Wednesday , April 26 2017

Do football injuries cause ALS? We explain the evidence

Scientists are once again calling on the NFL to acknowledge the links between football injuries and devastating brain diseases such as ALS and Alzheimer’s.

It has been a subject of contention for years as more and more studies show concrete evidence that heavy-impact slams to the head can wreak havoc in the brain.

Indeed, a landmark report by the the Centers for Disease Control and Prevention in 2012 said NFL players were four times more likely to die from ALS than the rest of the US population.

The NFL has made some motions to play ball, such as setting up a reimbursement fund (The 88 Plan) for former players diagnosed with neurodegenerative diseases.

But the franchise has fallen short of officially acknowledging the ties exist – and the debate resurfaced on Sunday night as San Francisco 49ers legend Dwight Clark became the latest NFL star to reveal he has ALS.

Former NFL star Dwight Clark (above) announced Sunday he has amyotrophic lateral sclerosisFormer NFL star Dwight Clark (above) announced Sunday he has amyotrophic lateral sclerosis

Former NFL star Dwight Clark (above) announced Sunday he has amyotrophic lateral sclerosis

Clark tweeted a link to his statement Sunday nightClark tweeted a link to his statement Sunday night

Clark tweeted a link to his statement Sunday night

WHAT IS AMYOTROPHIC LATERAL SCLEROSIS?

ALS is an acronym for amyotrophic lateral sclerosis.

It is also referred to as motor neurone disease, or Lou Gehrig’s Disease after the US baseball player when he was diagnosed in 1939 at just 36 years old.

The disease is a rare condition that progressively damages parts of the nervous system.

It occurs when specialist nerve cells in the brain and spinal cord called motor neurones stop working properly – known as neurodegeneration.

Life expectancy for about half of those with the condition is three years from the start of symptoms.

However, some people may live for up to 10 years, and in rarer circumstances even longer.

The condition can affect adults of all ages, including teenagers, although this is extremely rare.

It’s usually diagnosed in people over 40, but most people with the condition first develop symptoms in their 60s. It affects slightly more men than women.

There’s currently no cure for motor neurone disease.

Treatment aims to make the person feel comfortable and have the best quality of life possible

It also tries to compensate for the progressive loss of bodily functions such as mobility, communication, swallowing and breathing.

ALS, also known as Lou Gehrig’s disease, affects two in every 100,000 people. It is incurable, and has a life expectancy of three to 10 years.

Clark, 60, revealed he was diagnosed a few months ago with amyotrophic lateral sclerosis – a disorder that causes muscle weakness and eventual paralysis.

He is not the only one: players who contracted ALS in the wake of their football career include Steve Gleason of the New Orleans Saints, Tim Shaw of the Tennessee Titans, and Kevin Turner of the New England Patriots, who died aged 46 last year.

ALS is one of the diseases covered by The 88 Plan, which provides up to $88,000 a year for institutional care and up to $50,000 for home custodial care, plus costs for certain doctor care, medical equipment and medication.

However, neuropathologists claim there are some major pitfalls.

First, The 88 Plan does not acknowledge CTE (chronic traumatic encephalopathy) as a football-linked disease, despite the fact that CTE is common in ALS sufferers, and studies show at least 17 former players suffered an early death from CTE.

Second, despite offering some coverage, the NFL has refrained from assisting in medical research, fundraising, and discussing the ties directly.

These two points of contention reemerged on Sunday after Clark tweeted a link to a statement, with the words: ‘I want to share some unfortunate news: I have ALS’.

Clark played with the 49ers for nine seasons, in which he won two Super Bowls and entered team lore for ‘The Catch’ from Joe Montana in the 1981 National Football Conference championship game that helped the 49ers clinch a spot in their first Super Bowl.

Weakness in Clark’s left hand in September 2015 made him think something was wrong.

Doctors initially diagnosed him with a B-12 vitamin deficiency, which can mirror ALS symptoms.

Eventually, he lost feeling and control in his right hand, lower back, legs, and abdominal muscles – which led to his diagnosis.

He is now unable to run or walk.

I’ve been asked if playing football caused this. I don’t know for sure. But I certainly suspect it did
Dwight Clark

‘The one piece of good news is that the disease seems to be progressing more slowly than in some patients,’ Clark said in a statement.

‘I was mildly paying attention to it because since my playing days, I’ve constantly had pain in my neck,’ Clark wrote. ‘I was thinking it was related to some kind of nerve damage because it would just come and go.’

‘I’ve been asked if playing football caused this. I don’t know for sure. But I certainly suspect it did,’ wrote Clark.

‘And I encourage the NFLPA [the NFL Players’ Association] and the NFL to continue working together in their efforts to make the game of football safer, especially as it relates to head trauma.’

His words are nothing new – though experts hope this call from such a revered figure as Clark may trigger some more concrete action.

