Planet Rugby

Scientist blasts concussion hysteria

19th June 2014 07:05

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Toulouse centre Florian Fritz leaves the pitc 3138814

Disgrace: Florian Fritz saga

A neuropsychologist slams the hysteria over concussion in rugby, and denies the existence of degenerative brain disease, CTE, now diagnosed in several ex-rugby players.

In the ten months or so I have investigated, reported and commented on concussion in rugby, I have spoken to current and retired players, governing bodies, researchers, neurosurgeons and neuroscientists from Boston, to Birmingham to Melbourne and back again.

Such is the nature of science and the incredible complexity of the human brain, differences of opinion are common, and the area represents a minefield of beliefs and attitudes.

But never had I come across such scathing testimony that flew in the face of everything reported in today's media and everything widely accepted about head trauma and its effects until I heard Dr Jim Andrikopoulos.

In the space of one three-hour phone call from my home in Scotland to his office in Des Moines, Iowa, the neuropsychologist had systematically torn to shreds the research undertaken at Boston University's Centre for the Study of Traumatic Encephalopathy, where the brains of ex-rugby players have been examined in conjunction with scores of NFL footballers and diagnosed with the degenerative brain disease, Chronic Traumatic Encephalopathy (CTE).

He had attacked the call from former IRB medical adviser Dr Barry O'Driscoll to have parents pull their children out of rugby in the wake of the Florian Fritz farce.

He had claimed the phenomenon known as Second Impact Syndrome that led to the tragic death of Northern Irish schoolboy Ben Robinson did not exist.

And he slammed the manner in which - he believes - the "concussion crisis" has been wildly blown out of proportion in America by media sensationalism and hysteria, fuelled by select members of the scientific community. I was stunned.

To understand Andrikopoulos' withering statements, a brief detour through the murky waters of neurology and historical brain research is necessary.

The term CTE was first coined nearly sixty years ago by British neurologist Macdonald Critchley, who described symptoms akin to Parkinson's disease in boxers who, in the pre-WWII era, had fought hundreds of competitive bouts and sustained tremendous and recurrent head trauma.

Andrikopoulos claims that this form of CTE is completely different to that which has sent shock-waves through global collision sport, emanating from Boston and research led by Dr Bob Cantu, Dr Ann McKee, Dr Robert Stern , and ex-professional wrestler turned concussion campaigner, Chris Nowinski.

In fact, he goes as far as to say the syndrome - characterised by the build-up of abnormal tau protein in the brain - does not exist. That it is an illusion conjured by what he terms "concussion doctors", clinicians whose neurological knowledge is limited to concussion.

That it cannot come about simply through playing rugby. That the families of diseased and deceased American footballers suing the NFL in a multi-million dollar class action are guilty of extortion.

"This is not just a boxer problem, it's not just an American football problem, it's not just an ice hockey problem, it's a rugby problem, it's a football problem, it's a global problem," said Dr Willlie Stewart, a consultant neuropathologist in Glasgow who diagnosed the first case of CTE in the brain of a deceased amateur rugby player last year in an Irish Independent interview this month.

"Can you suffer CTE from playing sports like rugby? No," replies Andrikopoulos.

"Can repeated head injuries from sports like rugby produce deposits of tau protein in the brain? I believe that to be true.

"But CTE as defined by Boston is an illusion; the literature bears that out. They made up a disease that they're telling us can only be diagnosed post-mortem. There is no precedent for that in the history of clinical neurology. They have to go backwards, go to the parents, the kids, or the spouse to collect the symptoms.

"CTE is a disease you can see and hear in living people, in the form of Parkinson's-like symptoms and speech problems.

"There's the famous case of (ex-NFL athlete) Tom McHale. His wife, Lisa, is now a representative at Boston. He happened to overdose on drugs: he was a coke user, a drug addict. He played football, Boston got his brain and they said, 'you know what, he's got CTE'.

"His wife now says, 'Actually, he was a good father, he loved his three boys, he loved me, it was the disease that made him take drugs. Now that I see all my husband went through with this addiction, using cocaine, dying on the couch of a friend, was down to the disease.' That story was then fed to the media.

"And the modus operandi here for selling CTE is to do it in the media: if it bleeds, it reads. The American public is in complete hysteria over this.

"Even if you ask Dr Cantu if he believes that the media has overstated this, I believe Dr Cantu would tell you, yes.

"Then I would ask him to what extent do you believe that you and the Centre for Study of Traumatic Encephalopathy is directly responsible for this?

"My heart bleeds for the McHale family, but I'd like to say to Lisa, 'your husband had no CTE, your husband was a coke user, abused prescription drugs and died on the couch of a friend because you kicked him out of the house because you didn't want your kids exposed to drugs. Enough is enough. Stop telling mothers, families, sons, daughters, stop holding these family meetings and telling people this. It's offensive.'

"This litigation is extortion by people who are largely bankrupt. 80% of football players are bankrupt five years after they leave the game. It is simply extortion."

Andrikopoulos is a clinician of some 20 years, and reckons to have seen circa 250 cases of civilian concussion. A one-time ice hockey fanatic, he became interested, then engrossed, in the CTE-sports concussion saga when a beloved former star player, Rick Martin, was posthumously diagnosed with the disease by the Boston researchers in 2011.

He scanned, copied and read entire books, digested all the research papers he could lay hands on from the 1920s to the present day, then made efforts to gain some sports concussion knowledge of his own.

He began writing letters to journal editors criticising the research, and contacted as many governing bodies as he can. Though stating any correspondence is and will remain confidential, he was "pleased with the responses I got at a level that can influence policy".

He is affronted by what he sees as an attack on the integrity of his field.

"I am really offended by what I believe is intellectual dishonesty if not outright fabrication," he says.

Andrikopoulos believes the Boston group are guilty of "poor science", "non-science" and "scaremongering", frightening parents away from sports their children should participate in and enjoy. He labels O'Driscoll's comments "plain irresponsible", and says that although people can suffer brain swelling and die after a head injury, Second Impact Syndrome is not a real condition.

"What better way to scare the bejesus out of parents is than telling them if we don't recognise that first concussion and we send that player back onto the field they are going to die or be permanently disabled?" he asks.

"With great respect to the Robinson family, these things happen; that's the risk you run. We know in younger people, it is probably due to the development of the brain. But we have no evidence that this is the result of a second impact."

So what would this neuropsychologist say to concerned parents, to players and to the IRB?

"CTE does not exist, and Second Impact Syndrome is controversial; it's not the result of a second impact. I would not worry about concussion because it's transient, and kids should play, enjoy themselves and not be worried," he argues.

"There is no new medical evidence that suggests anything has changed with regards to the safety of those kids in rugby that causes us to change in any meaningful way what we've always done. Any evidence that does exist is not true empirical evidence and in my opinion, affects the integrity of the game.

"For the IRB, we've had this experience here in the States, we've lived through this experience, we've had time to analyse this experience. We are further along in the debate here than in the UK, but we are backwards.

"They have an obligation to make the decision whether they're going to tell parents that their child is going to develop a degenerative condition in just 40 years from playing rugby.

"My advice to the IRB is to stand firm."

By Jamie Lyall

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