110 N.F.L. Brains
July 27, 2017 4:27 PM   Subscribe

NYT Interactive: Dr. Ann McKee, a neuropathologist, has examined the brains of 202 deceased football players. A broad survey of her findings [JAMA, open access] was published on Tuesday in The Journal of the American Medical Association. Of the 202 players, 111 of them played in the N.F.L. — and 110 of those were found to have chronic traumatic encephalopathy, or C.T.E., the degenerative disease believed to be caused by repeated blows to the head.

From the JAMA article:
Among the 202 deceased brain donors (median age at death, 66 years [interquartile range [IQR], 47-76 years]), CTE was neuropathologically diagnosed in 177 (87%; median age at death, 67 years [IQR, 52-77 years]; mean years of football participation, 15.1 [SD, 5.2]; 140 [79%] self-identified as white and 35 [19%] self-identified as black), 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 NFL (99%) players.

The severity of CTE pathology was distributed across the highest level of play, with all former high school players having mild pathology (3 [100%]) and the majority of former college (27 [56%]), semiprofessional (5 [56%]), Canadian Football League (6 [86%]), and NFL (95 [86%]) players having severe pathology. The mean duration of play for participants with mild CTE pathology was 13 years (SD, 4.2 years) and for participants with severe CTE pathology was 15.8 years (SD, 5.3 years) (Table 1).
posted by Existential Dread (33 comments total) 14 users marked this as a favorite
 
How has the NFL not been sued out of existence already?
posted by Foci for Analysis at 4:32 PM on July 27, 2017 [10 favorites]


Because people like blood sports.
posted by Homo neanderthalensis at 4:37 PM on July 27, 2017 [8 favorites]


posted by Existential Dread... Eponysterical
posted by Bringer Tom at 4:41 PM on July 27, 2017 [1 favorite]


One flaw in this study, by Dr. McKee's own admission, is that these brains were donated precisely because the familiy's of the players involved thought they had CTE.
This study had several limitations. First, a major limitation is ascertainment bias associated with participation in this brain donation program. Although the criteria for participation were based on exposure to repetitive head trauma rather than on clinical signs of brain trauma, public awareness of a possible link between repetitive head trauma and CTE may have motivated players and their families with symptoms and signs of brain injury to participate in this research. Therefore, caution must be used in interpreting the high frequency of CTE in this sample, and estimates of prevalence cannot be concluded or implied from this sample. Second, the VA-BU-CLF brain bank is not representative of the overall population of former players of American football; most players of American football have played only on youth or high school teams, but the majority of the brain bank donors in this study played at the college or professional level. Additionally, selection into brain banks is associated with dementia status, depression status, marital status, age, sex, race, and education.
The findings are still disturbing, of course, but it's not random NFL players. It's more like a pathologist reporting that 110 of 111 tumors biopsied were in fact cancerous.

Also: the NFL has been sued re: CTE, and settled with payments to ex-players.
posted by msalt at 4:43 PM on July 27, 2017 [11 favorites]


People who believed (or whose families believed) they had severe CTE and donated their brains for study did, in fact, have CTE.

Estimated occurrence among former NFL players as a whole: somewhere between 9% and 99%.
posted by Huffy Puffy at 4:44 PM on July 27, 2017 [3 favorites]


To be fair to football (I know, I know, but still) this collection of brains was donated by people all of whom had some reason to make the donation, like symptoms. That they would have a high incidence of CTE wouldn't be surprising even if CTE should turn out to be relatively rare among players as a whole.

That said the NFL's reaction to the original CTE research was appalling and unconscionable and is exactly the sort of behavior that should not be tolerated from corporate entities.
posted by Bringer Tom at 4:45 PM on July 27, 2017


That's still a pretty alarming number of people with CTE, especially when we consider the families who didn't report something was wrong though there might have been.
posted by Aya Hirano on the Astral Plane at 4:54 PM on July 27, 2017 [7 favorites]


Timely. I still say OJ has CTE.
posted by nevercalm at 5:36 PM on July 27, 2017 [8 favorites]


I can't find the link now and I'm paraphrasing, but someone pointed out that something like 1100 people played in the NFL in the specified time period, and that even if not one more player had CTE that would still mean a rate 9% higher than expected.
posted by Automocar at 5:51 PM on July 27, 2017 [13 favorites]


I can't find the link now and I'm paraphrasing, but someone pointed out that something like 1100 people played in the NFL in the specified time period, and that even if not one more player had CTE that would still mean a rate 9% higher than expected.

