Leading medical journal calls on doctors to dial back dire warnings about CTE

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The discovery of Chronic Traumatic Encephelopathy eventually led to the creation of various media narratives about what it is, how it’s developed, and what it means. In many respects, those characterizations gave ignored that, as a matter of medical science, not nearly enough was and is known about how it develops, what it means to have it, and the short- and long-term consequences and complications associated with it.

The effort by some in the media to put the CTE cart before the horse has caused plenty of players to worry unreasonably about whether their brains have become ticking time bombs, destined to eventually implode into one of various serious conditions. Now, one of the leading peer-reviewed medical journals is calling on doctors and others to dial back the presumptions that have been perpetuated regarding CTE.

“Contrary to common perception, the clinical syndrome of CTE has not yet been fully defined, its prevalence is unknown, and the neuropathological diagnostic criteria are no more than preliminary,” declares The Lancet. “We have an incomplete understanding of the extent or distribution of pathology required to produce neurological dysfunction or to distinguish diseased from healthy tissue, with the neuropathological changes of CTE reported in apparently asymptomatic individuals. Although commonly quoted, no consensus agreement has been reached on staging the severity of CTE pathology. A single focus of the pathology implicated in CTE is not yet sufficient evidence to define disease.”

In other words, doctors still don’t know nearly enough about getting it, having it, and living with it. And some doctors and researchers all too often fail to acknowledge this fact.

“Unfortunately, the uncertainties around the clinical syndrome and the pathological definition of CTE are not acknowledged adequately in much of the current research literature or related media reporting, which at times has resembled science by press conference,” the article explains. “Too often an inaccurate impression is portrayed that CTE is clinically defined, its prevalence is high, and pathology evaluation is a simple positive or negative decision. This distorted reporting on CTE might have dire consequences. Specifically, individuals with potentially treatable conditions, such as depression or post-traumatic stress disorder, might make decisions on their future on the basis of a misplaced belief that their symptoms inevitably herald an untreatable, degenerative brain disease culminating in dementia.”

It’s no surprise that former players jump to CTE conclusions, when so much of the comments from certain doctors and researchers focus not on the lack of medical evidence to understand it but on the dire warnings and predictions made by persons who, coincidentally or not, have seen a sharp rise in their individual profiles and profitability based on the taking of prematurely aggressive positions about the dangers of CTE.

“We propose that the principle of, first, to do no harm, is used when communicating on CTE, whatever the platform,” the article concludes. “In particular, the many remaining uncertainties should always be acknowledged. Otherwise, the risk of doing harm is very real.”

This is a message to all doctors, reminding them of the fundamental underpinnings of the Hippocratic oath. Primum non nocere. First, do no harm.

Amen to that. Too many former players experience anxiety, stress, and depression not as a result of having CTE but simply from the fear associated with the condition, fear sparked by statements made publicly and privately by doctors. That fear that causes many former players to constantly wonder whether today is the day that they will begin an inevitable descent into the gradual loss of cognitive functioning, culminating in Alzheimer’s, ALS, dementia, and/or death. The article in The Lancet represents a clear and unambiguous message to all current and former athletes who worry about the long-term effects of head trauma: Do not assume the worst, because much still has to be learned about the condition.

Some will scoff at this explanation, attributing it to a football writer who has a vested interest in the ongoing existence of professional football. Some of those who will scoff, however, have a vested interest in the death of professional football, and they seem to be all too willing to ignore plain and obvious facts — such as those articulated by The Lancet — in the hopes of either bringing about the death of professional football or witnessing it in their lifetimes.

29 responses to “Leading medical journal calls on doctors to dial back dire warnings about CTE

  1. Folks just need to never leave their houses unless they’re completely covered in bubble wrap, living in constant fear of concussions.

  2. Boxing and football are my two favorite sports and both are bad for you long term if you do them to often. Understand that is what you are watching and let the athletes understand this as well. Sorry but we see the symptoms too regularly in both sports to deny it. You can come out all right and you can sometimes not.

  3. CTE is a devastating disease. And as more gets know about it, we all will be better informed. And ultimately what this is, is a choice for the players, if playing football, and the benefit of it, both financial reward, and the ability to express oneself using the talents one was blessed with, then the players have a choice.
    My only wish is the players, choose, and understand their choice, and those around them who support them, understand the choice also. ANd that choice is based on what is most aligned with the value of each person who choose.

  4. Too bad the nfl, college coaches, high school coaches,
    junior high coaches, and pee wee coaches told everyone
    that there is no danger.

  5. Not surprised at all. If you’re involved in research, you know there is still a long way to go. So many new discoveries every day. Lots of old middle linebackers have no problems, yet lots of older men and women who have never played football have problems. Some are more susceptible than others. It’s sorta like tree nut allergies. Some have them, some don’t. Any allergy for that matter. Some do, some don’t. Even things that don’t make our eyes itch can have internal affects, like swelling and inflammation. So if your diet or DNA causes you to have more inflammation than other people, you may be more susceptible to brain injuries when hit in the head. That’s why lots of non-football players get them too. So there might be a connection, but you have to reach for it. So when we said the NFL owners were in collusion about not admitting the concussions, perhaps some of the owners had a background in scientific research, and knew that nothing had been proven. They took extra cautions anyway.

  6. For some reason playing a game of football is a bigger health issue to some than hunting or even driving. There’s way more risk and serious damage that can occur doing these things but no one is going to stop driving because of the risks. It really is ridiculous.

  7. This is Goodell’s greatest failing, and that’s a long list. CTE is far from settled science.

    A bunch of people with agendas constructed the narrative that 1, Concussion guarantees you will have CTE and die young, and 2, the NFL knew all about it and covered it up.

    The problem is that even today, nobody knows the real long term effects of concussions. CTE is seen just as often in people who have never played football or had a concussion in their lives as it does ex football players.

    Goodell chose the easy road of grovelling to the media narrative than standing up for the NFL and actual science.

    What he should have done was admit that the NFL didn’t take concussions seriously enough in the past but that was because in the past, concussions weren’t thought to be a big deal. Then he would point out how the NFL is now at the forefront of the research in the area and is doing all it can to make things safe.

  8. Isn’t The Lancet the medical journal that published the now-discredited study that purported to link autism to the MMR childhood vaccination?

    So why should we believe what The Lancet has to say about CTE?

  9. CTE came to the forefront because people attached it to football and saw $Billions in potential damages. There was hardly any factual data concerning the condition but that did not stop the lawyers and their clients from preying upon others varying from concerned to paranoid. Surely there are some reasonable speculations but more information is needed. At least the medical community is slowing down some of the rhetoric. It seemed like the only professional voices on this issue belonged to those dependent upon funding the research or those hired to refute it.

  10. Finally a voice of reason in the CTE discussion. There has never been a rigorous (double blind) study of CTE. So science does not know how many people in the general public (who have never played football) will get CTE. I bet it’s more than zero. My prediction: Some people who played professional football will have CTE but not everyone who has CTE will have played football.

  11. FinFan68 says:
    February 16, 2019 at 2:52 pm
    CTE came to the forefront because people attached it to football and saw $Billions in potential damages.


    Actually it came to the forefront because a bunch of ex-players were taking their own lives because of CTE

  12. SWFLPC.INC says:
    February 16, 2019 at 3:39 pm

    Actually it came to the forefront because a bunch of ex-players were taking their own lives because of CTE

    So we know that “CTE” is the reason for a person’s actions? Does it cause people to hear a voice in their head telling them to harm themselves? Does it then make them act on the voice in their head? People that harm themselves make the CHOICE to do so.

  13. I’ve always thought it was interesting that Steve Young, Troy Aikman and Boomer Esiason all seem to be doing pretty well 20+ years after they had to retire… because of concussions.

