From: Russel Lonser Sent 3 Dee 2012 17.243 To: Stanley A. Herring Mitch Berger,Richatd Blenboger;Hunt BatjerKevin GGuskiewicssMa-got Putukian;ROBERT HARBAUGH Subject: Re: New Concu study ‘shen te atacker has mot ae inv They need to stp that now. Partculaly Aare nce oF CTR (other patien/subjec eanitiven), Veey directly withthe burl this, Russ on 1241 PM. "Stanfey A. Herrin ‘Yes lo the science, and there is no place for & Unprofessional to ay the least Origine! Message —— From: Boys, Mt! 5 To: Richa Habe. Hon Ba Kevin M Gushiewice Hswring i. Pusukian Buss (NIH/NINDS) |V t ROBERT HARBAUGIE Sent: Mondiy. December 5, 2012 7.03 AM Subject: RE: New Cana stay sehen sty dhe eoutse and dy oer popes sssnte investigations From: Richard Clemo i Sent: Mondsy, December 03, 2012 6:43 AM Tor Ilunt Batjcr, Kevin M Guskiowsc7, Berger. Mitchel S.: Stanley Herring; Margot Patukian; Russell (NILVNINDS) [Vj Lonset: ROBFRT HARBAUGH Subject: Fw: New Cantw siudy‘This is what we arc up against, IF you question their science y are a hssthen. Vpprecinte Chris Nowinski"s personal attack o mel ich Begin forwerded message From: "MeCany, Bria Le Subject: New Cantu study Date: Dacember 3.2012 2:55:31 AM PST To: Ric ESPN today. Fainara-WADA, will also be today's Study: New cases of CTE in players Researchers al Boston University have diseovere 28 new cases of chronic brain damage in de football players — including 18 who played int NEL ~ more than doubling the number ot documented cases connecting football 1 long-temn brain discase, The NFL players inctude to Hall of Famers running back Ollie Matson, who played 14 seasons the 1950s .nd 7960s, and Colts cht end JolMuckey, who played 10 seasons and once served as the head of the NFL players! union, Both died last year afer suffering from dementia, ‘The stdy examined bevin tissue from 85 people with a history of repetitive head trauma, incluting iniliury veterans, boxers and football and hockyy players. Some af the cases had been previvasty reported. Sisty-sight were found 10 hve chroni traumatic encephalopathy ~ 2 degenerative beain isorder linked to memory loss, depression and dementia According fo the study, the BU rescarchers now have $0 confirmed eases of forince foothall players witht CTE ~ 33 who played im the NPL, one inthe CFL, one semi-professionally. nine through college and sic who played only trough high school. That included Nathan Siles , 17, whe died of a subdural bemaioma after a hit in a 2030 high schoo! homecoming game in Spring Hill, Kan. The sheer volume of eases overwhelm anybody that wants toe in denial about the existence af this iroblem," said Robert C. Cantu, 3 co-director of BU"s Center for the Study of Traumatic Encephalopathy and a senior adviser to the NFL on concussions. Previously. CTE had beon found in 18 of the 19 former NFL players: whose brains were examined ‘The 15 new casts in the BU study mean that of the 34 brains of formicr NFA. players thst have been examined, 33 has the disease. Linemen made up 40 percent of those cases, supporting research tht suygesls repetitive head (cauna Occurring on every play -- not concussions associated with violent collins -- may be the biggest risk, BU also reported CTE in four formec NHL players.findings, published in the December issue oF Brain,” a meeical journal affilisied with Oxford University, are certain fa feed the growing debate bout the risks of playing football and the work of he BU research team, whieh has gained ‘international recognition while arguing that ‘ootballinduced brain damage is indisputable and possibly widespread, [BU agreed 19 provide a copy of the study to ESPN's “Outside the Lines" and PBS's “Frontline” on the tion it not be released hefore publication. At the Imernational Consensus Conference on Concussion in Sport last month in Zurich, the BU rescarchers faced open skepticism frory smedi experts with the Juferpational Olympic C amv! FIFA, cunong others. Ann McKee, he neuropathologist who led the BU stu, sid the ticismn felt hike getting "stabbed, you know. swords trough the hear.” With few exceptions, crties acknowledge that CTE, ‘which enn only he diayrosed afi death, is rei But some question whether BU bas Fueled ‘unarranted bysteria about the risks of playing football by overstating the signiffeance of its Findings. Some researchers eusstion whether other factors besides lead traumst may be behind the disease, “The BU research, which was funded in party a $1 tillion gift fom the NFL, bas been limited 10 individual case studies a subjects wha were significantly impaired before their deaths, making it impossible « mewsare the prevalence of CTE or ‘slablish conclusively thac repetitive head trauma Uriggered the disease, azcording to some scientists,Richard Ellenbayen, a Seattle ncuresurgeon who chairs the NFL's Head, Neck & Spine Committec, which helps set policy for the league, praised BU's research but cautioned that there is not enough data assess the risk of playing football "The only criticism t had and have always had, is thac we need to do the science to Figure aut what the metdence of this is." said Ellenbogen, who also silended the conference last month, “For me it's ll about the kids.” Ellenbogsn sid “Do we telikids not to play sports any more? What swe know fom the (Centers for Disease Control is kids are more fkely wo get hur cing a ke or falling dover. wile cunning, Theres nothing ei ‘in saying tha, rm just putting it ia perspective ‘What re the ra isks?