Neurologist Denies Concussion-Disease Link

In a October 2003 file photo Kyle Turley of the St. Louis Rams is treated after suffering a concussion during a game against the Green Bay Packers. He was brought back to practice a few days later. Dr. Ira Casson, a neurologist who resigned from an NFL panel studying head injuries, said during a House Judiciary Committee hearing on Monday, Jan. 4, 2010, that there is not enough evidence to determine whether repeated head impacts in pro football result in long-term brain damage. AP/Kyle Ericson, Paul Sancya

Under questioning from Congress, a doctor who used to lead the NFL's concussion committee stuck to his position that there is no proven connection between football head injuries and brain disease.

Members of the House Judiciary Committee expressed frustration at the oral and written testimony delivered at Monday's hearing by Dr. Ira Casson, a neurologist from New York and former co-chairman of the NFL's panel on head injuries.

"There is not enough valid, reliable or objective scientific evidence at present to determine whether or not repeat head impacts in professional football result in long-term brain damage," Casson said.

Lawmakers had made a big deal out of Casson's absence at an Oct. 28 hearing on the same topic, and they went after him in direct questioning Monday, at a committee hearing held at Wayne State University in Michigan, the home state of Committee Chairman Rep. John Conyers.

Hearing: Legal Issues Relating to Football Head Injuries

Rep. Linda Sanchez, D-Calif., also took shots at the league. She has compared the NFL's stance to that of tobacco companies who denied a connection between smoking and lung disease.

"I find it really ridiculous that he's saying that concussions don't cause long-term cognitive problems," Sanchez said. "I think most people you ask on the street would figure that repeated blows to the head aren't good for you."

Dr. Randall Benson, a neurologist and professor at Wayne State University, agreed with her.

"It's easy to wait for absolutes when there are no absolutes in what we do," he said. "It's common sense that playing football causes brain injuries. I think the questioning was somewhat of a waste of time because we all knew what Dr. Casson was going to say."

Sanchez noted that the league formed its concussion committee in 1994, and wondered aloud whether the league's recent moves on concussions took far too long to come about.

"It seems to me that the NFL has literally been dragging its feet on this issue until the past few years," Sanchez said, later asking: "Why did it take 15 years?"

Casson said it was "completely incorrect," to characterize the committee as having ignored the problem.

He resigned as co-chairman of the NFL's committee on mild traumatic brain injury in November, saying it was a mutual decision between himself and commissioner Roger Goodell. [Goodell was not present at Monday's hearing.]

In written testimony Monday, he laid out reasons why there were flaws in recent studies - including some funded by the NFL - examining football head injuries.

"Some have suggested that scientific evidence regarding the question at hand is conclusive and that there is no need for further research," Casson said in his prepared testimony. "I strongly disagree with that position."

(AP Photo/Paul Sancya)
He said more research must be done on the effects of performance-enhancing drugs on the brains of football players.

(Left: Rep. Linda Sanchez, D-Calif. views an older NFL football helmet during a hearing on sports head injuries in Detroit, Jan. 4, 2010.)

Since then, the league has instituted stricter return-to-play guidelines for players showing concussion symptoms; required each team to enlist an independent neurologist as an adviser; entered into a partnership with Boston University brain researchers who have been critical of the league's stance on concussions; and conducted tests on helmets. The validity of those tests was questioned by witnesses at the hearing.

Asked for his thoughts on those changes, Casson questioned the merits of the independent neurologist mandate.

"We don't know if these independent neurologists have expertise in head injuries," he said. "We don't know if their opinions are going to be independent and reliable and stand up to scrutiny."

Rep. Steve Cohen, D-Tenn., said he sensed that the league's recent moves could have resulted from concern about lawsuits, as in, "'What did we know and when did we know it?' - and that should be secondary to the health of the NFL players and the college players and the kiddie league players and the high school players," he said.

Addressing Joseph Maroon, a team doctor for the Pittsburgh Steelers and current member of the NFL concussion committee, Sanchez asked: "Why do you think it took that long for the NFL to bring about these rules changes - or am I just being crazy?"

Maroon replied: "I dispute your position that nothing has been done since 1994."

Sanchez also pressed Casson on whether the "concept of permanent brain damage and dementia following repeated blows to the head is a very well-established and generally accepted principle in medicine."

Casson refused to give a direct answer, and Sanchez's tone grew more exasperated when she asked whether he would not "agree on something most laymen, probably most physicians, would agree with."

"We can disagree," he answered.

At one point, Casson said, "I'm not saying concussions are good for you."

"Well," Sanchez said, drawing laugher in the packed conference room, "that's the strongest statement I've gotten you to say."

"A Lot of Lying"

Others, including former players, testified about their experiences with concussions.

Trainer Luther "Big Lu" Campbell said in written testimony that while rules governing what he called a "violent game" have been repeatedly adjusted by the league, injured have not abated. He said further modifications to the design of equipment, including helmets, and making neurologists mandatory on NFL teams would address some problem.

But also needed to be corrected, Campbell said, was a team's attitude of "fix you up, put you in, to win" at the possible detriment of the player.

(AP Photo/Paul Sancya)
Former NFL player Kyle Turley (left) told the Committee that while he still had a severe headache, the St. Louis Rams cleared him for full-contact drills four days after a concussion seven years ago.

"Frustrated with being injured and wanting to prove my toughness to my teammates and coaches, I used my head more aggressively than I normally would have in practice, not understanding the damage I was doing to my brain," Turley said Monday.

"I would like to tell you that this was an isolated incident," Turley said in his written testimony, adding that "the egregious negligence of NFL team medical staff is fairly universal, that its effects are perpetuated and magnified by the NFL disability committees, comprised of the owners and the players union representatives, which continually deny retired players' disability claims wrongfully, and that active players continue to be put into the game after suffering concussions."

"When I heard the first panel, I thought I had come to the wrong room and that I was at a tobacco-industry panel," said Bernie Parrish, who spent most of his career a half-century ago with the Cleveland Browns. "The NFL uses the same merchants of death system as the tobacco industry.

"There was a lot of lying," he added.

Bennet Omalu, co-founder of the Brain Injury Research Institute at West Virginia University, testified that it "has been established since the early 20th century" that repeated blows to the head cause damage.

Another witness, NFL Players Association executive director DeMaurice Smith, told Congress the league hasn't shared the injury data it collected from every player from 2006-2008.

"We have written the NFL a letter asking to clarify whether they have given us all the data that they have available or only a portion of it," Smith said after his testimony. "As of today, I have received an answer to that letter."

NFL executive vice president Joe Browne insisted the union has the same injury information that the league collected.

"We received an Oct. 12 letter requesting injury data and to the best of my knowledge we gave the union the info they requested," Browne told the AP.

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