Primum non nocere: a call for balance when reporting on CTE

William Stewart¹, Kieren Allinson², Safa Al-Sarraj³, Corbin Bachmeier⁴, Karen Barlow⁵, Antonio Belli⁶, Mark P Burns⁷, Alan Carson⁸, Fiona Crawford⁹, Kristen Dams-O'Connor¹⁰, Ramon Diaz-Arrastia¹¹, C Edward Dixon¹², Brian L Edlow¹³, Scott Ferguson¹⁴, Bruce Fischl¹⁵, Rebecca D Folkerth¹⁶, Steve Gentleman¹⁷, Christopher C Giza¹⁸, M Sean Grady¹⁹, Adel Helmy²⁰, Mark Herceg²¹, Janice L Holton²², David Howell²³, Peter J Hutchinson²⁰, Diego Iacono²⁴, Juan E Iglesias²⁵, Milos D Ikonomovic²⁶, Victoria E Johnson²⁷, C Dirk Keene²⁸, Julia K Kofler²⁹, Vassilis E Koliatsos³⁰, Edward B Lee³¹, Harvey Levin³², Jonathan Lifshitz³³, Helen Ling²², David J Loane³⁴, Seth Love³⁵, Andrew Ir Maas³⁶, Niklas Marklund³⁷, Christina L Master³⁸, Damien M McElvenny³⁹, David F Meaney⁴⁰, David K Menon⁴¹, Thomas J Montine⁴², Benoit Mouzon⁹, Elliott J Mufson⁴³, Joseph O Ojo⁹, Mayumi Prins⁴⁴, Tamas Revesz²², Craig W Ritchie⁴⁵, Colin Smith⁴⁶, Richard Sylvester⁴⁷, Cheuk Y Tang⁴⁸, John Q Trojanowski⁴⁹, Kathryn Urankar³⁵, Robert Vink⁵⁰, Cheryl Wellington⁵¹, Elisabeth A Wilde⁵², Lindsay Wilson⁵³, Keith Yeates⁵⁴, Douglas H Smith²⁷

