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Comment & Response
May 2014

Creating a Concussion Crisis and Chronic Traumatic Encephalopathy

Author Affiliations
  • 1Mercy Hospital Medical Center, Ruan Neurology Clinic, Des Moines, Iowa
JAMA Neurol. 2014;71(5):654. doi:10.1001/jamaneurol.2013.6408

To the Editor I read with skeptical interest Dr Cantu’s article on sports concussion.1 Unlike other neurology specialties, sports concussion is driven not by science but opinion in the form of the numerous consensus conferences he referenced. The mainstay of concussion treatment has been complete physical and cognitive rest based on previous conference recommendations. For the most recent international conference, a literature review was decided, which found sparse empirical evidence for this dogma.2 Stories abound from neuropsychology colleagues of student athletes who have been granted a vacation from life for weeks on end, with no scholastic work, video games, text messaging, or similar activities that might theoretically delay recovery. In a lecture at Williams College in September 2011, Dr Cantu and his colleague, Christopher Nowinski (an ex-professional wrestler), from the Center for the Study of Traumatic Encephalopathy gave the disturbing advice that ignoring rest can lead to suicide.3 In a number of high-profile cases, families have been led to believe the cause of the suicide was a single concussion or chronic traumatic encephalopathy (CTE).