Researchers have uncovered the first evidence of Australian rugby league players with a degenerative brain condition commonly found in retired American NFL athletes, findings which will have massive implications for the NRL.
Clinicians from Royal Prince Alfred Hospital, NSW Health Pathology and the University of Sydney's Brain And Mind Centre have discovered a local existence of Chronic Traumatic Encephalopathy (CTE), a state associated with repeated blows to the head.
The confirmation has been described as a "wake-up call" to local sporting authorities.
The reports were conducted on two middle-aged professionals who played more than 150 top-grade rugby league games each throughout their careers.
CTE is only diagnosed via autopsy and is associated with depression, mood swings, short-term memory loss and dementia while some research has linked the condition with an elevated risk of suicide.
The Australian findings have been published in an international neuropathology journal.
"It's the wake-up call we needed," lead author clinical associate professor Michael Buckland said.
"We're not immune and Australia is no different to anywhere else. I think we needed something like this to focus everybody's mind on the issue.
"I've been in this job for 10 years and I would personally report 100 brains a year from a variety of sources. We see all sorts of stainings when we assess anyone with any cognitive impairment and these changes I have not seen before. They're distinctive."
A study published in the Journal of the American Medical Association in 2017 reported of 111 brains examined of former NFL players 110 showed evidence of CTE. They ranged from players who died as young as 23 to as old as 89.
The NFL has already paid out more than US$500 million from about 2000 claims lodged by former players under the code's concussion settlement. The figure is forecast to easily top US$1 billion in time.
But until Thursday clinicians had not found any link between CTE and Australian rugby league players. The only known risk factor of CTE is repetitive head injuries in the form of concussion.
"We commend the authors for this groundbreaking discovery," said Dr Christopher Nowinski, an American-based former professional wrestler and head of the Concussion Legacy Foundation.
"We hope the first proof of CTE in rugby league inspires the Australian scientific community to mobilise in the fight against CTE, and advances the conversation on reforms to sport that can prevent this disease."
An NRL spokesman said: "The NRL's approach to the management of head injuries is based on global best practice.
"The NRL has significantly increased its focus and investment in this area of player safety and will continue as an active participant in the work of the global sport community to advance the understanding and management of head injuries in contact sport.
"The findings released today will be reviewed by the NRL before any further comment is made."
Associate Professor Buckland helped establish the Australian Sports Brain Bank last year to research CTE in brains donated by the public. More than 80 brains have been pledged to date by former athletes from all codes and varying levels.
Two former top-flight rugby league players have launched legal action against their old clubs over the handling of head knocks, headed by former NSW and Newcastle winger James McManus. He's arguing the Knights were negligent in their treatment of a series of concussions which prematurely ended his career.
The other is former Gold Coast Giants, South Queensland Crushers and Parramatta Eels player Brett Horsnell.
Former Sharks forward Reece Williams earlier this year dropped his own lawsuit against one of the most respected sports doctors in the country, Bulldogs medico and former Cronulla staffer David Givney. Williams was forced to retire at the age of 25 after a serious head knock.
The NRL has drastically stiffened its protocols around head knocks and concussion in recent years, only this year making it mandatory for each club to have two doctors operating on game day.
It also has officials monitoring real-time vision remotely from a dedicated brain bunker for every match, allowing them to relay information to officials at the ground.
Roosters five-eighth Luke Keary was ruled out of NSW State of Origin contention last month and hasn't played since suffering a fourth serious concussion in the space of 18 months. He's due to return within the next fortnight after a series of in-house and independent testing.
- SMH/The Age
