Wednesday, May 25, 2011

Clarification: The Term ‘Chronic Traumatic Encephelopathy’ Does Date Back to 1969

[posted 5/11/11 to htt]

A couple of different readers, with a couple of different viewpoints, have told me that my coverage of the announcement of Dave Duerson’s chronic traumatic encephalopathy maligned Boston University’s Dr. Robert Cantu by stating that he had vaguely backdated the definition and naming of the disease in a way that disrespects the work of Dr. Bennet Omalu.

On this point, I think the critics are right and I was wrong, so let me correct the record here.

After that, I’ll proceed to explain why I believe exposure of my error only deepens the suspicions that the sports medical establishment fell down on the job and that the National Football League was none too eager to see that a better j be done.

What Cantu said in Boston a week ago Monday was that CTE was identified in boxers as “punch drunk syndrome” in the 1920s, and “since the sixties and especially the seventies it has been known as chronic traumatic encephalopathy, with multiple case reports in the world’s clinical and neuropathological literature.” (The press conference video is at

That is accurate. Nor is there any reason to dispute this fuller chronology by the Sports Legacy Institute at

The term “Chronic Traumatic Encephalopathy” appears in the medical literature as early as 1969 and is now the preferred term. Through 2009 there were only 49 cases described in all medical literature since 1928, 39 of whom were boxers. Many thought this was a disease exclusive to boxers, although cases have been identified in a battered wife, an epileptic, two mentally challenged individuals with head-banging behavior, and an Australian circus performer who was also involved in what the medical report authors referred to as “dwarf-throwing.”

CTE remained under the radar when a Pittsburgh medical examiner named Bennet Omalu identified CTE in two former Pittsburgh Steelers who died in his jurisdiction in 2002 and 2005. He published his findings, drawing the attention of SLI co-founder Chris Nowinski, who worked with families to deliver three more cases that Dr. Omalu and others diagnosed with CTE, including SLI’s first case, former WWE wrestler Chris Benoit.


What happened?

In my several lengthy conversations with Dr. Omalu, he has taken credit for the term CTE; on one occasion, Omalu even gently reminded me that he had been the sole, and not merely a major contributory, coiner of it. To the extent that I ran with Omalu’s assertion, bad on me. If I’ve somehow misinterpreted what Omalu has been telling me (but I don’t think I have), then double-bad on me. (Omalu declined comment in an email this morning.)

Now that that piece is out of the way – again, apologies to Cantu, Chris Nowinski’s SLI, and the Center for the Study of CTE for the implication that they were deflecting due credit to Omalu by fudging history – what does all this mean for the story of the national head injury crisis in sports?

The answer is that it is, if anything, even less flattering to the powers-that-be.

Bennet Omalu didn’t discover CTE or even attach the most widely recognized handle to it. He was just the first to identify CTE in football players.

CTE was wending its way through the medical literature throughout the 1970s in association not just with boxers, but with battered women and circus performers as well. Meanwhile, as concussions took a skyrocketing toll on football players over the next 30 years, no one made the connection.

Remember Travis Williams, “the Road Runner,” a speedy running back who set kickoff return records as a rookie for the 1967 Super Bowl champion Green Bay Packers? He was finished way too early, battled depression, wound up penniless in a homeless shelter in Richmond, California, and died at 45. Of course, we can’t know if Williams had CTE, but his story is just one of dozens or scores or hundreds of similar ones prior to that day in 2002 when Omalu happened upon Mike Webster’s brain.

All of which leads to another broad observation – about the folly of “peer-reviewed scientific literature.” This phrase, preferably uttered in hushed tones and on bended knee, is the talisman of the same priesthood that has failed a sports-mad nation in disseminating needed public health information. Peer review, in my opinion, is a pastiche of standards, honored as much in the breach as in the observance when convenient, and it comes embedded with its own set of social, professional, and commercial biases. More on this in tomorrow’s post.

Irv Muchnick

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