03 July, 2011

Links between heavy impact sports and brain disease are too close for comfort: - with thanks to former Ireland rugby international Neil Francis:

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PAUL DARBYSHIRE: wishing him well in his next life
It is significant that nearly all NFL and rugby players are diagnosed in their mid to late 30s - sometimes much earlier         

Last week we learned that Munster strength and conditioning coach Paul Darbyshire had lost his battle with Motor Neuron Disease (MND).  The use of the word 'battle' evokes the notion that there was some form of contest going on.  There would indeed be winners and losers as there are in every contest.  In this case however, the winners and losers were pre-determined.
          Darbyshire's father died from the disease years ago; it left him in a minority of 5% of the population who are genetically pre-disposed towards the disease.   Darbyshire diagnosed himself and only presented himself clinically for confirmation.  He is one of the few rugby players who had the disease where you were not inclined to ask the question: is there a link between rugby/heavy impact contact sports and MND?
Wally Hilgenberger (Number 58): too many collisions
Progressive paralysis, physical impairment and atrophy occur before the end of life of an MND sufferer.  It's a grim exit.  I had heard that former Leeds manager Don Revie died from the disease.  Aside from that I did not know of anyone who had died from the disease.  The disease re-surfaced again last year on a HBO television documentary called  "Real Sports"  with the broadcaster Bryant Gumbel.  This episode was called 'After the Hits.'  The programme focused on Lou Gehrig's Disease also known as Motor Neuron Disease (MND) or ALS.
Neurology Professor: Dr. Ann McKee
          The clinical focus centred on Dr. Anne McKee of Boston University and Dr. Chris Nowinski of Harvard University who, after extensive research produced a paper which made a connection between brain trauma and concussion suffered in contact sport (NFL) and MND.  McKee's interest was caught by the diagnosis of Wally Hilgenberg, a line backer with the Minnesota Vikings - Hilgenberg was diagnosed with MND.  What sparked McKee's interest was that he was one of several sufferers on the same team.  After Hilgenberg's death; analysis on his brain and spinal cord and those of 12 other deceased NFL players - indicated the first firm pathological indications that brain trauma results in motor neuron degeneration.  All of the brains examined had chronic traumatic encephalopathy (CTE), a progressive disease in brain tissue that results in cognitive impairment and eventually dementia.  
          CTE is a pre-cursor to all sorts of neurological impairment.  The NFL has a disproportionate level compared to the general population of dementia, depression and Alzheimer's.  There are many reasons for this, but we know what the primary ingredient is.  Suicide is also at epidemic lengths among former and current players.  In the NFL though, Motor Neuron Disease is eight times the national average.
2008  Zurich Conference
          In a week when Berwick Barnes, the Australian centre who would have played a part in his country's pool match against Ireland this Septmeber, was advised to take an indefinite break from rugby as a result of continuous concussions sustained on the field of play, the IRB brought in revised protocols governing concussion evaluation and what are called  "graduate returns to play."   Sterling work lads.  The programme used the  'Zurich Consensus'  as a template and initiated their procedures based on its principles.  The Zurich Conference took place in November 2008 - I'm just wondering why it took two and a half years to implement?
           I have always thought the term 'proactive' was to have the capacity, foresight or vision to see something coming down the line and pre-empt or take calculated corrective action.  The latest action from the IRB has the sheen of reactionism to it.  A legal rearguard action or a preventative move based on the realisation that a game whose force equals to mass times acceleration quite often leaves is combatants with brain injuries and they are only a year or two from following the NFL into litigation from players who are brain damaged or worse.
          It is an unfortunate situation.  You still have people who smoke 40 a day suing tobacco companies for giving them lung cancer.  You cannot play a high-intensity contact sport without picking up head injuries - what these morph into in later life is a matter of chance - at the moment all I am doing is pointing out a series of coincidences.  In 50 years time or, hopefully, sooner, we will know for definite.
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