That's in the linked article as well. It was interesting to me because of course one knows that few people reach the level of playing pro football, but 1100 is a very small number overall, and for 110 of them to have this condition seems like pretty terrible odds. Of course this is a strongly biased sample, but there's not a lot of room for it to be anything but a pretty alarming number of cases no matter what's up with the other thousand players. And it's an alarming number of cases of an extremely devastating condition.
posted by Orlop at 6:10 PM on July 27, 2017 [2 favorites]


It's not just NFL players. I have a friend who was a lineman in HS. He tells stories about having a pounding headache after practice every day. When my wife got pregnant, he was the first person I told, and we had a long conversation about it. A week later when we saw each other next, he didn't remember that conversation. He's very worried about CTE. I bet there are thousands and thousands like him.

My son is not going to play football. The risk is too great. Plus the culture of football is head-in-the-sand stupid in the great majority of cases.
posted by Lyme Drop at 6:11 PM on July 27, 2017 [27 favorites]


The NFL still owes the National Institute of Health 18 million dollars. More than half of the 30 million they agreed to pay for concussion research 5 years ago.
posted by Uncle at 6:12 PM on July 27, 2017 [7 favorites]


>>someone pointed out that something like 1100 people played in the NFL in the specified time period,
>That's in the linked article as well. It was interesting to me because of course one knows that few people reach the level of playing pro football, but 1100 is a very small number overall


That number can't be right. There are 32 NFL teams, with 53 players each on their rosters, plus another 8 each on their practice squads, and a certain number out on the Injured Reserve List each year. And believe me, no one leaves empty roster slots.

So that's a minimum of 1,952 active players each year, not counting the Canadian Football League (whose players sometimes jump to the NFL).

In training camps, which just opened, each team has 90 players on the roster. If you count them, that's well over 3,000. Each year, and the average career lasts only 3 years.
posted by msalt at 6:27 PM on July 27, 2017 [4 favorites]


In related news, Baltimore Ravens offensive lineman John Urschel retired early today (at age 26) to finish his PhD in Applied Mathematics at MIT. A team source said his decision was linked to this study.

He has already published 6 peer-reviewed papers, with 3 more awaiting review. Perhaps counter-intuitively, offensive lineman are generally speaking the smartest (and largest) players in football, though they like to call each other "big uglies." On many teams the center analyzes the defense and calls out protections, not the quarterback.
posted by msalt at 6:48 PM on July 27, 2017 [24 favorites]


From the article:
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 had 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.
posted by Etrigan at 7:54 PM on July 27, 2017 [7 favorites]


Timely. I still say OJ has CTE.
posted by nevercalm at 6:36 PM on July 27


I've been wondering about that, too, and wondering if his (alleged) victim's families are going to sue the NFL eventually.

Although they may need definitive proof he had it, which might require his next of kin to agree to have his brain examined. But anyway it will be interesting to see if that happens, and if it does, what effect it will have on the surviving family of others who had it.
posted by MexicanYenta at 8:13 PM on July 27, 2017


The median age of death is 66 and if the average career in the NFL is only 3 years, then let's assume they played right out of college...so ages 22-25...so something like 41 years ago (+/- the study's IQR) which means they played somewhere around the year 1975 in which there were 26 NFL teams, not 32. Roster limits were 43 players in '75 so we're looking at 1118 players. A lot closer to that 1100 give or take number.*

*I am a very laywoman kind of numbers person so forgive any grievous estimations, please.
posted by weeyin at 8:49 PM on July 27, 2017 [4 favorites]


The 9% argument makes sense to me, though I suppose it might be skewed a bit as players with CTE presumably die younger.

I feel maybe a simpler interpretation is that "ex-football players who have symptoms of CTE are extremely likely to have actual CTE." Players are not being misdiagnosed. So any estimate of the rate of CTE based on living players is probably accurate (or more precisely, an accurate lower bound.)
posted by mark k at 9:37 PM on July 27, 2017 [1 favorite]


The sport is barbaric. It sucks funding from education starting in elementary school. It is a useless, ridiculously expensive gladitorial spectacle that serves no good purpose. I, for one, would welcome the end of football.
posted by SecretAgentSockpuppet at 9:51 PM on July 27, 2017 [16 favorites]


It sucks funding from education starting in elementary school.

