Posts Tagged ‘CTE’

A Career Built on Distortion, Exaggeration

January 28, 2020

The title of this post is identical to the title of an article by Will Hobson on the front page of The Washington Post, 26 Jan ‘20. The article was on the science and selling of CTE. The subtitle was, “Omalu, of ‘Concussion’ fame, has claimed he discovered the disease, He didn’t.

There have been many healthy memory posts on chronic traumatic encephalopathy, and on the extreme damages that can occur to the brain in playing contact sports. In the case of soccer the contact is not between individuals but of the ball contacting the head.

The article makes a very good argument that Omalu did not discover the disease and some of his diagnoses of CTE were questionable. It is important to understand that this criticism is technical and is being made by neurosurgeons and other neuroscientists. So they are arguing that some of his diagnosis of CTE were incorrect, not that serious brain damage had occurred that was at best lowering the quality of life or at worst risking life.

These criticisms of Omalu are valid and should be made. He is an absolute genius at self promotion. Yet he still deserves both attention and praise for drawing attention to the damage that can occur to the brain from contact sports. So previous warnings in the blog on CTE should be extended to brain images in general that occur during contact sports. Injuries that are below the concussion level can still cause damage due to cumulative effects of these insults. And research needs to continue on not only active athletes, but also on the effects during childhood that may manifest themselves during adulthood.

So no previous warnings or claims made on this blog, with the distinction of misclassifications at the technical level, are withdrawn. And HM still finds it ironic that educational institutions promote sports that risk injury to the brain.

© Douglas Griffith and healthymemory.wordpress.com, 2020. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

An Extremely Misleading Title

August 27, 2019

And that title would be “Heading off a concussion crisis” in the Sports section of the 21 August 2019 issue of the Washington Post. The author of this article is Roman Stubbs. The article is about Brittni Souder a soccer player who has ruined her health playing soccer. Now she is trying to help girls avoid a similar fate. No evidence is presented and there is no reason to believe that what she is teaching is of any value. That evaluation would need to take place over years to see if there is any evidence of a beneficial effect from Souder’s instructions.

There are about 300,000 adolescents who suffer concussions while participating in organized sports every year. In matched sports, girls are 12.1% more likely to suffer a concussion than boys, a 2017 study by the American Academy of Orthopedic Surgeons found. It was also concluded that female soccer players are more likely to suffer a concussion than male football players—and three times more likely to suffer a traumatic brain injury than male soccer players.

Wellington Hsu, an orthopedic surgeon at Northwestern who led the study said, “What was very surprising was that girls’ soccer was just as impactful as boys’ football. Girls who play soccer really need to be aware of these issues. These symptoms plus having a second concussion is sequentially worse than the first one.”

Former U.S. National team members Brandi Chasten and Michelle Akers announced that they would participate in a Boston University study of chronic traumatic encephalopathy. No female athlete has been diagnose with CTE, which can only be confirmed through autopsy. Akers and Chasten have publicly expressed concern about memory loss since they retired from soccer.

HM thinks that any educational entity that sponsors sports that can damage the brain is hypocritical. Presumably the justification for sports is that they develop teamwork and build healthy bodies. But if the brain is damaged, this justification evaporates. Sports can be modified, or new ones developed, that preclude brain injury.

Olympics and the Brain

February 27, 2018

This post is motivated by an article by Susan Svrluga titled “How gray matter helps Olympians go for gold” in the Metro Section of the 26 Feb 2018 issue of the Washington Post. This article addresses the question “What do neurologists and others who study the brain see when they watch the world’s best athletes in this Winter Olympics? And the answer is “many see brains propelling people to extraordinary things, allowing them to spin and flip without dizziness, to adapt quickly, to anticipant challenges—or, sometimes, to choke.”

Kathleen Cullen, a professor of biomedical engineering and co-director of the Johns Hopkins Center for Hearing and Balance said, “Iike watching really talented, amazing athletes. It’s beautiful to see what the body can accomplish…particularly beautiful. I’m thinking about the computations required to do it.” She explained that a snowboarder flying through a double McTwist or a skater spinning out a triple Lutz or Axel possesses a brain that built models for those intricate maneuvers. What makes Olympic athletes unique is the ability to create really complex models of self-motions and movement they expect as they complete these very sophisticated routines. Moreover, they can recalibrate on the fly. Their ability to adapt to the unexpected during the routine is not something the average person can do.