* ‘Claris Nowinski, a former Harvard football player and professional wrestler who serves #3 a ¢0- dlizeetor af the BU center, sid Elienbogen made a sSiuilar argument atthe Zurich conference "Vthink thats smoke an! micors; 1 mean, i's night sand day," Nowinski said “If peuple having ‘concussions riding @ bike means that football is safe, ifs a silly piece of evidence. Im surprised 3 doctor would Fower himself te thar became fe must know ita silly argument, too,” Lars Engebreisen, an orthopedic surgeen who is bead of scientific’ actsitics forthe IOC. sail he was “one attong several people who raised questivas about IBU's rescarch in Zurich,“AD of us tad cead the papers that had been published on this issue," he said, “and we were ‘concerned thatthe data were alittle bit, | woulda say skewed, but we would bke to see more data co se whether the daca was representing the truth of the matter or nx,” Engehtewsen said he thought there were “other possible ceasons!” that eould explain CTF and uestioned why the disease has not been seen in several other internativnal sports, Cantu said he believes the backlash stemmed from professional jealousy about the amount of media attention that MeKee and the BU group have receivudd Stan Grossfeld/the Boston GloberGetty Images Ann MeKee, co-tirectorof the Veterans fairs Center for the Study of Traumatic Bicephalopatiy, ‘was surprised by skepticism and criticism of het group's research of CTE. "You koow, scientists are human beings, they have the same range oF emotions as anyboxiy else,” said Cantu, "And think that people are jealous af the amount of exposure that she's gotten, and a jealous of her being in the right place at the right tine, to get all hese brains wo get ww study thi MeKeo, iam imerview with OTLeFruatline, said som sciemists in. Zucich questioned the Sink ‘petweettcepotitive head trauma and CTE, "One of the leaders of the vonterence was yetypointed when he said. read your papers acd Crary [think they're very poor scientific evidenve.” McKee said. I seemed like denial fo ine. Uhadn't really experienced denial for about four years." McKee compared the experience 19 one she had in 2009, when she presented her findings to tremivers of the NFL's sinceslishanded Mile! Trawnatie Brain Injury Comittee, which for more thar a decade denied the connection betwoen Foetal! and chron brain damage. “tt was Tike djvu," MoKe said. “Tageve we don't know how big & problem this is. we don't know what ull the risks ate, There's alot we don't know. Fut think we Know enough to know that this is a problem Kevin Guskiewicz, who serves an the NFL's Heat Neck & Spine cornmitce and also was in Zatich for the conterence, sid the ise of traumatic brain injuries is serious, Dut drawing aliak Fem Lou 10 CTE exclisively Gom case studies was analogous toa track team blaming Nike far 310s of ankle injuries simply because the athletes wore that brand eF shoe. Ober factors nee to he ‘considesed. he sid "The vase majority of the neuroseienee commnnity does noi believe that research has yet idemitied ‘causal relationship linking repetitive head wrauma in football and CTE; include tnyscl in that,” said Guskicwiez, co-deector of the Matthew Geller Spor-Related Traumatic Brain Injury Rescarch Institute at the University of North Caroli The BU researchers say they bave never drawn, conelnsions about the prevalence of CTE in Foothall Pindings hased exclusively on individual cases “will never establish the ineidence orPrevalcuve" of the disease but inscead will lay the ‘oundation for further research, the study states BU is drawing feom a sample size tha is “skewed beyond belief." acknowledged Cantu, becuse the brains invatiably come from subjects who were profoundly impaived. AC the same tine, MeKee, Cantu and others describe the growing body of cases as significant ang! ontinous, particularly for the NFL. (Cantu cited another rovent study that cxemined death certificates of former NFL players ane! ‘concluded they were four times rnore Likely to ‘suffer from meurodegenerative diseases. So probably atthe lowest level, the incidence of CTBis four times greater in NFL players than the population at large would lead you to expect,” ‘Cantu said. "Bur thats ewally the bottom of whet it 's. And where, ow nuch higher than that i i really don't know Long.teon brain damage was est documented in bowers in the 1920s, It was not seen in foetball players unti 2008, when a Pitsburgh pathologist Bennet Omalu,disgnosed late Hall of Fane Steelers center Mike Webster with CTE -iles/wireless/sory?storyPage=OTL-Mixed- Mosspges> =a finding that was holly contested by the NFL. huts no longer disputed. ‘The data indicate that CTF advances beth with exposure to hea! trauma