Affiliations

¹ Department of Neuropathology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK; Department of Neuropathology, Queen Elizabeth University Hospital, Glasgow, UK; Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK. Electronic address: william.stewart@glasgow.ac.uk.
² Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.
³ The Institute of Psychiatry Psychology and Neurosciences, King's College London, London, UK.
⁴ Roskamp Institute, Sarasota, Florida, USA; The Open University, Milton Keynes, UK; Bay Pines VA Healthcare System, Bay Pines, Florida, USA.
⁵ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
⁶ Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
⁷ Georgetown University Medical Center, Washington DC, DC, USA.
⁸ Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
⁹ Roskamp Institute, Sarasota, Florida, USA; The Open University, Milton Keynes, UK; James A Haley Veterans' Hospital, Tampa, FL, USA.
¹⁰ Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
¹¹ Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA; Penn Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, PA, USA.
¹² Department of Neurological Surgery, Brain Trauma Research Center, University of Pittsburgh, Pittsburgh, PA, USA; Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.
¹³ Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
¹⁴ Roskamp Institute, Sarasota, Florida, USA; Roskamp Institute, Sarasota, Florida, USA; James A Haley Veterans' Hospital, Tampa, FL, USA.
¹⁵ Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
¹⁶ City of New York Office of the Chief Medical Examiner, and New York University School of Medicine, New York NY, USA.
¹⁷ Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK.
¹⁸ UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA; Departments of Pediatrics and Neurosurgery, David Geffen School of Medicine and UCLA Mattel Children's Hospital, University of California, Los Angeles, CA, USA.
¹⁹ Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA.
²⁰ Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.
²¹ Department of Physical Medicine and Rehabilitation, Phelps Hospital Northwell Health, New York, NY, USA; School of Public Health, New York Medical College, New York, NY, USA.
²² Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, UK.
²³ Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA; Department of Orthopedics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
²⁴ Neuropathology Research, Biomedical Research Institute of New Jersey, Cedar Knolls, NJ, USA; Atlantic Neuroscience Institute, Atlantic Health System, Morristown, NJ, USA.
²⁵ Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK; Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA.
²⁶ Departments of Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
²⁷ Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA; Penn Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, PA, USA.
²⁸ Department of Pathology, University of Washington, Seattle, WA, USA.
²⁹ Department of Pathology, Division of Neuropathology, University of Pittsburgh, Pittsburgh, PA, USA.
³⁰ Departments of Pathology, Neurology, and Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Neuropsychiatry Program, Sheppard and Enoch Pratt Hospital, Baltimore, MD, USA.
³¹ Translational Neuropathology Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA.
³² Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
³³ Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA; University of Arizona College of Medicine Phoenix, Child Health, Phoenix, AZ, USA; Phoenix Veteran Affairs Healthcare System, Phoenix, AZ, USA.
³⁴ Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA; Shock Trauma and Anesthesiology Research (STAR) Center, University of Maryland School of Medicine, Baltimore, MD, USA; School of Biochemistry and Immunology and Trinity Biomedical Sciences Institute, Trinity College Dublin, Ireland.
³⁵ Dementia Research Group, Institute of Clinical Neurosciences, Medical School, University of Bristol, Bristol, UK.
³⁶ Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium.
³⁷ Skane University Hospital, Department of Clinical Sciences Lund, Neurosurgery, Lund University, Lund, Sweden.
³⁸ Center for Injury Research and Prevention and Division of Orthopedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
³⁹ Research Division, Institute of Occupational Medicine, Edinburgh, UK.
⁴⁰ Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA; Penn Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, PA, USA; Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA.
⁴¹ NIHR Global Health Research Group on Neurotrauma, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK; Division of Anaesthesia, Department of Medicine, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.
⁴² Department of Pathology, Stanford University, Stanford, CA, USA.
⁴³ Barrow Neurological Institute, Departments of Neurobiology and Neurology, Phoenix, AZ, USA.
⁴⁴ UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA.
⁴⁵ Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK.
⁴⁶ Academic Neuropathology, University of Edinburgh, Edinburgh, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
⁴⁷ Homerton University Hospital NHS Trust, National Hospital of Neurology and Neurosurgery, University College London, London, UK.
⁴⁸ Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁴⁹ Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA; Institute on Aging, University of Pennsylvania, Philadelphia, PA, USA; Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, PA, USA.
⁵⁰ Health Sciences, University of South Australia, Adelaide, SA, Australia.
⁵¹ Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, International Collaboration on Repair Discoveries, School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada.
⁵² Department of Neurology, University of Utah, Salt Lake City, UT, USA; Michael DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, USA.
⁵³ Division of Psychology, University of Stirling, Stirling, UK.
⁵⁴ Department of Psychology, Alberta Children's Hospital Research Institute and Hotchkiss Brain Institute, University of Calgary, AB, Canada.

PMID: 30784550
PMCID: PMC6594011
DOI: 10.1016/S1474-4422(19)30020-1

Primum non nocere: a call for balance when reporting on CTE

William Stewart et al. Lancet Neurol. 2019 Mar.

. 2019 Mar;18(3):231-233.

doi: 10.1016/S1474-4422(19)30020-1. Epub 2019 Feb 12.