I'm pretty sure essentially every extracurricular activity runs in the red.

And what elementary school fields a tackle football team? Isn't all football at that level run by Pop Warner and other local non-school leagues?
posted by paulcole at 10:46 PM on July 27, 2017 [1 favorite]


My family played contact sports. I played ice hockey growing up and into my early 40s. My boys played football and lacrosse in HS. They definitely got their bell rung more playing lax than football. One son was an offensive lineman and the other a quarterback and safety. My daughter played field hockey. I can recall three concussions I "earned" playing hockey. My HS has trained concussion spotters at football, soccer and lacrosse games now. The spotters can overrule a coach in terms of letting a player play.

I read this article and look at the numbers, and it is overwhelming that the likelihood of having CTE playing football in particular and probably, lacrosse, hockey and soccer is overwhelming. I am not sure I would make the same decision now to allow my kids to play football as I did 7 or 8 years ago. The question for pro players and their families now (post research) is, is the compensation worth it vis a vis the risk. Personally, I would say there is no amount of money that would get me to take the risk, but I think if a player whose only alternative to earn 10s of millions of dollars is playing football has to consider it. They can set their family up for life. It is the same decision, on a different scale that the guy working in the coal mine makes, that the person working on an oil rig, or any other host of jobs that come with material personal injury risk.

It sucks funding from education starting in elementary school This statement presumes that you don't consider scholastic sports as educational. I do. I know that I learned more life lessons and more about how to be a contributing member of a community through my participation in sports than I ever did in any class I took in a classroom with walls. My kids, in their early 20s have said to me that they were prepared for college in two ways. Academically and emotionally. They said their ability to get along with dorm mates, to persevere, to rebound from mistakes and from failures was from their participation in HS team sports, from classrooms without walls.

When the claim is made that an extracurricular activity sucks money from education, that ignores the fact that most of the coaches (In my district, as far as I can tell, 100% of the varsity and JV head coaches are teachers in our district or in a neighboring district) are teachers. A varsity head coach in my district, depending on years of experience, will make up to $11,000 for coaching a team in a season. Money going to a teacher is going to education as far as I am concerned.

The argument could be defined as one of priorities. What parts of education are more important than others and should get funding priority. I certainly appreciate that some people think an AP class should be funded over a sports team or we should cut junior high sports to pay for a reading specialist. I think a district's administration, its leadership, needs to set priorities according to their community norms.

Granted, it can get carried away. I think it was Gov. John Connolly of Texas who said while speaking at a UT Austin event, "What we need is a school the football team can be proud of."
posted by AugustWest at 11:38 PM on July 27, 2017 [5 favorites]


A friend of mine works in finance with a former defensive lineman for the University of Nebraka Cornhuskers (a traditional college football powerhouse that has had many alum in the NFL over the decades). The guy is only 30 and believes that football needs to be outlawed just based on the decline in mental faculties he's seen in his former teammates at recent reunions. Keep in mind that only a handful of the guys he played with even made it to the NFL. He is very worried about what the future holds for him.
posted by KingEdRa at 2:18 AM on July 28, 2017 [7 favorites]


I think the better way is to reduce physical manhandling that happens in all games and with everybody.
posted by lionelthoman at 2:50 AM on July 28, 2017 [1 favorite]


Because people like blood sports.

Maybe after this they'll switch to using condemned prisoners, as in Roman gladiatorial tournaments.
posted by acb at 4:02 AM on July 28, 2017


Personally, I would say there is no amount of money that would get me to take the risk, but I think if a player whose only alternative to earn 10s of millions of dollars is playing football has to consider it.

When I think about hockey here in Canada, I'm not worried about the elite few who get to make this kind of decision -- CTE or millions. I'm worried about the thousands of kids and their families who buy into the dream but won't make it. At what age will they actually start slamming each other into the boards? And why? It's not actually necessary. I'm worried about a culture that takes kids who have sustained injury back on the ice after they shake it off because that's the tough guy/hockey dad/mom mentality. What's the impact years later?

My family does martial arts and at a certain age and level there are throws involved and injury can happen. But it's not a team and there's no rush towards a scholarship or career. So on the rare occasions someone gets a concussion they are required to take a break and their re-entry is supported to go slow and avoid those particular activities for up to a year to heal, and because there are other skills to learn. It's a very different attitude.

