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September 4, 2024 18 mins

At a Senate committee last year, the NRL and Football Australia acknowledged the link between head injuries in contact sports and the neurodegenerative disease chronic traumatic encephalopathy (CTE).

But a core member of the NRL’s concussion research group is also one of the most outspoken critics of the link between repeated head injury and CTE, calling it an “invented disease … conjured out of thin air”.

His views corroborate the Australian NRL’s multimillion-dollar research program into former elite-level rugby league players, which to date has concluded there is no link between concussion and depression or other cognitive problems.

So how does the NRL justify advancing a position that most scientists don’t agree with? 

Today, journalist and contributor to The Saturday Paper Wendy Carlisle, on the brain epidemic killing ex-athletes and why the science is still being contested.


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Guest: Journalist and contributor to The Saturday Paper, Wendy Carlisle.

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Episode Transcript

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Speaker 1 (00:00):
So how did you come across doctor Rudy Castellani's involvement
in the research for the NRL Well.

Speaker 2 (00:06):
Doctor Castellani has been one of the many American scientists
who've been involved in research programs with the US National
Football League.

Speaker 3 (00:17):
I'm delighted to be here. I think it's a tribute
to the organizers that he'd be open minded enough to
have me come and talk about some of these issues.
I'm a neuropathologist and I've studied neuro de general diseases
quite a lot over the years.

Speaker 2 (00:30):
With status, Castellani had been on my radar for a
very long time as one of those sort of, if
you like, contrarian scientists disputing the link between repetitive head
injury and ct He gave a keynote speech at the
World Rugby Concussion Conference in Amsterdam in twenty twenty two,

(00:50):
and that's where he made his remarks that CTA was
a hypothesis and that he was a denier of certain
aspects of the research, and that this was a hypothesis
that they were investigating.

Speaker 1 (01:04):
But just to be clear, the science is in on
ct Yeah.

Speaker 2 (01:08):
I think there's no doubt about that. The US National
Institute of Health issued a statement a couple of years
back saying that ct was caused by repetitive head injury.
This is the finding of the world's top scientists. The
view of scientists associated with the NRL and the AFL

(01:29):
around whether or not CT is caused by repetitive head injury.
These are outlier views. These are fringe views, if you like,
and that's what's been you know, we're witnessing in this space.

Speaker 1 (01:44):
From sports media. I'm Daniel James. This is seven AM.
At a Senate committee last year, the NRL acknowledged a
link between head injuries in contact sports and the neurodigenity
ct But a core member of the NRL's Concussion Research

(02:04):
Group is also one of the most outspoken critics of
the link between repeated head injury and CTE, calling it
an invented disease conjured at a sin air. So how
does the NRL justify advancing a position that most scientists
don't agree with and one are the other major codes
like the AFL doing about the issue today? Journalists and
contributed to the Saturday paper Wendy Carlisle on the brain

(02:27):
epidemic killing X athletes and while the science is still
being contested. It's Thursday, September five. When can you sketch

(02:50):
it for us what CTE is and how our understanding
of it has evolved over time.

Speaker 4 (02:55):
Yeah.

Speaker 2 (02:55):
Ct stands for chronic traumatic encephalopathy, a form of a
neurodegenerative disease, So that puts it in the same category
as other kinds of dementias such as Alzheimer's, Parkinson's disease, ALS,
and so on. So those are all dementias and under
that sort of umbrella of neurodegenerative diseases those dementias sits CTE.

(03:22):
What's different about CTE from the other dimensions is what
causes it, and of the cases that have been identified
around the world, the only known environmental cause of it
is repetitive head injury. When scientists sort of dissect the brain,
what they discover is that this disease appears in unique

(03:44):
parts of the brain, and it occurs, you know, the
lumpy bits of your brain on the outside. The disease
tends to cluster at the base of those lumps in
the sulsi, and it really reflects the physics of the hit.
The force of the hit just shakes it the bottom
of those bits of the ripley curvy bits of the brain,

(04:04):
and so that's what they're starting to identify. Now you're
hearing all about it in former footballers. But what scientists,
and particularly these are scientists who are leading this research
in the United States, are finding is that CT is
not necessarily correlated with the number of concussions somebody's had.
What it's correlated with is years of exposure to repetitive

(04:26):
head injury. So these are the hits and the bumps
that are routinely part of contact and collision sports.

Speaker 4 (04:33):
David wider longer is Brown Sky height Murphy started and
charming for him and he's down.

Speaker 1 (04:50):
It might be out.

Speaker 2 (04:54):
What they're discovering is that thousands of these hits over
time is what causes for some people this brain disease.

Speaker 1 (05:04):
So, Wendy, you've taken a closer look at the NRL,
can you tell us about the first in our old
player to be diagnosed?

Speaker 2 (05:10):
Yeah, so that was Steve Folks.

Speaker 5 (05:13):
Tragic news. The rugby league community left in shock after
former high profile NRL player and coach Steve Fox passed
away the Canby build off.

Speaker 2 (05:22):
He died in his late fifties by heart attack. He
was exercising on his exercise bike at home. They could
not get a proper diagnosis of why he died. They
thought it was heart failure, but they couldn't really tell.

Speaker 5 (05:37):
Afternoon, the club has paid tribute to folks, saying his
legacy as a bulldog and what he did for the
club will never be forgotten and our hearts go out
to his family and friends at this difficult time coming
up shortly, and his family had been talking about Steve
having you know, memory problems. He kept reintroducing family friends

(05:58):
to each other and it's started to become a little
bit of a talking point in the family. So his
brain was sent to Michael Buckland at the Australian Sports
Brain Bank because Michael Buckland is the chief neuropathologist for
the coroner. And Buckland examined his brain and he made
the CTE diagnosis.

Speaker 1 (06:19):
Okay, so tell me about the NRL's own research. What
does their research say.

Speaker 2 (06:24):
Well, there was a couple of studies on depression and
cognition and concussion and they found that the two were
not correlated. And note also that they're only looking at concussion,
they're not looking at years of exposure to football. So
that's a real problem. There's other studies that are looking

(06:44):
at what they call is the risk of over diagnosis
in CTE, and they produced research suggesting that half of
the American men who were diagnosed with depression would fit
the in life criteria for the diagnosis of CTE. But
that research ignores the very critical in question of whether

(07:06):
or not they're exposed to repetitive head injury for ten
years or more. They're doing a what they call a
cradle to grave study of former NRL players, which they
say will take thirty years to determine whether ct is
caused by repetitive head injury. And you know, why would

(07:29):
you do such a study when it's already known that
that's what causes it, And families and former players say
to you, look, we need help now. Why are they
doing studies that won't come in for another thirty years
and who knows if it's actually ever going to be
completed when what we want now is help And that's

(07:51):
what players and former players and the families are calling
out for help now.

Speaker 1 (07:56):
One of the researches that the NRL have been in
contact with and have worked with, his doctor Rudy Castellani,
what have you found out about him?

Speaker 2 (08:06):
Well, doctor Castellani is one of the go to doctors
used by professional sport around the world. You know, doctor
Castellani has been on the conference circuit in sports concussion
conferences for many years and so his views on CTE
have been repeated numerous times in the last decade. He's

(08:28):
used by the NRL in their research program and he
is what he calls, quote an unabashed denier of CTE.
He claims, this is a hypothesis.

Speaker 3 (08:38):
I'm an ambush to CTE is a well defined entity.
I don't think it is clinically. I don't think it
is pathologically. I don't think the reader progression or whether
or not whatever it is.

Speaker 2 (08:48):
Now he is one of the key people who is
part of this paradoxical position by the codes.

Speaker 6 (08:56):
But like to reiterate that the NRL takes the matter
of repeated head trauma and concussion very seriously. Players safety
and well being integral to the way in which we.

Speaker 2 (09:08):
Can The NRL made a quite extensive submission to the
Senate Inquiry into Repetitive head Injury and Contact Sports, and
they had about twenty pages of their research and Castellani
was named as one of I think the thirteen researchers
involved in I think what they call the International Consortium

(09:29):
of Research into the Brain Health of Former Players. Do
you recognize the casual relationship between concussion and ct.

Speaker 6 (09:38):
CT in its form as the neuropathological diagnosis made post
mortem senator, there is an association with repeated head trauma.
We don't know how strong this association is.

Speaker 2 (09:57):
There's a lot of controversy around that research. You know,
they proclaim that they are you know, play health and
safety is at the center of what they do, and
they say that they're doing everything they can to make
the game safer. So let's just accept that at face value.
Their research is trying to re establish whether or not

(10:20):
CT is caused by repetitive head injury when we actually
know that it is. And so I think the question
has to be asked of vested interests who are funding
research that perhaps threatens their industries.

Speaker 1 (10:36):
The NRL is not the only code to have controversies
with its research. That's after the break. When do we
have a number of hicondact sports in Australia and RL
and AFL are the two biggest with the most at stake.

(10:58):
What are the steps of these codes take to better
understand the threat of CTE for their players.

Speaker 2 (11:03):
Well, I think this is where it starts to get
really interesting. The research that's done by the NRL and
the AFL, it's not independent research. The AFL turns over
a billion dollars a year and they have said for
more than a decade that they've got these very comprehensive
research programs into head injury. And they announced their first

(11:26):
tranch of research, you know, more than a decade ago now,
in twenty thirteen, and then in twenty twenty two they
had to admit that that had all been a complete
fiasco after it was revealed that their top concussion researcher,
doctor Paul McCrory, was a scientific fraud who plagiarized and

(11:46):
made up scientific quotes to make it seem that head
injury and concussion was less of a serious problem that
it actually is. They announced that they were going to
do a twenty five million dollar research program and it
was going to involve brain donation to the Australian Sports
Brain Bank and also a longitudinal program research program yet

(12:09):
again trying to establish whether ct is caused by repetitive
head injury will look now nearly three years on, those
research programs do not appear to have begun. So once
again there's a lot of controversy around the AFL's research
program and whether or not they are actually telling the

(12:29):
truth about what they're doing. But you know they will.
You know, I when I put questions to the AFL now,
as I routinely do, they don't even respond now to
my questions about whether the research has begun or why
they haven't begun their brain donor program. It's just shrouded

(12:50):
in mystery.

Speaker 1 (12:51):
Really, if you were to do a comparison with how
the NRL are grappling with it and how so the
AFL are grappling with it, what differences do you so.

Speaker 2 (13:00):
One of the really fascinating things that's happening in Australia
is the launching of class actions by former players against
the codes and particularly the AFL. So I think one
hundred former players have launched a class action against the
AFL alleging that the AFL has done not enough to
protect them from the effects of repetitive head injury and

(13:23):
also not been frank with the former players about the
risks of repetitive head injury. So this class action is
likely to run for years, and it mirrors the billion
dollar class action in the United States, where I think
something like three and a half thousand former NFL players

(13:43):
took the NFL to court alleging a cover up of
quite gigantic proportions, alleging that the code had misled the
players about the dangers of repetitive head injury, allowed them
to continue to play while they're injured, and then these
former players have been suffering, you know, long term effects

(14:06):
of repetitive head injury, and then others have been suffering
lifelong effects of depression, cognitive damage, and even the development
of other clinical diagnosis of dementias such as Alzheimer's and Parkinson's.
So I think at last count, the NFL's up for
around two billion dollars, So you know, it's just not

(14:27):
going to go away. It's just going to keep getting bigger.
And the AFL has just announced they're going to spend
a billion dollars recruiting new players to the game over
the next ten years, so it's it's a huge amount
of money. And they say that they're spending twenty five
million dollars on research, so it speaks volumes to the

(14:50):
concern the codes have around if not addressing this issue,
which some would say is not really being addressed, but
to managing public perceptions around around the issue.

Speaker 1 (15:02):
What else are experts that aren't paid by the big
sporting codes saying in terms of preventing ct.

Speaker 2 (15:09):
They're saying, reduce contact training sessions.

Speaker 4 (15:12):
He wants the AFL to limits full contact training by
twenty twenty five, employee and independent concussion spotter, separate the
club medicos with the power to remove a player from
the field, improve players education about CTE, and to increase
the number of players wearing special mouthguards that detect head knocks.

Speaker 2 (15:33):
These were the recommendations of the expert witness in the
Shane Tuck coronial, but as yet neither code is embracing that.
I'm not sure that they're really grappling with it yet,
but I think that as the threat of legal action increases,
the codes will be under greater pressure to demonstrate that

(15:54):
they're actually reducing the risk to prevent CTE.

Speaker 1 (15:59):
You think will ever be a medium between the tension
around player safety and the spectacle of the game. You
reckon that there's some way that that medium can be found.

Speaker 2 (16:11):
Well, we love the game, don't we We love the hits,
that's what we love. We love that competitive physicality of
the game. These are very big sports, they're very popular.
But I do think that you know, the games have
always changed and they've survived. We've had rules that you know,

(16:31):
particularly in the NRL and the AFL, that have spared
the game up, and the players are fitter and stronger
than they have ever been. So it's a simple question
of physics, isn't it. The hits are bigger there, the
games are more intense, they're faster. I mean, I don't
think the game will ever end or will die. I
just think it'll evolve to be safer.

Speaker 1 (16:54):
Wendy, thank you so much for your time.

Speaker 2 (16:56):
Thanks so much, Daniel.

Speaker 1 (17:11):
Also in the news today, Australia's economy grew zero point
two percent of the dune quarter and one percent over
the last year, according to figures from the Australian Bureau
of Statistics, excluding the COVID nineteen pandemic period. It's the
weakest rate of annual growth in Australia since ninety one
ninety two, the year which included the recovery from the
nineteen ninety one recession. The slow down in economic activity

(17:34):
is in line with the APA's forecasts. However, does make
any sudden interest rate move from the bank's board unlikely,
and the Spring bush Fire Outlook shows that increase is
for large parts of Queensland and the Northern Territory, as
well as southwest of Victoria and neighbouring areas in South Australia.
It comes as the Bureau of Meteorology is forecasting an
increased chance of higher than average temperatures across many parts

(17:57):
of the country from August to Ober. I'm Daniel James
seven am will be back tomorrow
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