Sports Illustrated The MMQB Interviews Dr. Williams About New Study Linking CTE to Football Players

Posted By Vernon B. Williams, MD || 27-Jul-2017

Dr. Vernon Williams, director of sports neurology and pain medicine at the Kerlan-Jobe Institute in Los Angeles, and a consultant for the Rams, has seen the change in mentality happen before his eyes the past few years.

“Two years ago, I’m talking with a coach, a Super Bowl-winning coach, about this kind of injury,” Williams said this week. “And he said, ‘a few years ago, if you told me 44 is out with a concussion, I’m going to 44 and saying what’s up?’ The implication was, and you didn’t have to even say it, ‘Are you with us or not? Let’s get going!’

“And then he said, ‘It’s completely different now. Now, I don’t want a guy back in there if he’s not ready.’ Part of that is the player’s well-being. But part is also recognizing they don’t perform as well. Things like speed of mental processing, memory, balance, decision-making and the increased likelihood of other usage injuries all play into it. It’s definitely changed.”

And yet, there’s still a long way to go.

On Tuesday, the New York Times and Washington Post published the results of a Boston University study into the brains of 111 ex-NFL players, finding that 110 tested positive for CTE. Considering that, and the rest of the work done by BU, our offseason lesson for this week: We still don’t know nearly enough about football’s impact on the brain.

Without being able to test for CTE in the living, Williams explains, it’s hard for doctors to connect the pathological abnormalities to clinical symptoms. Are slowed cognition, violent tempers and depression all directly connected to CTE? Or are other factors like genetic predisposition or PED use or other damage from the game at work? Williams’ belief is that “it’s probably multi-factorial.”

But, no one knows definitively—yet. What can we draw from the BU study? I asked Williams, and a few things that he said stuck out.

The big one was the range in age of the players studied—23 to 89. That CTE was found in a 23-year-old brain, in particular, was interesting to the veteran neurologist. “Is there a dose effect here?” Williams asked. “In other words, since there’s a 23 year old, is it a little CTE at a young age and a lot at an older age? That’s a pattern suggested. This pattern suggests a dose effect.”

On the flip side, Williams believes the caveat that BU was sure to emphasize—that the study was inherently biased, since the brains were donated by patients concerned about the effects head injuries had on them—is important, too.