Better News!

O ver the past decade, the sports medicine community has dealt with a very worrisome knowledge gap: that between those who suffer concussions playing football and the postmortem findings of chronic traumatic encephalopathy (CTE) in former National Football League (NFL) players. At one end of the spectrum, we know that football players sustain regular head trauma, and as a medical community, we have become more aware of the acute consequences and clinical course of these events. On the other end, the postmortem CTE findings in some deceased football players understandably generate great concern among football players, their families, the sports medicine community, and American society in general. Our knowledge gap centers on the lives and well-being of those between the 2 ends of the spectrum: living, retired NFL players. Some theorists have already connected the dots, concluding that football concussions lead to CTE. Consequently, a thorough examination of living, former NFL players has the potential to answer several troublesome questions about the natural history of concussion. Is there a detectable course of mental deterioration after football? Can this course be correlated with objective findings on physical examination or imaging studies? Some of this critical information on the health and well-being of retired, former players has been supplied in previous studies. 3,4 However, these surveys must be scrutinized because of their lack of clinical correlation and known methodological shortcomings. In short, in those studies, players were surveyed but not examined. Those studies do not correlate the trends that they detect with objective physical examination or imaging study findings. A study by Hart et al 5 attempted to fill the knowledge gap with an evaluation of 34 retired, living NFL players using neuroimaging to detail cognitive dysfunction and depression. They used neurologic and neuropsychologic assessment along with neuroimaging in a subset (26 players) in comparison with 26 healthy controls. They found cognitive deficits and depression more common in aging former NFL players than healthy controls, generating obvious cause for concern. The most recent study by Casson et al 2 deserves special attention because of the extent of the examinations performed. Forty-five former NFL players were studied as a convenience sample in an age range from 30 to 60 years. They had played in the NFL for an average of 6.8 ± 3.2 years and sustained an average of 9.0 ± 6.9 concussions in their football careers, which included an average of 12.2 …