An NFL Doctor Wants to Know Why Some Players Get CTE and Others Don’t

Joseph Maroon, a neurosurgeon, began working for the Pittsburgh Steelers as a consulting physician in 1977 and spent more than 46 years examining and treating stars of notoriously harsh descents, including Hall of Famers Terry Bradshaw, Mean Joe Greene and Lynn Swann. Have treated. ,

Many of them, he said, worry about the health of their minds because they played when concussions were viewed as “dings”, full-contact drills were common and the most violent hits were still permitted.

“Certainly, everybody who participates at that level has some concern,” Maroon said last week in his office at the University of Pittsburgh Medical Center Presbyterian Hospital. “But we haven’t seen the epidemic that might have been anticipated from playing in that era with less protective helmets, fewer rules and harder fields. There are still many unknowns.

An increasing number of scientific studies conducted over the past 15 years have found an association between repeated head trauma and chronic traumatic encephalopathy, a degenerative brain disease. Many of them have come through the CTE Center at Boston University, which has examined the brains of hundreds of former NFL players and other athletes and military personnel.

But Maroon, who has in the past called rates of CTE in football players a “rare” phenomenon and “grossly-exaggerated,” felt more research needs to be done into why some athletes have few or none of the symptoms associated with CTE. is required. including memory loss, impulse control issues and depression, while others are overwhelmed by them.

So five years ago, Art Rooney II, owner of the Maroons and Steelers, approached doctors at the University of Pittsburgh’s Alzheimer’s Disease Research Center to discuss starting a sports-focused brain bank that could track age, genetics, substance abuse, and memory loss. , studies numbers. Head hits and other factors play a role in the development of CTE.

The result is the National Sports Brain Bank at the University of Pittsburgh, which will formally open Thursday. After several years of delay by the Covid-19 pandemic, the center has accepted mindfulness pledges from athletes including former Steelers Jerome Bettis and Merrill Hoge.

CTE can only be diagnosed after death, and doctors are still years away from developing a test to detect the disease early in life, so posthumous donation to brain banks is still the primary way to advance research.

The center will also begin recruiting volunteers — athletes from all levels of sport as well as non-athletes to serve as a control group — to provide their health histories and be monitored over the coming years. That information will be compared to the conditions of their brains after they died to determine what factors, if any, played a role in whether or not they had CTE.

“We don’t know where the threshold is for CTE,” said Julia Koffler, director of the neuropathology department at the University of Pittsburgh, who will oversee the sports brain bank. “You certainly see cases that had very little pathology that had symptoms, and that’s the question. I think we really need to have as many cases as we can to answer these epidemiological questions.” “

The National Sports Brain Bank will rely on infrastructure from the Alzheimer’s Disease Research Center, which already has more than 2,000 brains, although most are not from athletes. The Sports Brain Bank will use seed funding from the Chuck Noll Foundation, the Pittsburgh Foundation and the Richard King Mellon Foundation to find volunteers and people willing to pledge their brains for the long-term study.

Maroon, Kofler and others in Pittsburgh acknowledged the work of doctors at Boston University, who have been the undisputed leaders in CTE research. The researchers have access to more than 1,350 brains not only from football players, but also from athletes playing hockey, rugby, soccer and other sports, as well as members of the military. CTE has been found in about 700 of those brains so far.

But Maroon said some of the research produced by the Boston group was biased, because families typically donated the brains of relatives who exhibited symptoms consistent with CTE when they were alive. When asked to provide details of their loved ones’ head trauma, those families’ memories of former players’ injury histories may be inaccurate.

The long-term study, conducted by researchers in Pittsburgh, should “reduce, eliminate, reduce that kind of bias,” Maroon said.

Neuropathologist Ann McKee, who leads the CTE Center at Boston University, said her group has acknowledged the selection bias among families for many years. He also noted that doctors at Boston University were already conducting several longitudinal studies.

“We’re doing all of this,” Mackey said. “It’s always good to have another group involved, and it will accelerate research and speed up scientific discoveries, especially with regard to treatments. So that’s fantastic.” .

Unlike Boston University, the National Sports Brain Bank is not shying away from ties to the NFL’s Chuck Knoll Foundation for Brain Research, which was named after the former Steelers head coach, who was diagnosed with Alzheimer’s disease before his death in 2014. The bank has provided the seed money. The foundation was started in 2016 partially with a donation from the Steelers’ charitable arm and has provided more than $2.5 million in research grants primarily to explore the diagnosis and treatment of brain injuries that occur in sports.

“It was important to the Steelers that we get behind this,” Rooney said in a phone interview. “Obviously, we’re in the early stages of this, but we hope it gets the kind of attention it needs to be really successful.,

Hogg, the former Steelers who has agreed to donate his brain, said he chose the National Sports Brain Bank because the University of Pittsburgh and other institutions in the city were centers of innovation in brain health, including the development of helmet technology. , He also noted that Noll, his former coach, had insisted on the development of a test to evaluate a player’s cognitive abilities, which could be used to identify concussions at baseline. This was the forerunner of the Immediate Post-Concussion Assessment and Cognitive Testing (IMPACT) which has been used globally.

Hogg, who co-authored the book “Brainwash: The Bad Science Behind CTE and the Plot to Destroy Football” in 2018, said he believes in the integrity of the research at the Pittsburgh Brain Bank.

“There is so much misunderstanding and fear,” Hogg said. “Helping them find the right information and giving them other information and resources to help with the thought process is, I think, very important.”

Referring to the Pittsburgh group’s NFL link, Gil Rabinovici, director of the Alzheimer’s Disease Research Center at the University of California, San Francisco, said, “This type of research is best done when the funder and the investigator are free of any potential conflicts.” ” ,

He added that the researchers in Boston had done an “excellent job” of describing the pathology of CTE, “but in science, you look for independent replications with different groups, using different methods to find the same results.” Scientists study the questions, and hopefully reach similar conclusions.”