There have been varying reports on whether football participation has been affected by years of reporting on concussions, and their-long term impact on players. Today, the Journal of the American Medical Association has posted results of a study regarding the prevalence of chronic traumatic encephalopathy, better known by its abbreviation CTE, that is going to give a lot of parents pause about whether their kids should play football -- and maybe give a lot of people pause about whether they should enjoy watching it.
Results Among 202 deceased former football players (median age at death, 66 years ...), CTE was neuropathologically diagnosed in 177 players ... including 0 of 2 pre–high school, 3 of 14 high school (21%), 48 of 53 college (91%), 9 of 14 semiprofessional (64%), 7 of 8 Canadian Football League (88%), and 110 of 111 National Football League (99%) players. Neuropathological severity of CTE was distributed across the highest level of play, with all 3 former high school players having mild pathology and the majority of former college (27 [56%]), semiprofessional (5 [56%]), and professional (101 [86%]) players having severe pathology. Among 27 participants with mild CTE pathology, 26 (96%) had behavioral or mood symptoms or both, 23 (85%) had cognitive symptoms, and 9 (33%) had signs of dementia. Among 84 participants with severe CTE pathology, 75 (89%) had behavioral or mood symptoms or both, 80 (95%) had cognitive symptoms, and 71 (85%) had signs of dementia.
The study analyzed brains donated to a bank at Boston University, the institution that has been the epicenter of CTE research. Researchers said the results suggested "that CTE may be related to prior participation in football."
Two things stand out in this study. First, the longer one participates in football, the higher the likelihood of CTE, which only can be identified after death -- so there's no way to fully know the extent of the damage until then, although as the study points out, there are behavioral and medical signs that something is amiss. And second, only one out of 111 NFL players studied DIDN'T have CTE is shocking, and might make the sport harder to watch knowing the long-term aspect of what you're seeing.
The New York Times broke down the numbers on pro players by position (linemen, who take the most hits, were most represented), and included the names of stars such as Ken Stabler and Dave Duerson who were included in the study.
The Times also quoted lead researcher Ann McKee, a neuropathologist and professor at Boston University who also is chief neuropathologist for the National VA ALS Brain Bank, expressing some caution about the study's numbers. But even if they're overstated, there's still a lot of reason for concern. From the Times:
The set of players posthumously tested by Dr. McKee is far from a random sample of N.F.L. retirees. “There’s a tremendous selection bias,” she has cautioned, noting that many families have donated brains specifically because the former player showed symptoms of C.T.E.
But 110 positives remain significant scientific evidence of an N.F.L. player’s risk of developing C.T.E., which can be diagnosed only after death. About 1,300 former players have died since the B.U. group began examining brains. So even if every one of the other 1,200 players would have tested negative — which even the heartiest skeptics would agree could not possibly be the case — the minimum C.T.E. prevalence would be close to 9 percent, vastly higher than in the general population.
McKee has said before the point of her research is not to kill football. After all, she identified herself as a rabid Green Bay Packers fan -- a self-described "Cheesehead" -- in a 2012 Grantland profile in which she described her research as a means to make the game safer, and save it:
This explains the framed 1968 Green Bay Packers yearbook and the January 22, 1969, cover of Sports Illustrated with Jerry Kramer cradling Vince Lombardi in his arms. Her pooches at home wear Green Bay Packers dog tags. Within reach of her desk, she has a roster of empty-headed bobbleheads — Brett Favre in green-and-gold, in white-and-green, in purple-and-white; and Aaron Rodgers, Favre’s estimable successor in the huddle and in her affections. And a hero of another kind of artistry — a ringer in street clothes named Vincent van Gogh.
Every football Sunday, she parks herself in front of the TV in her authentic Packers foam Cheesehead ($17.95 at packersproshop.com) and Rodgers’s no. 12 jersey and prays that none of the men on the field end up on a dissection table.
Organizations such as Pop Warner, USA Football and state high school associations have adjusted rules and training techniques to reduce football's impact on the head. I personally consider playing high school football, on the whole, a very positive thing for my oldest son.
On the other hand, as we all see numbers like those in the JAMA study, the decision as parents is this: are we comfortable enough with the risk to put our kids on the field? Surely, other sports have concussion risks, but in a world where your future depends on your brain, do you want to risk it in a sport where violent contact is a part of its design? And knowing what's happening with NFL players, is it getting harder to personally separate your fandom from the impact you know Sunday's violence will have?
I don't that parents en masse will pull their kids out of football, or not let them play. But as we get more informed about the risks, putting our kids in football is getting to be a harder decision.
