An N.F.L. Doctor Wants to Know Why Some Players Get C.T.E. and Others Don't

An N.F.L. Doctor Wants to Know Why Some Players Get C.T.E. and Others Don't

The National Sports Brain Bank, newly established, plans to study specific head injuries in athletes. Jerome Bettis already pledged his brain donation.

Credit...Kristian T. Thacker, The New York Times

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Ken Belson

May 18, 2023

Joseph Maroon is a neurosurgeon who began consulting for the Pittsburgh Steelers in 1977. Over the past 46 years, he has treated and examined stars of the notoriously tough dynasty including Terry Bradshaw Mean Joe Greene, and Lynn Swann.

He said that many of them worry about their brains' health because they played at a time when concussions and full-contact practice were the norm, and even the most violent of hits was allowed.

Maroon, who works at the University of Pittsburgh Medical Center Presbyterian Hospital, said that everyone involved in this level of play is concerned. He spoke last week at his office. We haven't experienced the epidemic one would expect from playing at that time with fewer protective helmets and a softer field. There are just so many unknowns.

In the last 15 years, an increasing number of scientific studies have shown a link between repeated head injuries and chronic traumatic brain disease. C.T.E. has been a major source of information for many. The C.T.E. Players, athletes and military personnel.

Maroon has in the past called C.T.E. rates among football players a 'rare' phenomenon and 'over-exaggerated. Football players are a rare' and over-exaggerated' phenomenon. Maroon felt that more research was needed on the reasons why some athletes show few symptoms of C.T.E.



Five years ago, Maroon, along with the Steelers' Art Rooney II owner, approached the University of Pittsburgh's Alzheimer's Disease Research Center about starting a sports brain bank to study the role that age, genes, substance abuse and head hits play in C.T.E.

The National Sports Brain Bank will be officially opened at the University of Pittsburgh on Thursday. The center, which was delayed by several years due to the Covid-19 epidemic, has now accepted brain donations from former Steelers runningbacks Jerome Bettis & Merril Hoge.


The center will begin to recruit volunteers, including athletes of all levels and non-athletes as a "control group" to give their health histories. They will be monitored over the next few years. This information will be compared with the condition of their brains when they die in order to determine if there were any factors that contributed to their C.T.E.

Julia Kofler is the director of neuropathology at the University of Pittsburgh. She will be overseeing the sports brain banks. You can see cases with very little pathology and symptoms. That's what's important. I believe we need as many cases as possible to answer these questions.


The National Sports Brain Bank is going to rely on infrastructure from the Alzheimer's Disease Research Center. This center already has over 2,000 brains. However, most of them are not athletes. The Sports Brain Bank is using seed funding from the Chuck Noll Foundation as well as the Pittsburgh Foundation and Richard King Mellon Foundation in order to recruit volunteers and brain donors for a long-term study.

Researchers have 1,350 brains from footballers, athletes from other sports such as rugby, hockey, soccer, and more, as well military personnel. About 700 of these brains were found to contain C.T.E.

Maroon, however, said that the Boston group's research was biased because the families donated the brains from relatives who had C.T.E. symptoms when they were alive. When they were still alive, families often donated the brains of relatives who had symptoms consistent with C.T.E. Families may not be able to recall the exact details of head trauma suffered by their loved ones when asked.

Maroon stated that the long-term research undertaken by researchers in Pittsburgh would'reduce or eliminate this kind of bias'.



Ann McKee is the neuropathologist and director of the C.T.E. Ann McKee, the neuropathologist who leads the C.T.E. She said that doctors at Boston University are already conducting several longitudinal studies.

McKee added that "it is always good to have another group on board, it will accelerate research and scientific discoveries and, in particular, treatment." That's great.

The National Sports Brain Bank, unlike Boston University does not hide its ties with the N.F.L. The Chuck Noll Brain Research Foundation, named after the former Steelers coach diagnosed with Alzheimer's before his death in 2014. This foundation has contributed seed money to the bank. The Chuck Noll Foundation for Brain Research, named after the former Steelers head coach who was diagnosed with Alzheimer's disease before his death in 2014, has contributed seed money to the bank.

Rooney told a telephone interviewer that it was crucial for the Steelers to get behind this. We're still in the beginning stages, but we hope that this project will get the attention it needs to be successful.

Hoge, a former Steelers runningback who has agreed that he will donate his brain, explained that he chose the National Sports Brain Bank as the University of Pittsburgh, and other institutions, had been centers of innovation for brain health in Pittsburgh, including the development of the helmet technology. Noll, Hoge's former coach, pushed to develop a test that would evaluate a player’s cognitive abilities and could be used to determine concussions. This was a precursor to the Immediate post-concussion assessment and cognitive test (IMPACT), which is used worldwide.


Hoge, who co-wrote in 2018 the book "Brainwashed": The Bad Science behind C.T.E. Hoge, who in 2018 co-wrote the book 'Brainwashed: The Bad Science Behind C.T.E.

Hoge stated that there was a lot of misinformation and fear. It is important to me that I help them find the right information, and give them resources and other information in order to assist them with their thought process.

Gil Rabinovici of the Alzheimer's Disease Research Center of the University of California in San Francisco said, "This type of research can only be conducted when both the funders of the study and the investigators have no conflicts of interest." He was referring to N.F.L. links of the Pittsburgh group. links.

He said that Boston researchers had done a 'great job' in describing C.T.E. pathology, but in science you want independent replication, with different groups studying similar scientific questions using different methodologies, and hopefully coming to similar conclusions.