The Pro Football Concussion Report

A Fan's Look at Head Injuries and the Concussion Crisis in Football

Top CTE Scientist says, What the hell do you mean?

CTE Researchers Cantu and McKee
Dr. Robert Cantu and Dr. Ann McKee (BU)

03.18.13

Even though renowned neurosurgeon Dr. Robert Cantu’s name is listed as one of the 28 authors of the recently published  Zurich Consensus Statement, he was “stunned” at the paper’s published position on CTE. Cantu, the Co-Director of the Center for the Study of Traumatic Encephalopathy at the Boston University School of Medicine disagreed with the paper’s statement, “a cause and effect relationship has not as yet been demonstrated between CTE and concussions.”

Dr. Cantu revealed his surprise to sports columnist Dave D’Alessandro in a Sunday blog post at NJ.com.

“When I saw in the consensus statement that we need more data in terms of CTE, I wrote to the other authors, in essence, “What the hell do you mean that we need more data?”” Dr. Robert Cantu said in a phone conversation Thursday. “The whole breadth of the document is large, and 99 percent of it it I strongly support. But that part of it, I don’t support at all. Frankly, it stunned me.”

The Zurich Consensus Statement is the product of the November 2012 conference, “Concussion in Sport” that brought together 28 physicians and academics (mainly from 3 countries, US, Canada and Australia) to discuss issues surrounding concussions suffered in major sports.  The conference was organized by the International Olympic Committee, and the governing bodies for professional soccer, rugby and ice hockey.  Although the NFL was not listed as an organizer they were well represented at the conference with several presenters. Dr. Cantu, an advisor to the NFL’s Head, Neck and Spine Committee was involved, as well as the NFL’s Dr. Margot Putukian,  Dr. Richard G. Ellenbogen,  Dr. Kevin Guskiewicz,  Dr. Stanley Herring and Dr. Barry D. Jordan.  Dr. Jordan has the distinction of sitting on the NFL’s powerful, but controversial Neuro-Cognitive Disability Committee. The 3 member Neuro-Cognitive Committee determines if an NFL retiree qualifies for medical benefits due to a brain injury.

In addition to Dr. Cantu’s presentation, CTE  (and its pathology) was also the focus of researcher Dr. Ann McKee’s presentation. Dr. McKee is the neuropathologist at Boston University who has actually autopsied the brains of deceased athletes and discovered numerous cases of CTE.

The most surprising thing coming from the 7,500 word consensus statement was that the issue of CTE only took 1 paragraph, 100 words. That was about the same amount of coverage as whether elite athletes should be treated from a concussion management perspective any differently from non-elite athletes  (the consensus was no, they should be treated the same).   Here is the part of the consensus statement devoted to CTE and the longterm effects of concussions in sport.

“Clinicians need to be mindful of the potential for long-term problems in the management of all athletes.  However, it was agreed that chronic traumatic encephalopathy (CTE) represents a distinct tauopathy with an unknown incidence in athletic populations. It was further agreed that a cause and effect relationship has not as yet been demonstrated between CTE and concussions or exposure to contact sports. At present, the interpretation of causation in the modern CTE case studies should proceed cautiously. It was also recognised that it is important to address the fears of parents/athletes from media pressure related to the possibility of CTE.”

Dr. McKee was equally disappointed in the published statement from the conference.

“This is a time that calls for immediate action to reduce the amount of head trauma experienced by athletes in all sports to prevent CTE,” McKee said via email. “And it is now irresponsible to justify inaction by requesting a level of scientific proof that will take decades to acquire.”

 

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