Concussion researcher claims AFL hampered two-year research project into players’ health | concussion in sports

A leading researcher on concussion in sports has called on the AFL to be more transparent in its research into the long-term health effects on its players, alleging the league obstructed a two-year study the AFL had funded itself.

Associate Prof Alan Pearce said he signed a $60,000 contract with the AFL in 2016 to perform neurological testing on retired AFL players who suffered concussions while playing.

The two-year study took place amid growing concerns about chronic traumatic encephalopathy, also known as CTE, in athletes who play contact sports. CTE is a neurodegenerative disease associated with repetitive head trauma, including concussion. Symptoms include cognitive impairment, impulsive behavior, depression, suicidal thoughts, short-term memory loss, and emotional instability.

But despite the AFL’s funding for the project, Pearce said it seemed reluctant to cooperate until the project was near completion.

His claim follows Guardian Australia’s revelation in March that the results of another major concussion study never saw the light of day.

The AFL is under increasing pressure to disclose what became of the study and clarify the evidence that informs the league’s concussion policy after its chief concussion counselor, Dr. Paul, became known McCrory, had been accused of plagiarism.

Two of McCrory’s articles were withdrawn from scientific journals for alleged plagiarism, leading to his resignation as chair of the Concussion in Sport Group (CSIG) on March 5. The CSIG and its concussion consensus statements are used by professional and amateur athletes around the world to inform their concussion policies. McCrory has since been accused of further plagiarism and has reportedly apologized for some instances, telling website Retraction Watch that “the errors were not intentional or intentional”.

Questions about McCrory’s work and questions about studies involving the AFL have prompted Pearce to demand transparency from the league regarding its concussion research and policies to protect and prioritize athlete health.

He said he believes his study of retired AFL athletes and concussions has been hampered by the organization and he wants to know why.

Pearce said that after his work on the effects of concussion on athletes’ health gained recognition, he was approached by AFL official Patrick Clifton in early 2015 to conduct a study that would include a battery of neurological tests on retired AFL players, who suffered concussions during their playing career. Pearce agreed and after further discussions signed a deal in March 2016 to receive funding from the AFL until 2018 to complete the work.

The contract states that Pearce should use transcranial magnetic stimulation (TMS) on the players, a non-invasive test that uses a magnetic coil to stimulate the brain. The contract said other tests would be done alongside TMS to measure fine motor skills, memory, attention, visual processing and reaction time. The contract states that a primary purpose of the study was to determine “differences in brain physiology” in retired players who had suffered a concussion and to compare those results to study participants of similar age who did not play AFL and never had a concussion had suffered.

Shortly after Clifton asked him to lead the study, Pearce said McCrory, then the AFL’s senior consultant on concussions and a neurologist at the Florey Institute of Neuroscience and Mental Health, contacted him and asked to meet.

“Part of what he wanted to talk to me about was the funding I received from the AFL for the study,” Pearce said. “Even though he was the AFL’s concussion expert, he had nothing to do with my study.” Pearce said he felt McCrory was trying to tell him what he could and couldn’t do about the research.

“We had our first face-to-face meeting on July 27, 2015 at 10:30 am at the Baretto Coffee Shop at the University of Melbourne. The AFL study [methodology] was pretty set. He got quite patriarchal, saying things like, “Your idea isn’t viable, neurophysiological measures are too difficult,” and he didn’t think my current ethics license would transfer from Deakin University to Melbourne University, which is where I was supposed to have my lab for the AFL study. Of course it was broadcast.”

However, Pearce told the Guardian he was eventually asked to leave the University of Melbourne and find a lab elsewhere after a report on Pearce’s study aired on ABC. Pearce said McCrory later emailed him asking if he had permission to speak to the media, even though he knew the AFL and the university had actually underwritten funding the study in the ABC story.

Pearce moved his lab to Swinburne University and insisted. He began recruiting non-AFL participants to administer the cognitive tests, the scores of which were later compared to the scores of former AFL players. This group of people who had never had a concussion – known in the scientific community as the ‘control group’ – were subjected to the same tests Pearce planned to use on the former players, including reaction time and memory tests, as well as TMS.

