A group of over 60 leading international neuroscientists have called for caution when reporting on the potential late effects of head injuries in sport.

In correspondence, published today in The Lancet Neurology, experts in research and clinical practice in brain injury from around the world have asked for balance when reporting on chronic traumatic encephalopathy (CTE).

cte

A type of dementia associated with exposure to repeated concussions, CTE has been linked with a variety of contact sports such as boxing, football, American football and rugby. 

However, the letter’s authors are concerned about the tone of reporting around this issue – specifically the lack of acknowledgement that CTE is at an early stage of scientific and medical understanding, with many important aspects of the disease yet to be established.

Crucially, although CTE is commonly discussed in scientific papers and the media, there is often a failure to note that there is only preliminary agreement on how to recognise this disease, and no agreement on how to assess its severity.  There is also no clear understanding of the link between CTE pathology and any specific symptoms.

The corresponding author, Dr Willie Stewart, Consultant Neuropathologist and Honorary Clinical Associate Professor at the University of Glasgow, said: “In recent years there has been a worrying trend to imply that the causes, diagnosis and prevalence of CTE are fully understood, or at least that data to date leave little doubt.”

“The truth is we know very little about CTE, certainly not enough to be able to estimate with any certainty how many people might be affected, or what the various symptoms might be. Much more research effort is required before we can confidently say we understand this condition.”

Another author, Dr. Douglas H. Smith, Professor of Neurosurgery and Director of the Center for Brain Injury and Repair at the Perelman School of Medicine at the University of Pennsylvania, said: “Current reporting on the possible consequences of CTE without acknowledging the many unknowns and uncertainties can do real harm.

“In particular, individuals with potentially treatable conditions might make decisions on their future based on a misguided understanding that their symptoms are the inevitable consequence of a brain disease that will lead to dementia."

The Correspondence letter, ‘Primum non nocere: a call for balance when reporting on CTE’ is published in The Lancet Neurology.  

First published: 12 February 2019

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