Concussion

A neuropathologist battles the NFL after discovering a link between football and a newly discovered degenerative brain disease, Chronic Traumatic Encephalopathy.

​Dr. Bennett Omalu, a Nigerian born neuropathologist and medical examiner, makes a startling discovery when asked to examine the brain of a former NFL player. Omalu discovers what he believes to be a neurodegenerative disease responsible for the mood swings, depression, intense headaches and unstable behavior he exhibited before he died. Through more examinations of former NFL players Omalu names this disease Chronic Traumatic Encephalopathy. Omalu is determined to inform the public about the long term health risks associated with playing football. despite resistance from the NFL.

Neuropsychological Review
CTE: The brain disease that is changing the NFL
Timothy J. Grillo

​Concussion depicts Dr. Bennett Omalu’s efforts to identify what was causing former NFL players to exhibit signs of psychosis and dementia. Omalu, a neuropathologist is staggered when he analyzes a former player’s brain. He was expecting to see an ugly degraded brain, like the brain of someone suffering Alzheimer’s disease, but to his surprise the brain of former Pittsburg Steeler Mike Webster looked different (Kirk, 2013). 

Doctor Omalu meticulously examines the effects of repeated blows that are customarily delved out during NFL.  He hypothesizes that the effect, in the longer term, is on cognitive functioning. Omalu enters the fight of his life against the NFL as he attempts to bring to light the dangers of playing America’s most beloved game.
Concussion is defined as a traumatic brain injury that alters the way the brain functions. Effects of mild concussions are usually temporary but can include headaches and problems with concentration, memory, balance and coordination (Mayo clinic, 2014). In the film, it is said that it takes about 60 g force to cause a concussion. The average hit in an NFL game is 100 g force. Players are at risk for suffering multiple concussions per game.  Dr. Omalu named a condition that had not been identified, Chronic Traumatic Encephalopathy or CTE. He believed many of those who experienced recurring brain trauma in the NFL had CTE. CTE is a progressive degenerative brain disease that persists and may build over a period of years as the result of traumatic impacts to the head (BRRI, 2016).

Concussion does not go into detail about what is happening neuropsychologically to those afflicted with CTE. It is only described in neuopathological terms;  killer proteins are  unleashed, which strangle the brain from the inside out. The film proclaims that neuro imaging techniques will not pick up any early signs of CTE. For the time period of the film this is correct.  However, today, with finer detailed imaging there may be some warning signs of CTE that become apparent via 3T MRI. The bodies of NFL players examined post mortem revealed higher rates of Cavum Septi Pellucci. A study conducted by Korete et al. (2016) found that football players exhibiting signs of behavioral and cognitive distress had a “higher rate of CSP, a greater length of CSP, as well as a greater ratio of CSP length to septum length was found in symptomatic former professional football players compared with athlete controls. CSP may serve as a potential early in vivo imaging marker to identify those at high risk for CTE”.

The movie’s characters, former NFL players Mike Webster, Terry Long and Andre Waters are  portrayed as plagued by CTE. They are depicted as broken men, tormented by memory loss, mood swings, depression and violent outbursts. Mike Webster is destitute living in his van. He suffers from memory loss and has taken to ripping out his own teeth and super gluing them back. Terry Long has violent outbursts that terrify his family. Andre Waters deals with memory loss and chronic headaches. For Waters and Long the suffering is too much to endure, they both commit suicide.

The depiction in the movie of those suffering from CTE is an accurate portrayal of how the symptoms of the disease manifest themselves in actuality. Omalu, Hamilton, Kamboh, DeKosky and Bailes (2010) conducted an autopsy of a 44 year old former NFL player who had been displaying almost identical behaviors as those portrayed in the film including committing suicide. The autopsy confirmed the man had CTE. Dr. Omalu, the man on whom film is based, was involved in this study. Once Omalu was certain that more NFL players were suffering from CTE, he tried to inform the public about the dangers of football. However, he is met with scorn and ridicule. The NFL refuses to recognize his research and denounces Omalu as a quack.  The NFL refuses to admit that there is any link between playing football and chronic brain injury. Omalu is ultimately forced to stop investigating any further cases of CTE. Years later, at the request of former Steelers doctor Julian Bailes, Omalu reopens his investigations on CTE. By this time many more players have fallen victims to CTE, the NFL begrudgingly admits the validity of Omalu’s research in the process taking precautions to try and limit brain injury in the NFL. 
    
I think this film was accurate in portraying the symptoms that are associated with CTE. The audience really got a sense of the pain and suffering people go through living with CTE. In terms of a neurological perspective, I don’t think nearly enough information was presented with regard to what areas of the brain are effected by CTE, this could be because information was not available during the time the movie was reflecting. Accuracy-4/5.
 
I think Concussion can be an extremely valuable educational tool. Everyone who has thought about putting a pair of cleats should watch this film. Concussion exposes the dangers and ramifications playing contact football on any level can have. Omalu’s research is having tangible effects, in the last few years numerous NFL players have retired early citing concerns about developing CTE as the reason. Educational value- 5/5
 
As a whole I did not think this movie was anything special, however, I thought Will Smith did a phenomenal job depicting Doctor Bennett Omalu. Smith delivered an Oscar worthy performance. I thought there was not enough focus on the neurological effect. I thought CTE should have been explained in much more detail. I thought the supporting acting was decent, the casting could have been better. For example, Luke Wilson does not resemble Roger Goodell in the slightest.  Entertainment- 2/5
 
                                                            Reference List
Bagger, A. (Producer), & Landesman, P. (Director). (2015). Concussion [Motion Picture]. United States: Columbia Pictures.
 
 
Kirk, M. (2013, March 25). League of denial: The NFL’s concussion crisis. Retrieved from http://www.pbs.org/wgbh/pages/frontline/sports/league-of-denial/the-frontline-interview-dr-bennet-omalu/
 
Mayo Clinic Staff. (20014, April 4). Diseases and conditions, concussion. Retrieved fromhttp://www.mayoclinic.org/diseases-conditions/concussion/basics/definition/con-20019272
 
Brain Injury Research Institute. (NA). Protect the brain. Retrieved fromhttp://www.protectthebrain.org/     
                            
Koerte, I. K., Hutschmindt, J., Muehlmann, M., Tripodis, Y., Stamm, J. M., Pasternak, O.…Shenton, M. E. (2016). Cavum septi pellucidi in symptomatic former professional football players. Journal of Neurotrauma, 33 (4), 346-353.

Omalu, B. I., Hamilton, R. L., Kamboh, I. M., DeKosky, S. T., & Bailes, J. (2010). Chronic traumatic encephalopathy (CTE) in a National Football League player: Case report and emerging medicolegal practice questions. Journal of forensic Nursing, 6, (1). 40-46.