I don't know about football but I think hockey could benefit from more of that idea, putting players first.
posted by warriorqueen at 4:04 AM on July 28, 2017 [1 favorite]


that ignores the fact that most of the coaches (In my district, as far as I can tell, 100% of the varsity and JV head coaches are teachers in our district or in a neighboring district) are teachers.

From my experience, it's at least as much if not more that they're coaches who have to teach than teachers taking on coaching. Which means the classes they do get aren't their first priority, which is only too obvious much of the time as many seem to be run more as fiefdoms than classrooms, favoring players and those aligned with them while treating the rest of the class with either benign neglect or outright contempt should you be seen as not sporty enough. Many schools not only tolerate that behavior but virtually encourage it as long as they get a winning team out of it. Just look to all the crap star athletes are allowed to pull in mysterious school transfers and the like to see where the priorities lie in high schools that fashion themselves as important sports centers.

Football isn't that different from the military in some ways, where even in the height of an unjust war where the threat of being permanently disabled or killed exists, people still join due to lack of better seeming options for their experience and skills and to flat out pride in and love of the game. Old former players often flat out denounce these studies, using their own hard knocks experience as "proof" of the studies flaws and how great the game is, they inculcate that love of something that they see as making them special in their kids and sometimes the community if its a town without much else of exceptional note. Breaking that pattern isn't going to be as easy as simply showing them the studies as many will treat them as global warming skeptics treat information on melting ice caps.
posted by gusottertrout at 5:44 AM on July 28, 2017 [4 favorites]


From my experience, it's at least as much if not more that they're coaches who have to teach than teachers taking on coaching.

This was definitely my experience in HS. We had two coaches who were smart and passionate about teaching. We had like nine other coaches, though, and they all had to teach, too. And their classes were miserable demonstrations of what happens when a teacher has neither knowledge of nor interest in the topic they purport to teach. I'm not saying there's any kind of likelihood I would have fallen in love with and pursued the study of history if only I'd had different teachers, but I probably wouldn't blanch at the sight of a history textbook like I do.
posted by solotoro at 6:24 AM on July 28, 2017 [3 favorites]


Just a reminder that CTE is NOT primarily caused by major concussions, but by years and years of subconcussive impacts. Like the ones that happen during every blitz, every play where a person gets knocked to the ground, like the ones that happen after the play when players smack their helmets together in celebration. The tiny hits, the ones where you feel fine after. Thousands of them, over and over, the brain jostled and thrown into the interior wall of the skull, every time.

I’m a major downer when people in my office talk about fantasy football leagues, let me tell ya.
posted by a fiendish thingy at 7:16 AM on July 28, 2017 [18 favorites]


> This statement presumes that you don't consider scholastic sports as educational. I do. I know that I learned more life lessons and more about how to be a contributing member of a community through my participation in sports than I ever did in any class I took in a classroom with walls.

There are many school activities, both sports and non-sports, that teach these things. Football is not necessary to provide this.
posted by at by at 7:41 AM on July 28, 2017 [8 favorites]


Yeah, coaches tend to be coaches first and teachers second. It seems like every social studies class I ever had was taught by a coach who had other priorities. Although, it might have helped me, as those classes were the ones with the most propaganda. The choice of teacher made me skeptical of the message. Also, wasn't there an article a while back that revealed that the highest-paid public employee in most states is a coach? Our tax dollars at work, people. We waste so much time and money and run our kids through the meat grinder for what? Entertainment? We need to ask ourselves if it's worth it.
posted by domo at 8:13 AM on July 28, 2017 [1 favorite]


At the high school I went to, male teachers were commonly called "Coach" even if they didn't coach anything and even if the student wasn't in a sport. Saying "Coach" was just being properly respectful since we all know what confers status.
posted by elizilla at 9:53 AM on July 28, 2017 [2 favorites]




I went to a poor school where many students really, really believed that the only way they could "make it" was as a pro football (or maybe basketball) player. Because they got more time being instructed in sports than in any academic subject. Because they knew one or two people who had made it as pro athletes, and none who were successful in anything else. In that frame of mind, they'd happily take a 100% chance of CTE for a 0.01% chance of going pro. Of course if they had access to a reasonable education and took advantage of it, they'd have a near-100% chance of making a decent income and no chance of CTE. But those weren't the cards they were dealt.
posted by miyabo at 3:08 PM on July 28, 2017


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