Donna O’Donnell Figurski
Concussion is scheduled to be in theaters in late December, but it is already making headlines (review and trailer). The National Football League (NFL) knows that its Achilles heel is the high risk of brain injury to its players, not only from documented concussions, which are likely to be far fewer in number than actual concussions, but also from the repeated sub-concussive hits, which many neurologists believe contribute to brain injury. Former players are concerned (video of the song Final Drive by former NFL star Kyle Turley), and current players are becoming concerned. Recently a promising rookie linebacker with the San Francisco 49ers quit after one season over the fear of brain injury.
Concussion is based on the true story of the discovery of the brain disease known as chronic traumatic encephalopathy (CTE) by Dr. Bennet Omalu, a Nigerian pathologist who did the autopsy of Hall-of-Fame Pittsburgh Steelers center, Mike Webster. Dr. Omalu first saw CTE during his study of Webster’s brain. Webster was homeless, depressed, and suffering from dementia when he died at age 50. Dr. Omalu’s story, which is the basis of Concussion, is given in the PBS Frontline documentary League of Denial: The NFL’s Concussion Crisis. I urge everyone to watch the documentary before seeing Concussion. The 2-hour PBS documentary is available online at no cost. In Concussion, Will Smith plays Dr. Omalu.
This movie may change what you think about American football and the NFL. Knowing that brain disease is a major problem for the future of the game, the NFL tried to discredit Dr. Omalu and his provocative work. The NFL had previously established a questionable committee of doctors to study mild traumatic brain injuries (MTBIs), otherwise known as concussions. The NFL committee published papers claiming that MTBIs, even multiple MTBIs, were not a problem for players. (The conclusions are contradicted by current data. Also, some scientists question the validity of the published studies.)
Dr. Omalu thought that the NFL would be very interested in his data. Instead, the NFL’s MTBI committee immediately attacked Dr. Omalu and his findings. At one point, the committee tried to get Dr. Omalu to retract the paper. Going against the multibillion dollar NFL has a steep price. Dr. Omalu has stated that he wishes he had never discovered CTE.
To date, CTE has been found in 88 of 92 autopsied NFL brains (1, 2). The currently accepted way that CTE is identified is by studying the brain postmortem. The major criticism of the postmortem analyses that were done is that the brains came from former players who already showed signs of brain disease. In other words, the claim is that the sample is biased. Dr. Ann McKee, a neuropathologist at Boston University’s CTE Center, studied most of the brains. She argues that the results would be extraordinary even in a biased sample.
With a recent advance in technology, it seems that the bias criticism can soon be put to rest. Dr. Omalu is an author on a recent publication, in which neuroscientists from the University of California at Los Angeles (UCLA) and from the University of Chicago showed that CTE can be accurately diagnosed in a living person by a special PET (positron emission tomography) scan. If such scans were taken of all the current players, we would know if CTE is rare among players, as the NFL would like players and fans to believe, or if it’s relatively common, as Dr. Ann McKee believes.
Until that happens, we are left to decide about the risk of brain disease in players of American football on the basis of what we know. Concussion tells the little-known story of Dr. Omalu and the discovery of CTE. With this movie, we will be more informed and better able to evaluate the risk.
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