  14. People make decisions on how they live their lives. Some ride motorcycles, some choose not to wear helmets. Some choose to jump out of a perfectly running airplane. Some like to swim with sharks. All personal decisions. Wether athletes choose to race motorized vehicles, get the crap beat out of them in MMA and boxing, or play professional football, it’s a choice they make knowing the fame and fortunes they may get offsets the inherent risks to their bodies. Just stop already. Information is valuable. Too bad some people choose to turn it into a money grab.

  15. Sometimes simple common sense must be applied in combination with what science is known. As I understand it, the tragic circumstances of Mike Webster, Jr Seau and close to 100 hundred others have been pretty well documented in conjunction with observable post mortem pathology. This taken together with the common sense observation that boxing or football
    generally involves blows to head and sustaining such over an extended time would seem likely and logically to result in some form of adverse consequences.
    I think it also abundantly clear from their past actions on this matter that the health of the players is of little concern to the NFL–unless public opinion threatens their bottom line–which is all the NFL is really concerned with.

  16. A year before Seau killed himself, there was a story in SI about how hard it was for him to be away from the game and out of the spotlight. What happened to him was tragic, and it’s easier to blame CTE than to think the guy was depressed. Erik Kramer’s son died from a drug overdose before he tried to kill himself and naturally CTE was blamed…

    Not to mention Aaron Hernandez. CTE was blamed for him doing what he did.

    I’m not trying to say concussions aren’t something we should pay better attention to, but the last few years, the reporting on this has been highly irresponsible.

  17. Thank you for bring this information to light. The information has been out there but hasn’t gained much traction. I support all sports giving athletes time to heal from concussions.
    I wish similar articles were published regarding climate change, the truth is much different than the popular belief that is pushed throughout the media

  18. Apparently the medical community has not crossed path with sports journalist yet. Maybe they need to sit down and have the journalist teach them something about their our profession.

  19. SWFLPC.INC says:
    February 16, 2019 at 3:39 pm
    FinFan68 says:
    February 16, 2019 at 2:52 pm
    CTE came to the forefront because people attached it to football and saw $Billions in potential damages.


    Actually it came to the forefront because a bunch of ex-players were taking their own lives because of CTE
    Stop it. That is not proven. How many of those guys were actually still playing football when they did it? None. Thousands of veterans take their own lives after struggling in various ways after they get out. Most of them didn’t play football. It seems to me you have a better chance proving those NFL guys did it due to depression than you do blaming a disease that has not even been adequately defined yet.

  20. Guys –In the cases you mention above and many others –there was a post mortem done—their brains were dissected and extensive pathology was found —what part of that do you not understand

  21. I love it when the anti-kaepernick crowd
    that argues against stem cell research enters
    a science conversation shouting about Lancet.


  22. gibbyfan says:
    February 16, 2019 at 8:09 pm
    Guys –In the cases you mention above and many others –there was a post mortem done—their brains were dissected and extensive pathology was found —what part of that do you not understand
    That procedure is not automatic. It was either requested or done for a specific reason. Nobody is discounting the fact the abnormalities were discovered. The issue is that the results required further study but the talking points being thrown around state a cause when it is at best a correlation that may or may not be significant. If they did that procedure on 100 truck drivers who died and they all showed the same results would that mean they all MUST have played football? No. More data is needed but certain precautions are prudent.

  23. Please tell us who these “Some … have a vested interest in the death of professional football” are. Tell us what that “vested interest” is.

    And how do these “vested interests” compare to the huge vested interests of billionaire owners and multimedia interests?

  24. One thing the vast majority of research has shown is that the injuries that they believe cause the most damage and lead to CTE is done well before these players ever hit the NFL, like at the Pop Warner, Jr High, High School and college levels because the brain isn’t fully developed at those stages of their lives.

    So my question is why is it the NFL is the ONLY one being sued?

    The sad answer is: they’re the only ones with enough money to pay! If those others would get sued and lose, they’d be no more, it would flat out devastate the game at those levels!

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