Heads Up


Concussion conference tackles effects of brain injury, with NFL football a focus

NFL players are modern-day gladiators—it is a common metaphor made in today’s media, but DeMaurice Smith, executive director of the NFL Players Association, takes issue with the comparison.

Smith is not shy about defending his point—or the players he represents. “The reality is they are not gladiators,” he said during his keynote address at an October 18 conference on the diagnosis, treatment, and prevention of concussions at Fordham Law. While the gladiators of ancient Rome were expected to fight to the death for the entertainment of the masses, Smith recently declared the health of NFL players to be a “non-negotiable issue,” and has promised to hold the league and each of the NFL’s 32 clubs accountable to the highest standards.

This means not only implementing new safety rules, including stricter concussion protocol and better helmets, but also analyzing the research on traumatic brain injuries and learning how they affect the body, in both the short-term and long-term.

“We had to make sure we fundamentally engaged ourselves with the business of understanding neuroscience,” Smith said.

There is a lot at stake, including beyond the human toll: experts estimate that the NFL will generate $15 billion in revenue this year, and recently, an NFL class-action suit resulted in a $1 billion dollar settlement.

Professor Deborah Denno

Professor Deborah Denno

Wednesday’s conference, presented by the School’s Neuroscience and Law Center and organized by the center’s director, Professor Deborah Denno, served as an overview of current medical and legal issues surrounding traumatic brain injury (TBI).

The first panel of the day, “The Hidden Harm of Traumatic Brain Injuries,” sought to define concussion, explain what modern medicine does and does not know about TBI, and explore some of the differences of the ways in which concussions affect men and women.

For panelist James Noble, associate professor of neurology at Columbia University Irving Medical Center, the thorny question is “How much injury is too much for certain athletes to keep playing high-risk sports?” As more is learned about TBI, scientists believe the answer will become clearer.

Kristen Dams-O'Conner, Michael Flomenhaft, James M. Noble, and Yelena Goldin

Kristen Dams-O’Conner, Michael Flomenhaft, James M. Noble, and Yelena Goldin

Panelist Yelena Goldina, staff neuropsychologist at the JFK Johnson Rehabilitation Institute, talked about how TBI affects the sexes differently, noting that, although men are more likely to die from TBI, women are more likely to stay in rehab longer and more likely to have persistent psychiatric symptoms in the aftermath of TBI, such as anxiety and depression.

The following panel addressed current approaches to the prevention and treatment of concussion. Panelist Amanda Sacks-Zimmerman, assistant professor of neuropsychology at Weill Cornell Medicine, stressed the importance of psychotherapy in treating TBI. She homed in on practices like attention training, which increases the individual’s ability to self-monitor distraction, with the ultimate goal of raising the patient’s confidence in their own mental abilities. “Psychotherapy helps patients recover hope,” Sacks-Zimmerman said. Indeed, studies have shown that hope and confidence have very real effects on rehabilitation.

Amanda Sacks-Zimmerman, Wayne A. Gordon, and Barclay Morrison III

Amanda Sacks-Zimmerman, Wayne A. Gordon, and Barclay Morrison III

The final two panels of the day dealt with two hot-button issues involving concussion: its effects on military personnel, and ongoing litigation surrounding concussion in the NFL. The two topics at one point overlapped. When panelist James Kelly, professor of neurology at the University of Colorado School of Medicine, was tasked to help design a concussion protocol for the military, “the generals and admirals told me, ‘We want it done like they’re doing it in the NFL,’” he said.

Regina McGlinchey, professor in psychiatry at Harvard Medical School, gave a particularly sobering presentation on TBI in the military. “We may have underestimated the problem,” she began, going on to note that many conditions, including post-traumatic stress disorder, become more severe for military personal with TBI. McGlinchey stressed the importance of monitoring soldiers over the course of their lifetimes in order to better understand how concussions contribute to other medical conditions.

The final panel of the day, “The NFL Concussion Litigation: The Impact of Traumatic Brain Injury on America’s Most Popular Sport,” dealt primarily with legal issues surrounding concussion. The panel discussion was conducted by the lead lawyers in the litigation: Brad S. Karp, lead counsel for the NFL, and Chris A. Seeger, co-lead counsel for the plaintiffs, as well as NYU Law Professor Samuel Issacharoff, who is involved with the most current litigation. The three talked about the importance of understanding the science behind TBI and how to establish that an injury was specifically caused by involvement in NFL football (as opposed to earlier college or high school participation) so as to hold the NFL accountable.


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