NFL PLAYERS DIAGNOSED WITH ALS POST-CAREER

Dozens of former NFL players have been diagnosed with ALS after the end of their career. They include:

New Orleans Saints safety Steve Gleason, 40, pictured with his wife and son last yearNew Orleans Saints safety Steve Gleason, 40, pictured with his wife and son last year

New Orleans Saints safety Steve Gleason, 40, pictured with his wife and son last year

Tennessee Titans linebacker Tim Shaw , 32 (pictured in 2012)Tennessee Titans linebacker Tim Shaw , 32 (pictured in 2012)
Minnesota Vikings safety Orlando Thomas (pictured in 2000) died aged 42 in 2014Minnesota Vikings safety Orlando Thomas (pictured in 2000) died aged 42 in 2014

Tennessee Titans linebacker Tim Shaw , 32 (pictured, left, in 2012). Minnesota Vikings safety Orlando Thomas (pictured, right, in 2000) died aged 42 in 2014

OJ BriganceOJ Brigance
OJ BriganceOJ Brigance

Baltimore Ravens linebacker OJ Brigance , 47 (pictured, left, in 2001 and, right, in 2015)

There was widespread expectation in 2012 that the NFL would acknowledge the ties after the CDC’s landmark report.

Looking at death certificates, it found players are four times more likely to contract ALS than other Americans.

The report drew on a long-running study of more than 3,400 NFL players with at least five playing seasons in the league between 1959 and 1988. Some 334 had died by the end of 2007, the cutoff for being included in the study. Researchers compared their death rates from various causes to that of a comparable group of American men.

One or another of the three brain diseases was listed as the underlying cause of death in 10 cases, which is about three times the general rate for American men, the researchers reported.

Researchers noted that the study couldn’t prove that the results were caused by football-related concussions, and that they may not apply to pro or amateur players who’ve played fewer than five years.

Experts say one of the most compelling reasons for the NFL to support ALS research is to clarify the link between concussions and CTE.

CTE is not acknowledged by the NFL, nor is it covered by The 88 Plan.

However, experts believe many brain disease deaths counted in the CDC study may have actually come from misdiagnosed CTE, which can only be diagnosed by an autopsy.

The NFL is not completely quiet on the matter. Commissioner Roger Goodell did release a statement on the 2012 research, saying it could benefit athletes and potential areas of study may include CTE, concussion management and treatment and disorders from later in life such as Alzheimer’s.

But campaigners and patients are calling for more.

The biggest campaign for affected NFL players and other ALS sufferers was started by Steve Gleason.

The former Saints safety dedicated his life to improving the lives of ALS patients and finding a cure, by launching his nonprofit foundation Team Gleason.

He’s raised money to send ALS patients on international adventures and last year successfully lobbied Congress to pass the Steve Gleason Act, making speech-generating technology for ALS patients covered through Medicare and Medicaid.

Gleason also famously started the ice bucket challenge.

STUDIES SHOW SPORTS INJURIES COULD CAUSE BRAIN DISEASES

1. CLEAR LINK BETWEEN LOW-IMPACT INJURY AND ALZHEIMER’S

Research published last week confirmed the strongest ever link between sports concussions and Alzheimer’s disease.

Until now, doctors only considered severe traumatic brain injury a key risk factor for developing neurodegenerative diseases.

But the new study by Boston University School of Medicine (BUSM) has – for the first time – shown even low-impact injuries like concussion could have life-threatening consequences.

They reached their conclusion by scanning the brains of 160 wounded war veterans after tours in Iraq and Afghanistan.

Using MRI imaging, the researchers measured the thickness of their cerebral cortex in seven regions that have been pegged at the ‘ground zero’ for Alzheimer’s disease.

They also scanned seven control regions – regions that tend not to be affected.

They found that having a concussion was associated with lower cortical thickness in brain regions that are the first to be affected in Alzheimer’s disease.

Lead author, Dr Jasmeet Hayes, said: ‘Our results suggest that when combined with genetic factors, concussions may be associated with accelerated cortical thickness and memory decline in Alzheimer’s disease relevant areas.’

2. BRAIN CHANGES IN HIGH SCHOOL PLAYERS AFTER JUST ONE SEASON

A study at Wake Forest School of Medicine has been examining the brains of high school football players.

One of the participants is the son of former Minnesota Vikings player Greg DeLong.

The study published in the journal Radiology found measurable brain changes in teen players after a single season of ball – even without a concussion diagnosis.

Now DeLong is speaking out to say he would have seriously reconsidered his football career if he had known the risks.

‘Football’s important to us, but there are other things out there that are more important,’ DeLong told Good Morning America.

3. CDC BUILDING DATABASE ON SPORTS-RELATED CONCUSSIONS

The CDC has estimated that up to 3.8 million concussions occur in sports and recreational activities each year.

But some experts wonder if those numbers underestimate total brain injuries, as some individuals may not seek treatment for mild or moderate symptoms.

The agency has applied for federal funding to create a database in order to investigate sport injuries and brain diseases more in-depth.

Meanwhile, the state of Texas has embarked on the largest ever study into concussions.

State officials hope to track brain injuries among high school sports to discover whether more needs to be done to improve player safety and protect athletes.

The University Interscholastic League, Texas’ governing body for public high school sports, is partnering with the O’Donnell Brain Institute at UT Southwestern Medical Center for the project.

A state as large as Texas, which has more than 800,000 public high school athletes, would be a key step in developing a national database of brain injuries in youths, officials say.

Posted on; DailyMail>>

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