But Pearce couldn’t recruit enough retired AFL players for his study. Pearce said the AFL has repeatedly refused to give him access to a 600-strong list of former VAFL and AFL players, despite initially promising to provide him with participants and their contact details and to set up meetings with them.

Pearce knew some former players through his previous concussion research and offered to recruit them himself but said the AFL turned it down. It baffled Pearce, who couldn’t understand why the AFL funded a study and then didn’t support him with the resources to do it.

Nearly 18 months into the study, when his funding from the AFL was about to expire, Pearce, then the AFL’s chief medical officer, Dr. Peter Harcourt, told Pearce the league would make ex-players available to him on one condition: he remove all tests from his study except TMS.

“I told them I couldn’t do that because doing TMS in isolation isn’t enough to make a diagnosis,” Pearce said. “You have to do the other tests like memory and reaction tests to be able to draw reliable conclusions from the results. I told Harcourt that without these additional tests, the study would provide meaningless data.”

Pearce said Harcourt did not respond to his concerns.

Just six months before the study funding expired, Pearce said he finally received a list from the AFL of about 40 players who could be contacted. He said many of their email addresses bounced back. He only had enough money and resources to conduct tests on one player a week, so by the time the study’s funding ended, he had only screened eight former players. He just ran the TMS test on them, as Harcourt had requested.

“In the week leading up to the end of the funding deal with the AFL, I received an email from Harcourt saying he was genuinely concerned about the lack of data I had collected from the former players. I wrote back and said, ‘Thanks for the email, but I’ve been telling you this for a year.’ I told him we had to run all the tests to get meaningful data. I said, ‘Can we catch up on that and talk about it?'” Pearce said.

“I didn’t get an answer from him. The contract came and went. And none of that research ever saw the light of day.”

Funding for the study ran out and Pearce never completed it.

The AFL did not respond to several questions from Guardian Australia for comment on Pearce’s claims about the study, including why he was asked to change research methods and whether the AFL was impeding the research, as Pearce believes.

There are people with head injuries, including ex-players, who have simulation issues that affect their brains, and who are struggling to get help in 2022, associate Prof Alan Pearce

An AFL spokesman said: “Former AFL players were encouraged to participate in the AFL-sponsored study by Dr. Pearce to attend, but unfortunately they largely chose not to participate, preferring to focus on clinical care.

“After the two-year contract period for the study, the AFL was open to proceeding with the study as the funds invested to date were significant, but ultimately it did not proceed.”

Pearce said he was never informed of any plans to continue the study beyond the two years. He also said that he asked for access to the players’ contact information multiple times throughout the duration of the study and was only given a list 18 months after the start of the study. He was also not told of any efforts to actively encourage players to participate.

Pearce said the ordeal has impacted his career and he wants answers.

“There are people with head injuries, including ex-players, who have simulation issues that are affecting their brains and who are struggling to get help in 2022,” he said. “We need a thorough investigation of her injuries.”

The AFL has announced that it is now reviewing all of McCrory’s work for her in light of allegations of plagiarism. The AFL also said the alleged plagiarism and revelations by Guardian Australia that McCrory had made a voluntary enforceable commitment to medical regulators in 2018 not to perform certain neurodiagnostic procedures, nerve conduction studies or electromyography until approved by the board were “matters of.” which the AFL was previously unaware of.”

“The top priority of our code is to protect the health and well-being of everyone who participates in our game,” said a spokesman.

A spokesman for the Australian Health Practitioner Regulation Agency (Ahpra) confirmed the obligation is still in force and will remain in effect until removed from the public register. When asked about the reasons for the commitment, they replied: “Privacy provisions in national law prevent us from expressing ourselves further.”

The spokesman confirmed on March 29 that regulators had opened a new investigation into allegations reported in the media that McCrory may have breached his obligation, although it was unable to provide further details.

“Public safety is our top priority and we take any concerns about practitioners seriously,” she said.

“We are limited in our ability to speak publicly, but we are aware of allegations in the media that Dr. Paul McCrory breached an obligation in his registration.

“We take such allegations seriously and will investigate them.

“We cannot comment further.”

McCrory has not responded to several Guardian requests for comment.