Brain injuries and concussions: Legislation must draw from science | Opinion – Lohud

Mark Herceg, Special to the USA TODAY NETWORK Published 12:15 p.m. ET Nov. 8, 2019

Mark Herceg talks about Irvington's approach to handling athlete's suspected concussions. (Video by Nancy Haggerty/The Journal News)

On Tuesday, Oct.29, I had the privilege of testifying before the state Assembly about a proposal to ban youth football in New York.As we know well, concussions have been the hot button topic for well over a decade. Much has changed since I was in graduate school 25 years ago, but we know much more about concussions today and yet we remain in the early scientific stages, regardless of what some may say. There are aspects of the injury, the background of each cohort examined and recovery that we have yet to firmly understand. And the simple reason is the human brain is the most unique and complex organ, with no two brains being alike.

While it is important to have earnest discussions and research, and even criticism, it is also vital that we continue to examine the facts provided by scientific research, and not headlines, or well designed infomercials.

DEBATE GROWS:Should New York ban tackle football for under age 12?

No professional in this field that I know of wants to harm children. While meaningful work has come from Boston University, other studies have not found an incidence of neurocognitive or mental health problems. Studies from Boston University have linked age at first exposure and subconcussive hits over time to increased neurocognitive dysfunction. Sub-concussions remain a research-focused concept that have yet to make their way to clinical understanding.As scientists and clinicians, we have yet to identify clinically observable indicators of these injuries.But in contrast to the important work from BU, a recent study, in the news just last week, from the University of Colorado, found no link between contact sports, in this case football, in a study sample of almost 11,000.

Other studies (Solomon, et al, 2016; Deshpande, et al, 2017, Caccesse, et al, 2019) have also not found a link to contact sports, including football, and later-stage neurocognitive decline. Additionally, a recent study found CTE in 8 individuals without a history of brain injury (Iverson, et al, 2019).

Each of the studies have flaws, and as a clinician and researcher, I cannot take sides but instead, I let the evidence guide me. The discussion in contact sports such as football has almost entirely focused on CTE. The simple truth is we don't know why some people get CTE and others do not. While members of the Boston University group have stated that there is a link between football and CTE, others from Boston University have presented slides at professional conferences that state "repetitive impact exposure is a necessary but not a sufficient cause of CTE."

In other words, not everyone who hits their head will get it.They have also stated that while post mortem description of the neuropathology of CTE has had an effect on public awareness, the public thinks that the science of CTE is more advanced than it really is."

That is an important statement.

As such, it is critical that we examine many other variables in CTE or brain injury and not just football. Equally important is we have yet to understand how the neuropathology of CTE translates to clinical symptoms.It is why I was one of over 60 international scientists to pen a piece in the prestigious journal Lancet Neurology calling for a balance when reporting CTE in March 2019. We just don't have all the answers yet.

As a clinician, research findings guide my treatment of those who sustain concussions and help them and their families make decisions. This is not to say I care about sports more than young developing brains, or that parents who allow their children to play football display bad parenting skills. But I know many former players and families who state that playing football, which includes youth football, changed their lives for the better. But as a scientist, how are we painting the arbitrary cut off lines for participation and risk? What makes head injury exposure at 12 worse than 13 or 14? Is it ok to hit your head at 13 or 14? Is it ok to hit your head in other sports? Why should a small, thin-framed, five-foot-two-inch boy of 13 be allowed to play football but a six-foot, able-bodied, strong athlete at 12 not be allowed? Why limit it to only football? In New York, why does a bike helmet only need to be worn until the age of 14?It becomes a slippery slope and we really dont have the science to back our responses to those questions right now.

Concerns over brain injuries have expanded well beyond the pros. Studies have found the dangerous effects they have on the brain development of young athletes and not just football players.(Photo: The Journal News file photo)

It is premature for public policy to ban one particular sport or activity at this stage, with the research still undecided.We are all committed to the brain health and well being of our children. But we need to collect the data, let the science lead us, make informed decisions, and engage in a robust, civil discourse.

Good public policy needs to be grounded in hypothesis confirming scientific findings. A policy that is not grounded on scientific findings, with a full grasp of all factors, can have unintended consequences.

Mark Herceg is a neuropsychologist atPhelps Hospital. He specializesin treating brain injuriesand concussions.

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Brain injuries and concussions: Legislation must draw from science | Opinion - Lohud