BU Brain Researchers Grapple with NFL Offer

League proposes $1 million for concussion research

Sunday afternoons have felt different for football fans lately, thanks in no small part to researchers at BU.

A dramatic shift has altered the NFL culture over the past few months: rule changes, TV commentators pointing out dangerous hits, public service announcements about concussions, and star quarterbacks ordered to sit out important games after blows to the head. This stunning mid-season transformation has evolved from research at BU’s Center for the Study of Traumatic Encephalopathy (CSTE) linking concussions to later-life brain disease.

In the past, the league cast doubt on CSTE’s claims and insisted it would conduct its own studies. But in the face of overwhelming scientific evidence, U.S. congressional hearings last October, and a slew of bad press, the NFL last month offered $1 million — or more — to fund CSTE’s work.

BU Today caught up with CSTE codirector Robert Stern, a School of Medicine associate professor of neurology and codirector of the Alzheimer’s Disease Center’s Clinical and Research Program, to ask about the ethical considerations of taking money from the NFL to study what has become its gravest liability in terms of athletes’ health, as well as public relations: head trauma.

BU Today: What was your initial reaction to the NFL’s offer?

Stern: I was quite shocked. Dr. Robert Cantu, one of our codirectors, had been having high-level meetings with the NFL about their wish to support our research by encouraging current and retired players to serve as brain donors, as well as some rules changes they’ve been making. We’ve been in close touch, but never had money been mentioned.

This from the same folks who once tried to discredit you?

Not discredit, but they cast doubt on the link between repetitive head trauma and later-life disease. They weren’t our fans, and we weren’t necessarily their fans. However, since the October congressional hearings, they’ve been making some unbelievable changes in dealing with the health of their players. For example, the two cochairs of their mild traumatic brain injury committee were forced to resign. One of them refused to acknowledge the link between head trauma and disease.

Also, there have been unprecedented mid-season rule changes. Players showing any sign of concussion cannot return to play that day, whether to a game, or more strikingly, a practice. And there has to be an independent neurological specialist appointed for each team to diagnose and make decisions about return to play. To have Pittsburgh Steelers quarterback Ben Roethlisberger and Arizona Cardinals quarterback Kurt Warner both sit out a game in a critical time of the season because of concussions would never have happened before. These are the two Superbowl quarterbacks from last year. There’s still a huge need for more change, more awareness, and more research.

Under what conditions, if any, would CSTE accept the NFL’s money?

There’s nothing formal proposed yet. We’ve made it clear that the only way we could discuss the possibility would be if there were no strings attached, an unrestricted donation that would be free of any real or perceived conflict of interest. The most important thing is that we retain our complete independence and maintain terrific vigor in our research. As long as the wording is such that the donors don’t have any say in the research, its interpretation, and publication of the results, then that makes it kosher.

What would a million dollars mean to your research?

It sounds like a lot of money, but this research is quite expensive. It would allow us to continue to examine the brains of deceased athletes, expand our infrastructure, expand our pilot data collection for clinical studies such as neuroimaging and cerebrospinal fluid measuring for proteins. It wouldn’t necessarily allow us to do a major study, because research is much more expensive than that. But it would be a tremendous shot in the arm.

What are your funding sources?

Three basic sources: one was start-up money from BU’s School of Medicine, as well as individual departments across MED, the School of Public Health, and the Veterans Affairs Medical Center. We also obtained two grants from the National Institute on Aging as supplements to our NIA-funded Alzheimer’s Disease Center. Finally, we received a two-year grant from the National Operating Committee for Standards in Athletic Equipment (NOCSAE). The federal money thus far is around $200,000 and from NOCSAE it’s around $250,000. I’m in the midst of writing a grant for the National Institutes of Health, which is millions of dollars, to do an in-depth clinical study of chronic traumatic encephalopathy (CTE).

Are you looking to historical precedents as you consider forging a financial relationship with a one-time nemesis?

The analogy is the tobacco companies. Big Tobacco was funding research in the ’60s and ’70s, and because of their funding there was lots of conflict of interest about the results and how they could be interpreted.

Concussion is — quote — a no-brainer. The more times you hit your head, the more likely there is to be something wrong in the future. We just want to find out what the specifics are and how to cure and prevent it.

This BU Today article was written by Caleb Daniloff. He can be reached at cdanilof@bu.edu.