Professor Cullen studies the neural mechanisms that encode motion. She studies the ways the brain uses information from the vestibular in the inner ear—the “sixth sense” that gives people a sense of where they are, how they’re moving through space, and other sensory mechanisms to help navigate the world.

She said that the sense of vision is very slow. If your slipping on ice and waited for the visual system to tell you you’re slipping, it would be game over. But if the incoming sensory information from the inner ear is different than what the brain expects, that a can be sensed within milliseconds. This helps snowboarders when they’re flying through the air; the brain received moment-to-moment updates about where the head is and from the muscles about where arms and legs are relative to the rest of the body, all of it arriving within milliseconds. Then the brain compares the information it has learned to expect with the snowboarder’s actual motion, so that it can send an appropriate signal to the spinal cord to rapidly adjust balance within milliseconds.

HM has long wondered how these figure skaters can spin without getting dizzy. He feels dizzy after he spins because fluid in the inner ear continues to move, giving the sensation of continued motion. Figure skaters who twirl on the ice teach themselves to counter that natural sensation. She can train herself to use an object after spinning as an anchor to let herself know how she is moving. But after years of repetition in practice the brain learns to better interpret the information coming from the inner ear; it recognizes, in effect, that a sensation of spinning is false when when the body has actually stopped spinning. Professor Cullen says that the abilities to build and recalibrate these models is really impressive.

Nathaniel Sawmill, a neuroscience at Columbia University’s Zuckerman Institute said the a figure skater who is pitching backward intentionally during his routine, the challenge is resisting the reflex that normally prevents a skater from falling over. Those reflexes are hard-wired in the spinal cord and the brain stem, and trying to override them doesn’t happen perfectly at first. But over time, with repetition they are able to do it.

Dr. Sawmill continued, “Motor skills might seem relatively basic, but there are amazing feats of learning that are really a great scientific puzzle, and a challenge to understand how we do these incredible things. Even the most amazing robot is nothing compared to humans playing sports.”

Jam Ghajar, director of the Stanford Concussion and Brain Performance Center, where they train athletes to improve performance, said “Great athletes brains need to be able to predict what is going to happen and adapt quickly. With Olympic athletes, it’s incredibly important to get their timing, and react to a bump in the snow or a patch of ice at high speed.

Christopher Fetsch, an assistant professor of neuroscience at Johns Hopkins says, “That’s what really sets Olympic athletes apart, not their bodies so much as their brains’s speed and flexibility in taking sensory information and translating it into muscle movements. In our day-to-day lives, we make countless small conscious decisions like this. But in the Olympics the stakes are much higher, the world is watching, but the processing going on in the brain is very similar. In these athletes, it has been honed to perfection to perform a particular skill.

Vikram Chib, assistant professor of biomedical engineering at Johns Hopkins, studies how our brains process incentives and how that influences performance, sees potential parallels between the lab and the Olympics. In his research, when people are paid to do certain tasks, performance increases along with incentive—until the reward gets too big. Then the researchers see the opposite effect. When the subjects see a potential $100 reward, a scan shows “their brain lights up: I have $100 to gain. But when subjects actually do the task, researchers see activity in another part of the brain.”The brain activity looks like they are thinking they have $100 to lose, and performance deteriorates. So when a gold medal is at stake, Chib said, athletes who can keep their minds off the possibility of losing are those more likely to perform well and win.

Ghajar said there’s another thing than can help give athlete an edge that has nothing to do with training in the gym. It’s simple: rest. “A major part of brain performance is getting enough sleep.”

This information led HM to think of another athletic activity that requires complex computations by the brain and the coordination with motor movements. That activity is done by the batter in baseball. The computations done to place a small bat on a small ball that need to be done in an extremely small amount of time are most impressive. Moreover, pitchers change the speed and directions of the ball. Nevertheless, batters mange to accomplish this feat sufficiently often that an interesting game results. HM remember a major league player describing his eye exercises he was doing to improve his hitting. But if the exercises affected only the eyes, and not the brain and subsequent motor activity, then it is doubtful that they would be helpful.

All these activités promote healthy brains and memories. But there is one popular sport that damages brains. Does this make sense? The purpose of athletics is to promote health and teamwork. If the reader wonders what this is all about, the reader should enter CTE into the search block of the healthy memory blog. CTE stands for Chronic Traumatic Encephalopathy. HM is an alumnus of Ohio State University. Nevertheless, he thinks they should close down football. For an educational institution to promote an activity that damages the brain is unconscionable.

To be fair, we should also consider injuries that occur at the Winter Olympics. Broken limbs can be tolerated, by what about paraplegia and quadriplegia. Olympic athletes are highly skilled and appear to be able to protect themselves doing acrobatics. But what about people who are learning? It is difficult to believe that severe injuries do not occur. HM would like to see statistics on this. HM would also like to see how these skills are taught, and if there are any protective measures taken during training.

© Douglas Griffith and healthymemory.wordpress.com, 2018. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

A Surprising Prediction from Some Knowledgeable Individuals

November 12, 2017

There have been many healthymemory blog posts on the risk of chronic traumatic encephalopathy (CTE) from head blows suffered playing football. Sportscaster Bob Costas, Tony Kornheiser, Michael Wilbon, and Christine Brennan were headliners at the University of Maryland’s 12th Shirley Povich Symposium. This panel touched on something that would have been difficult to imagine 14 years ago: a future without football.

Costas said that the most substantial—existential—the existential issue—is the nature of football itself. “The nature of football is this: Unless and until there is some technology which we cannot even imagine, let alone has been developed, that would make this inherently dangerous game not marginally safer but acceptably safe, the cracks in the foundation are there. The day-to-day issues, serious as they may be, they may come and go. But you cannot change the basic nature of the game. I certainly would not let, if I had an athletically gifted 12- or 13-year old sone, I would not let him play football.”

Costas rejected those who are quick to dismiss football’s concussion crisis as part of a “left-wing conspiracy to undermine something that is quintessentially American.” Costa said, “The truth is the truth,” referencing the memoir “Truth Doesn’t Have a Side,” by Bennet Omalu, the researcher credited with discovering CTE.” Costa continued, “Some of the best people I’ve met in sports have been football people, but the reality is that this game destroys people’s brains…That’s the fundamental fact of football, and to me is the biggest story in American sports.”

Kornheiser suggested that football eventually will go the way of horse racing and boxing, two other sports that once were wildly popular. “It’s not going to happen this year, and it’s not going to happen in five or 10 years, but Bob is right: At some point, the cultural wheel turns just a little bit, almost imperceptibly, and parents say, ‘I don’t want my kid to play.’ And then it becomes only the province of the poor, who want it for economic reasons to get up and out, and if they don’t find a way to make it safe—and we don’t see how they will—as great as it is, as much fun as it is…the games not going to be around. It’s not.”

The preceding was taken from as article by Scott Allen in the Sports Section of the 9 November 2017 issue of the Washington Post.

HM has argued previously that the game might be changed by making certain adjustments. One would be to put weight restrictions on the participants so that very large individuals would not have an advantage. There would also be restrictions against hard hitting in blocking or tackling. This might even lead to a faster more exciting version of the game. Players might prefer this version because it minimizes the possibility of disabling injuries. And fans might enjoy a faster, more sophisticated version of the game. The popularity of this game would depend on what really attracts people to watch. A fast moving sophisticated game, or the violence of the game.
© Douglas Griffith and healthymemory.wordpress.com, 2017. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Football Before Age 12 Can Lead to Behavior Issues

September 30, 2017

The title of this post is identical to the title of an article by Rick Maese in the Sports section of the 20 September 2017 Issue of the Washington Post.
A study published recently in the medical journal Translational Psychiatry reported that those who participated in football before age 12 were twice as likely to have problems with behavior regulation, apathy, and executive functioning when the get older. Executive functioning includes initiating activities, problem solving, planning, and organizing. The younger football players were three times more likely as those who took up the sport after age 12 to experience symptoms of depression.

One of the authors of this study, Robert Stern is the director of clinical research at Boston University’s Chronic Traumatic Encephalopathy (CTE) Center, said “Perhaps that is a window of vulnerability…It makes sense that children whose brains are rapidly developing should not be hitting their heads over and over again. ”An interesting result was that the findings were not affected by the number of concussions the former players reported, meaning the danger posed by football can’t be boiled down simply to big hits to the head. Research is increasingly focusing on the effects associated with the accumulation of smaller hits that a player might more easily shake off during a game or practice. Stern said, “Concussions are a big deal when it comes to short term problems, and it has to be dealt with. But the dialogue out there needs to now start focusing on these repetitive hits that are part of the game and their potential for long term problems.”

Another study was done by researchers from the Wake Forest School of Medicine. They followed a group of 25 players, ages 8 to 13, for a single season, measuring the frequency and severity of helmet impacts. The players underwent magnetic resonance imaging (MRI) tests before and after the season, and they showed significant changes in the brain’s white matter. White matter affects learning and brain functions, modulating the distribution of action potentials, acting as a relay and coordinating communication between different brain regions.
None of the participants in that study showed signs or symptoms of concussions, and the players who suffered more hits saw more significant changes to the brain.

The healthy memory blog has many posts on chronic traumatic encephalopathy. At the professional level the damage caused by playing football is costly, and apparently the brain is adversely affected at very young ages.

Football is a very interesting and complicated game, but modifications of the game could make it much safer. This might not be possible at the professional level, because the violence is a big part of the appeal of the game. However, these modifications should be made for young people. Colleges and universities should also consider modifications to make the game safer. It is ironic that institutions whose purpose is education and building healthy brains pursue a sport that damages brains.

© Douglas Griffith and healthymemory.wordpress.com, 2017. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

 

CTE Goes Beyond the NFL

March 11, 2016

CTE stands for Chronic Traumatic Encephalopathy.  Previous healthymrmory posts titled Chronic Traumatic Encephalopathy (CTE), and Watching Football, Feeling Guilty have discussed this devastating brain condition.  After much legal action the NFL has set up a mechanism for compensating players who suffer from this disease.  It is estimated that at least one-third of NFL players will suffer from early onset Alzheimer’s.  Others can  suffer symptoms that border on, if not cross, insanity and this insanity causes them to commit suicide.

The Sports section of the March 4, 2016 Washington Post contained two articles on CTE.  One article ty Rick Maese is titled “Chastain will donate brain for research.”  This is Brandi Chasten who played parts of 12 years for he U.S. national soccer team, helping the American win a pair of Olympic gold medals and two World Cup titles.  She has become an advocate for making soccer a safer sport, urging youth leagues to ban heading the ball by athletes under age 14.  Her brain eventually will go to the brain bank run by the Concussion Legacy Foundation, the U.S. Department of Veterans Affairs and the Boston University School of Medicine.  Currently only 4 of the 307 brains in this brain bank are from women.  This shortcoming is especially important because the female brain may be more prone to injury and adverse long-term outcome that the male brain .  Injury data  for both college and high school athletics has found that women suffer more concussions than men who compete in similar sports.

Another article by Steven Goff titled, “Concussion symptoms lead D.C. United’s Arnaud to retire” reviews how Davy Arnand is retiring because he has been unable to shake the symptoms he’s suffered from recent concussions.  He said that he had been unable to shake the “drunk, dizzy feeling” of a head injury suffered heading the ball in practice last summer.  Other  soccer players, Bryan Namoff, Josh Gros, Alecko Eskandarin, Devan McTavish, and Taylor Twellman are other players who have been forced into retirement by head injuries.

Dr. Bennet Heakandu Omalu who discovered, diagnosed, and define the condition is especially concerned about youth playing football.  Their brains are especially vulnerable at those ages.

I find it ironic when athletics, whose primary objective is, or should be, health result is serious debilitating conditions.

© Douglas Griffith and healthymemory.wordpress.com, 2016. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Chronic Traumatic Encephalopathy (CTE)

December 29, 2015

I titled an earlier post, “Watching Football, Feeling Guilty.”  After having viewed the movie, “Concussion,” starring Will Smith, I think that I will feel too guilty if I ever viewed football again.  “Concussion” is an outstanding move.  Will Smith is a fine actor, and the part of Dr. Bennet Heakandu Omalu allows him to show his full talent.    Dr, Omalu is an immigrant from Nigeria, a brilliant doctor, and an extremely conscientious coroner.  He performed an autopsy on former Pittsburgh Steelers center Mike Webster in 2002.  Although Webster’s brain looked normal after the typical autopsy, Webster had been living out of his truck, trying to paste lost teeth back into his gums, and has been shocking himself with a taser.  He had been struggling for years with cognitive and intellectual impairment, dentition, mood disorders, depression, drug abuse, and suicide attempts, yet his autopsy did not indicate any problems with his brain.  Dr Omalu needed to use not only his initiative, but also his own money to conduct further research.  He conducted detailed tissue analysis and found the evidence of the cause of Webster’s dementia.  He did further research into likely causes.  In 2005 together with colleagues in the Department of Pathology at the University of Pittsburgh. his finding were published in the journal “Neurosurgery” in an article titled “Chronic Traumatic Encephalopathy in a National Football League Player.”  The NFL quickly started work to impugn both his integrity and his research.  Dr. Omalu persevered and published a second “Neurosurgery” paper based on his findings in the brain of former NFL player Terry Long, who suffered from depression and committed surgery in 2005.  Although long died at 45 he had a brain more characteristic of a 90 year old with advanced Alzheimer’s.

Evidence continued to accumulate.  After seven years refusing to recognize the legitimacy of Dr. Omalu’s research, the NFL finally acknowledged the link between concussions sustained in football and CTE.  In 2012 some four thousand NFL players “joined civil lawsuits against the league, seeking damages over the League’s failure to protect players from concussions, according to Judy Battista of the New York Times.”

In 2015 a final settlement was reached between players in the NFL in the case adjudicated by Judge Brody.  The NFL will make payments for $75 million for “baseline medical exams” for retired players, $10 million dollars for research and education, as well an uncapped amount for retirees “who can demonstrate that they suffer from one of the several brain conditions covered by the agreement,” will total payments expected to exceed $1 billion dollars over 65 years.

So the NFL regards the problem as a cost of doing business.  The have established a concussion protocol, whereby players who have suffered a concussion are allowed back into the game.  From games I have watched and read about, it seems that this protocol is administered inconsistently.  It is also believed to be the case that concussions are not a necessary condition for CTE.  Consistent pounding of the brain can have deleterious effects on the brain.

I read a review of the movie in Deadpan, “How Sony Changed Concussion to Make the NFL (Or Their Lawyers)  Happy.  Although I do not deny that the NFL was able to negotiate changes in the script, having viewed the movie I cannot believe that either the NFL or its lawyers happy.  The NFL comes across as a ruthless entity, oblivious to the damages being wreaked on its participants, interested only in money, and having no regard for the truth.  The agreements they eventually did agree to were forced upon them by the strength of the evidence.

Earlier diagnostic techniques, and treatments are being researched.  Perhaps changes in equipment or the rules of the game can mitigate the problem.  I am particularly interested in the effects this movie will have on the public.  It is well done and highly moving.  How many people, if any, will be like me and swear off the sport as a viewer.  There are already some professional players who are retiring early and an unknown number who might be reconsidering pursuing football as a sport.  Of particular interest are parents, who might not regard playing football as a risk their children should undertaken.  Young brains are especially vulnerable.

We seem to forget the purpose of athletics, namely as activities to make us healthier.  It’s perverse when the opposite results.  This goes beyond football.  I’ve known runners who have injured themselves  who continue to run knowing that they are putting their well being at risk.  It is easy to find many such examples.

Dr. Omalu continues his research.  He has discovered CTE in the brains of war veterans.  Oman has written a paper linking Post Traumatic Stress Disorder (PTSD) to the CTE spectrum of diseases.

© Douglas Griffith and healthymemory.wordpress.com, 2015. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.

Watching Football, Feeling Guilty

November 8, 2015

That is American and Canadian football.  Given that this is the healthy memory blog, a post on Chronic Traumatic Encephalopathy (CTE) is in order.  An earlier post mentioned CTE, but not in the context of football.  CTE produces a loss in memory or failures of memory to function correctly.  Its prevalence has been linked to football.  There is  a definite link, and the strength of this link remains under investigation.  The NFL has taken actions in an attempt to reduce the occurrence of CTE, and I am sure that equipment manufacturers are working to develop means of safeguarding players from CTE.

So I watch football, and I feel guilty about it.  Are these men damaging their brains for my enjoyment?  If I had children I would strongly discourage them from playing football.

It will be interesting to see how this issue plays out.  Football is such a popular game and generates enormous revenues, so it is unlikely that it will be outlawed, at least in the short term.  Rules will be formulated to minimize the dangers from hits.  Protective equipment will be improved.  Perhaps there will even be size limits put on players.  Actually, a game consisting of smaller, faster players might be more interesting.

It will take a long time to play out.  Research takes time.  And the damage from CTE can take many years to manifest itself.  Early in the twentieth century the public became enraged by the injuries that were being incurred in college football, and changes were made to reduce injuries.  But CTE takes time to emerge, and unless it is being looked for, the link between playing football and CTE might be missed.  Now extreme scrutiny will be exercised in finding that link.  And it will take time to see changes in the rules and improvements in equipment are beneficial.  Of course, claims will be made that they do, and it will take time and improved diagnostic techniques to see if they are having the desired effect.

© Douglas Griffith and healthymemory.wordpress.com, 2015. Unauthorized use and/or duplication of this material without express and written permission from this blog’s author and/or owner is strictly prohibited. Excerpts and links may be used, provided that full and clear credit is given to Douglas Griffith and healthymemory.wordpress.com with appropriate and specific direction to the original content.