Authors

Affiliations

¹ Department of Neuropathology, Queen Elizabeth University Hospital, Glasgow G51 4TF, UK; Department of Neuropathology, Queen Elizabeth University Hospital, Glasgow, UK; Institute of Neuroscience and Psychology, University of Glasgow, Glasgow, UK. Electronic address: william.stewart@glasgow.ac.uk.
² Department of Pathology, Cambridge University Hospitals NHS Foundation Trust, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.
³ The Institute of Psychiatry Psychology and Neurosciences, King's College London, London, UK.
⁴ Roskamp Institute, Sarasota, Florida, USA; The Open University, Milton Keynes, UK; Bay Pines VA Healthcare System, Bay Pines, Florida, USA.
⁵ Child Health Research Centre, Faculty of Medicine, The University of Queensland, Brisbane, QLD, Australia.
⁶ Institute of Inflammation and Ageing, University of Birmingham, Birmingham, UK.
⁷ Georgetown University Medical Center, Washington DC, DC, USA.
⁸ Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
⁹ Roskamp Institute, Sarasota, Florida, USA; The Open University, Milton Keynes, UK; James A Haley Veterans' Hospital, Tampa, FL, USA.
¹⁰ Department of Rehabilitation Medicine, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
¹¹ Department of Neurology, University of Pennsylvania, Philadelphia, PA, USA; Penn Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, PA, USA.
¹² Department of Neurological Surgery, Brain Trauma Research Center, University of Pittsburgh, Pittsburgh, PA, USA; Veterans Affairs Pittsburgh Healthcare System, Pittsburgh, PA, USA.
¹³ Center for Neurotechnology and Neurorecovery, Department of Neurology, Massachusetts General Hospital and Harvard Medical School, Boston, MA, USA; Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
¹⁴ Roskamp Institute, Sarasota, Florida, USA; Roskamp Institute, Sarasota, Florida, USA; James A Haley Veterans' Hospital, Tampa, FL, USA.
¹⁵ Athinoula A Martinos Center for Biomedical Imaging, Department of Radiology, Massachusetts General Hospital and Harvard Medical School, Charlestown, MA, USA.
¹⁶ City of New York Office of the Chief Medical Examiner, and New York University School of Medicine, New York NY, USA.
¹⁷ Division of Brain Sciences, Department of Medicine, Imperial College London, London, UK.
¹⁸ UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA; Departments of Pediatrics and Neurosurgery, David Geffen School of Medicine and UCLA Mattel Children's Hospital, University of California, Los Angeles, CA, USA.
¹⁹ Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA.
²⁰ Division of Neurosurgery, Department of Clinical Neurosciences, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.
²¹ Department of Physical Medicine and Rehabilitation, Phelps Hospital Northwell Health, New York, NY, USA; School of Public Health, New York Medical College, New York, NY, USA.
²² Queen Square Brain Bank for Neurological Disorders, UCL Queen Square Institute of Neurology, London, UK.
²³ Sports Medicine Center, Children's Hospital Colorado, Aurora, CO, USA; Department of Orthopedics, School of Medicine, University of Colorado Anschutz Medical Campus, Aurora, CO, USA.
²⁴ Neuropathology Research, Biomedical Research Institute of New Jersey, Cedar Knolls, NJ, USA; Atlantic Neuroscience Institute, Atlantic Health System, Morristown, NJ, USA.
²⁵ Centre for Medical Image Computing, Department of Medical Physics and Biomedical Engineering, University College London, London, UK; Computer Science and Artificial Intelligence Laboratory, Massachusetts Institute of Technology, Cambridge, MA, USA.
²⁶ Departments of Neurology and Psychiatry, University of Pittsburgh, Pittsburgh, PA, USA.
²⁷ Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA; Penn Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, PA, USA.
²⁸ Department of Pathology, University of Washington, Seattle, WA, USA.
²⁹ Department of Pathology, Division of Neuropathology, University of Pittsburgh, Pittsburgh, PA, USA.
³⁰ Departments of Pathology, Neurology, and Psychiatry and Behavioral Sciences, Johns Hopkins University School of Medicine, Baltimore, MD, USA; Neuropsychiatry Program, Sheppard and Enoch Pratt Hospital, Baltimore, MD, USA.
³¹ Translational Neuropathology Research Laboratory, University of Pennsylvania, Philadelphia, PA, USA.
³² Department of Physical Medicine and Rehabilitation, Baylor College of Medicine, Houston, TX, USA.
³³ Barrow Neurological Institute at Phoenix Children's Hospital, Phoenix, AZ, USA; University of Arizona College of Medicine Phoenix, Child Health, Phoenix, AZ, USA; Phoenix Veteran Affairs Healthcare System, Phoenix, AZ, USA.
³⁴ Department of Anesthesiology, University of Maryland School of Medicine, Baltimore, MD, USA; Shock Trauma and Anesthesiology Research (STAR) Center, University of Maryland School of Medicine, Baltimore, MD, USA; School of Biochemistry and Immunology and Trinity Biomedical Sciences Institute, Trinity College Dublin, Ireland.
³⁵ Dementia Research Group, Institute of Clinical Neurosciences, Medical School, University of Bristol, Bristol, UK.
³⁶ Department of Neurosurgery, Antwerp University Hospital and University of Antwerp, Edegem, Belgium.
³⁷ Skane University Hospital, Department of Clinical Sciences Lund, Neurosurgery, Lund University, Lund, Sweden.
³⁸ Center for Injury Research and Prevention and Division of Orthopedic Surgery, The Children's Hospital of Philadelphia, Philadelphia, PA, USA.
³⁹ Research Division, Institute of Occupational Medicine, Edinburgh, UK.
⁴⁰ Department of Neurosurgery, University of Pennsylvania, Philadelphia, PA, USA; Penn Center for Brain Injury and Repair, University of Pennsylvania, Philadelphia, PA, USA; Department of Bioengineering, University of Pennsylvania, Philadelphia, PA, USA.
⁴¹ NIHR Global Health Research Group on Neurotrauma, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK; Division of Anaesthesia, Department of Medicine, Cambridge Biomedical Campus, University of Cambridge, Cambridge, UK.
⁴² Department of Pathology, Stanford University, Stanford, CA, USA.
⁴³ Barrow Neurological Institute, Departments of Neurobiology and Neurology, Phoenix, AZ, USA.
⁴⁴ UCLA Steve Tisch BrainSPORT Program, Los Angeles, CA, USA.
⁴⁵ Centre for Dementia Prevention, University of Edinburgh, Edinburgh, UK.
⁴⁶ Academic Neuropathology, University of Edinburgh, Edinburgh, UK; Centre for Clinical Brain Sciences, University of Edinburgh, Edinburgh, UK.
⁴⁷ Homerton University Hospital NHS Trust, National Hospital of Neurology and Neurosurgery, University College London, London, UK.
⁴⁸ Department of Radiology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
⁴⁹ Department of Pathology and Laboratory Medicine, University of Pennsylvania, Philadelphia, PA, USA; Institute on Aging, University of Pennsylvania, Philadelphia, PA, USA; Center for Neurodegenerative Disease Research, University of Pennsylvania, Philadelphia, PA, USA.
⁵⁰ Health Sciences, University of South Australia, Adelaide, SA, Australia.
⁵¹ Department of Pathology and Laboratory Medicine, Djavad Mowafaghian Centre for Brain Health, International Collaboration on Repair Discoveries, School of Biomedical Engineering, University of British Columbia, Vancouver, BC, Canada.
⁵² Department of Neurology, University of Utah, Salt Lake City, UT, USA; Michael DeBakey VA Medical Center and Baylor College of Medicine, Houston, TX, USA.
⁵³ Division of Psychology, University of Stirling, Stirling, UK.
⁵⁴ Department of Psychology, Alberta Children's Hospital Research Institute and Hotchkiss Brain Institute, University of Calgary, AB, Canada.

