I read the study. My biggest thoughts:
1a. The interquartile range for these brains was 51 with an age range of 33-71. There was no brain by brain breakdown. IQR in this case is pretty....weird. I'm not discrediting the study, but they should be breaking down the brain groups by age, because then it would show us the more relevant (read also: more recent) data. It shouldn't take a neurologist to figure out people who played in the 70s and 80s (the older brains) would show a tremendously higher rate of CTE vs more recent brains, what with the rules changes, helmet tech changes, the fact that more players actually wear helmets and mouthguards as time passes, etc. In other words, 42 brains out of 77 exhibited signs of CTE; is this data skewed by a bunch of dudes who played in an era where head injuries were not taken seriously? I would lean yes, but we don't know. Big weakness to the study imo
1b. I understand this is an inherent issue with CTE. To my knowledge you can't find out if a person has CTE without an autopsy. That means any data is going to lag behind by 2 generations since you have to wait for people to die; it doesn't show what's happening now. Which is unfortunate, but you can reasonably conclude the steps taken by the sport have significantly reduced CTE prevalance as it has already been shown better and more frequently worn helmets/mouth guards and rules changed have decreased the incidents of concussions, who's frequency serves as a surrogate market for CTE development
2. Looks like every single brain that died by suicide had CTE. Additionally, it was the most common cause of death. First off, sheesh. Second off, this sample is heavily, heavily skewed, and this shows exactly why. Let me explain
These brains were donated by loving family members. People would be more inclined to "investigate" the brain of someone who exhibited symptoms of CTE vs not. In other words, wouldn't we all like to know what's going on with Antonio Brown? Perhaps Eric Lindros, who suffered a thousand concussions? Nolan Patrick, with his headache issues? How about Evander Kane, considering his erractic gambling and how he treated his ex wife? Now, what about Claude Giroux? Just your everyday, normal hockey player who's has a few concussions at the NHL level? You can see how the brain submission process can be biased toward CTE vs not. And as stated, with the leading cause of death in the CTE brains being suicide, it kind of makes sense.
This is not me discrediting the study. But it is healthy to critically think about these things because it helps not only with context but also how to improve the methods of future studies to reduce bias, which I think we all agree are needed. Doctors are literally taught how to read and analyze studies in school for this reason