm CTE is not an easy task.

now if they can find a way to definitively diagnose CTE based on symptoms and MRI/CAT scans, then the task becomes very possible.

 

[chasa]

Soccer's a good game, anyways.

Think again,
soccer headers and concussions - Google Search