PMID: 30784550
PMCID: PMC6594011
DOI: 10.1016/S1474-4422(19)30020-1

Erratum in

Correction to Lancet Neurol 2019; 18: 231-33.
[No authors listed] [No authors listed] Lancet Neurol. 2019 Apr;18(4):e3. doi: 10.1016/S1474-4422(19)30075-4. Epub 2019 Feb 15. Lancet Neurol. 2019. PMID: 30879478 No abstract available.

No abstract available

PubMed Disclaimer

Comment in

First report the findings: genuine balance when reporting CTE.
Finkel AM, Brand KP, Caplan AL, Evans JS, Wolpe PR. Finkel AM, et al. Lancet Neurol. 2019 Jun;18(6):521-522. doi: 10.1016/S1474-4422(19)30159-0. Lancet Neurol. 2019. PMID: 31122490 No abstract available.
First report the findings: genuine balance when reporting CTE.
Casper ST, Golden J, Oreskes N, Largent M, Goldberg DS, Gillett G, Philpott-Jones S, Moreira T, Virdi J, Meyers T, Morrison D, Rodriguez JE, Gabriel JM, Steere-Williams J, Ross R, Smith JM, Ballenger JF, Bil G, Kawaguchi Y, Dyck E, Callard F, Ortega F, Kleinman S, Brown M. Casper ST, et al. Lancet Neurol. 2019 Jun;18(6):522-523. doi: 10.1016/S1474-4422(19)30158-9. Lancet Neurol. 2019. PMID: 31122491 No abstract available.

References

1. Belson K Doctors said hockey enforcer Todd Ewen did not have C.T.E. but he did. November 30, 2018. The New York Times https://www.nytimes.com/2018/11/30/sports/hockey/todd-ewen-cte-hockey.ht... (accessed Dec 1, 2018).
1. Wilson L, Stewart W, Dams-O’Connor K, et al. The chronic and evolving neurological consequences of traumatic brain injury. Lancet Neurol 2017; 16: 813–25. - PMC - PubMed
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Primum non nocere: a call for balance when reporting on CTE

Affiliations

Primum non nocere: a call for balance when reporting on CTE

Authors

Affiliations

Erratum in

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