and with age, according t0 the BU study. So typically, the longer player spemt in the NFL, the worse his ease looked.believe that this is a dose-related pheno ‘tol just 10 concussions but total brain trauma said Cant, "So clearly there's a relation 0 how 1 hits you've taken, an that eogs enerelate with how long you playeil.” ‘The shcer volume af cases T think is going to just overwhelm anyhovty Anat wants to be in denial about the existence of this problem. Dr, Robert C. Canty, BU Center forthe Study of Traumatic Encephalopathy Cantu, a nevrosurgcun und eoncussiva experhos soived his oppasition to tackle football “files/wireless'tory ?storyld=XSN4852> for ‘children younger than 14. an ides some skeptics consider alarmist and arbitrary, ‘The NFL's $1 million research gift BU in January 2010 acknowledged its right to conduct Independent research, but the Icague also. agreed 10 steer brain ftom former NL players tothe contey's brain bank, whieh is administered joincly with the Vetecans Administration, The bank currently holds 13S brains ftom military veterans, athletes and ether subjects, More than 60 athletes have pledged to donate their brains to BU after theie ders. CTE occurs when repetitive head! iraun produces abnormal proteins in the brain called "rat" The proteins form neurofibrillary tangles chat cam Gfleclively strangle brain ec. Undera m wilt roscopes ining, the tangles look like dark brewwnsploclis that gun spread dhroughout the br Mek ce deseribed the study as “an attompt 0 look at the spectrumn” of the disease: "What does it look like in the earliest stages. What docs it Look like as it gets more severe? How does it appear (o progress throughout the nervous system and what does it Jook like in advanced disease?” The study also for the fist ime identified tovr different stoges oF CTE. n Stage I few tangles ae evident, and symptoms range form” eslaehes to short-term memory foss and depression. By Stage IV. according to the study, the tangles are widespread, and most subjects show sigs of full blown dementia, including "profound loss af allervion and eoncentratioa, exzeutive dysfunction, nguage diticulties, explosivity. aggressive ndeucies, parinoia, depression” ane difculies walking and with depth perception, According t0 the study, 3! of the 34 professional football players. were fouud to have at least Stage IN CTE, which is marked by memory foss and depression, among other symptoms, Dave Ducrson, the former Chicago Bears safecy who connmited sswicidle last year by shooting himself inthe chest, had Stage I CTE atthe rine of his death, according to McKee, In addition to Matson and Mackey, other former players confinmed in the study 10 have CTE were Cookie Gilebrst,a fonmer NET. and CFL. linebacker who cied of thtoat eancer lst year; Rom Perryman, a former Boston College linebacker who ded ast ‘yar afer suffering ftom Lou Gehrig's Disease; and Eric Pelly, a former high school faotball and rugiy player who died ac 18 after suflering muliple concussions BU has previously identified several other NFLplayers with CTE, including John Grimsley, an Alle PPro linebucker who played nine seasons with the ousten Oilets and Miami Dolphins, ond Tom Meilake, an offensive lineman who played nine seasons, primarily with Tarmpa Bay ancl Philadelphia. Other names have not beer disclosed tor privacy and scientilic reasons BMeFrom: Sent: To: ce: Putuki Guskiewice, Kevin M 3 Dec 2012 17:37:30 -0500 Berger, Mitchel S. Richard G. Ellenbogen;Hunt BatierStanley Herring. Margot ian;Lonser, Russell (NIH/NINDS) [VI;ROBERT HARBAUGH Subject: Re: New Cantu study ‘Agreed. It’s cherry picking, not experimental investigation ‘Sent from my iPhone On Dec 3,2012, a 5:19 PM, "Berger, Mit! ST wrote: Just think about ths. f 34 people with signs and symptoms ofa brain tumor came to an autopsy | bet 33 or 34 would have a brain tumor at autopsy. but inthe ‘general population for all comers there are only 8 tumors found per 100,000 population. So wen 34 brains get sent to ann mckee with the dinical symptoms of eurodegeneratve cisease i it surprising there are findings in most? dant the press get it? From: Richard G. Ellenbogenl Sent: Monday, December 03, 2012 11:24 AM To: Berger, Michel S.; Hunt Batjer; Kevin M Guskiewice; Stanley Herring; Margot Putukian; Russel (NIH/NINDS) [V] Lonser; ROBERT HARBAUGH ‘Subject: Re: New Cantu study MsB. ‘Amen to tall rich Original Message From: Berger. Mitchel S. lunt Baller; Kevin M Guskiewice : Stanley Herring [Margol Putukian ; Russel (NIM/NINDS) [V] Lonser : ROBERT HARBAUGH, ‘Sent: Monday, December 03, 2012 7:08 AM Subject: RE: Now Cantu wiudy we have to stay the course and do our proposed scientific Investigations. From: Richard Ellenbogen Sent: Monday, December 03, 2012 6:43 AM ‘To: Hunt Batjer; Kevin M Guskewicz; Berger, Mitchel S; Stanley Herring; Margot Putukian; Russell (NIH/NINDS) [V] Lonser; ROBERT HARBALIGH Subject: Fwd: New Cantu study ‘This is what we are up against. If you question their science you are a heathen. I appreciate Chris Nowinski's personal atack on me! rich Bogin forwarded message: