A leading researcher into concussion in sport has called on the AFL to be more transparent over its research into the long-term health impacts on its players and claims the league hindered a two-year-study the AFL itself had funded.
Associate Prof Alan Pearce said he signed a $60,000 contract with the AFL in 2016 to carry out neurological tests on retired AFL players who had suffered concussions during their playing careers.
The two-year study came amid growing concern about chronic traumatic encephalopathy, also known as CTE, in athletes playing contact sport. A neurodegenerative condition, CTE is linked to repeated head traumas including concussion. Symptoms include cognitive impairment, impulsive behaviour, depression, suicidal thoughts, short-term memory loss and emotional instability.
But despite the AFL funding the project, Pearce said it appeared reluctant to cooperate until the project was nearly finished.
His allegation follows Guardian Australia revealing in March that the results from another major concussion study never saw the light of day.
The AFL is under increasing pressure to disclose what became of the study and to clarify the evidence that informs the league’s concussion policies after it was revealed their lead concussion advisor, Dr Paul McCrory, had been accused of plagiarism.
Two of McCrory’s papers have been retracted from scientific journals for alleged plagiarism, leading to his resignation as chair of the Concussion in Sport Group (CSIG) on 5 March. The CSIG and its consensus statements on concussion are used by professional and amateur sports around the world to inform their concussion policies. McCrory has since been accused of further plagiarism, and has reportedly apologised for some instances, telling website Retraction Watch that “the errors were not deliberate or intentional”.
The questions around McCrory’s work, and questions around studies involving the AFL, have prompted Pearce to call for transparency from the league around its concussion research and policies in order to protect and prioritise the health of athletes.
He said he believed his study into retired AFL athletes and concussion was hindered by the organisation and he wants to know why.
Pearce said after his work on the impact of concussion on the health of athletes started to gain recognition, he was approached by AFL official Patrick Clifton in early 2015 to conduct a study running a series of neurological tests on retired AFL players who had suffered concussions during their playing careers. Pearce agreed and after further discussions, signed a contract in March 2016 to receive funding from the AFL until 2018 to complete the work.
The contract states Pearce was to use transcranial magnetic stimulation (TMS) on the players, a noninvasive test using a magnetic coil to stimulate the brain. The contract said other tests would be conducted alongside TMS to measure fine motor skills, memory, attention, visual processing and reaction time. The contract states a key purpose of the study was to “determine differences in the physiology of the brains” in retired players who had suffered concussion injuries and compare those results to similarly aged study participants who had not played AFL and had never received a concussion.
Shortly after he was approached by Clifton to lead the study, Pearce said McCrory, then the AFL’s senior advisor on concussion and a neurologist with 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. “Although he was the AFL’s concussion expert, he had nothing to do with my study.” Pearce said he felt as though McCrory was trying to tell him what he could and couldn’t do with respect to the research.
“We had our first face-to-face meeting at 10.30am at Baretto coffee shop at the University of Melbourne on 27 July, 2015. The AFL study [methodology] was pretty much set. He became quite patriarchal and said things like: ‘Your idea isn’t feasible, neurophysiological measures are too difficult’, and he didn’t think my current ethics approval from Deakin University would be transferred to Melbourne University where I was to have my laboratory for the AFL study. Of course, it did get transferred.”
However, Pearce told the Guardian he was ultimately asked to leave the University of Melbourne and find a laboratory elsewhere after a report about the study aired on the ABC, featuring Pearce. Pearce said McCrory later emailed him asking if he had permission to speak to the media, even though he understood the AFL and university had in fact signed off on promoting the study in the ABC story.
Pearce relocated his lab to Swinburne University and persisted. He began with recruiting non-AFL participants to conduct the cognitive tests on, whose results would later be compared with the results of former AFL players. This group of people, who had never received a concussion – known in science as the “control group” – underwent the same tests Pearce intended to conduct on the former players, including reaction time and memory tests, and TMS.
But Pearce could not recruit enough retired AFL players for his study. Pearce said the AFL 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 arrange meetings with them.
Pearce knew some former players through his former concussion research and offered to recruit them himself, but said the AFL refused this. It baffled Pearce, who could not understand why the AFL would fund a study and then fail to assist him with the resources needed to do it.
Almost 18 months into the study, when his funding from the AFL was close to expiring, Pearce said the AFL’s then chief medical officer, Dr Peter Harcourt, told Pearce the league would provide him with former players on one condition: he remove all of the tests from his study except for TMS.
“I told them I couldn’t do that, because conducting TMS in isolation isn’t enough to diagnose,” Pearce said. “You need to perform the other tests, like the memory and reaction tests, to draw any reliable conclusions from the results. I told Harcourt the study would produce meaningless data without those additional tests being included.”
Pearce said Harcourt did not respond to his concerns.
With just six months to go before the study funding ran out, Pearce said he was finally sent a list by the AFL of approximately 40 players to contact. He said many of their email addresses bounced back. He only had enough funding and resources to perform tests on one player per week, so by the time the funding for the study ended, he had assessed just eight former players. He only performed the TMS test on them, as Harcourt had requested.
“The week before the funding contract with the AFL was going to end I got an email from Harcourt saying he was really concerned about the lack of data that I had collected from the former players. I wrote back and said: ‘Thanks for the email, but I’ve been telling you this for the last year.’ I told him we needed to perform the full range of tests to get meaningful data. I asked: ‘Can we catch up and talk about this?’” Pearce said.
“I didn’t get a response from him. The contract came and went. And nothing ever saw the light of day from that research.”
The funding for the study expired and Pearce never finished it.
The AFL did not respond to multiple questions from Guardian Australia for comment about Pearce’s claims about the study, including why he was asked to change the research methods and whether the AFL hindered the research, as Pearce believes.
An AFL spokesman did say: “Past AFL players were encouraged to participate in Dr Pearce’s study funded by the AFL but regrettably they largely chose not to participate preferring to focus on clinical care.
“Following the two-year contract period for the study, the AFL was open to the study continuing given the funding that had been invested to that time was significant but ultimately it did not proceed.”
Pearce said he was never told of any plans to continue the study beyond the two years. He also said he requested access to player contact information numerous times throughout the duration of the study and was not provided with a list until 18 months into the study. He was also not told of any efforts actively encouraging players to participate.
Pearce said the ordeal impacted his career and he wants answers.
“There are people with head injuries, including ex-players, who have lingering issues impacting their brain and they’re struggling to get help in 2022,” he said. “We need strong research into their injuries.”
The AFL have said it is now reviewing all of McCrory’s work for them in light of the plagiarism allegations. The AFL also said the alleged plagiarism, and revelations by Guardian Australia that in 2018 McCrory had given a voluntary enforceable undertaking to medical regulators not to perform certain neurodiagnostic procedures, nerve conduction studies or electromyography until approved to so by the board, were “matters of which the AFL was previously unaware”.
“The number one priority of our code is to protect the health and wellbeing of all people who participate in our game,” a spokesman said.
A spokesperson for the Australian Health Practitioner Regulation Agency (Ahpra) confirmed the undertaking is still in effect, remaining in force until it is removed from the public register. When asked for the reasons why the undertaking was given, they said: “Privacy provisions in the national law prevent us from commenting further.”
The spokesperson confirmed on 29 March that a new investigation had been launched by the regulator into allegations reported in the media that McCrory may have breached his undertaking, although it could not provide more details.
“Public safety is our number one priority and we take all concerns about practitioners seriously,” she said.
“We are limited in what we can say publicly but we are aware of allegations in the media that Dr Paul McCrory has breached an undertaking on his registration.
“We take such allegations seriously and will be investigating them.
“We cannot comment further.”
McCrory has not responded to multiple requests for comment by the Guardian.
