The quest for better CTE detection, and what it means for hockey

Ken Dryden joined Tim and Sid in studio to discuss his book and the on-going issue of concussions in hockey.

We’ve only known about the devastating realties of CTE — chronic traumatic encephalopathy — for about 15 years. And yet in that relatively short period, those three letters have threatened the future of contact sports like nothing before.

The disease is believed to have a variety of critical symptoms that are still being studied — it can affect behaviour and mood, and can create cognitive and motor problems. It has been discovered in the brains of deceased football and hockey players at an alarming rate. Bob Probert had it. As did both Derek Boogaard and Steve Montador. So too, one might guess, do many current and retired NHL players.

Right now, the disease can only be detected in the brains of the deceased. It is a revelation of death, while the many who suffer from severe symptoms of brain trauma can only assume what they can never know for sure.

But recently, researchers from Boston University’s CTE Center announced that they may have found a way for CTE to be diagnosed in living patients. And if further medical research supports their findings, it could fundamentally change the game of hockey.

In the course of the study, the researchers studied the brains of 23 former college and professional football players, 50 non-athletes with Alzheimer’s and 18 healthy brains from non-athletes. Through the results, researchers identified a potential biomarker in the football players that wasn’t found at the same level in the others tested.

A lot of work and research still needs to be done, but the results were promising, says Dr. Jonathan Cherry, who was the first author on the report.

“This work is more hopeful than all of the news around CTE, that always says x-person had CTE,” Cherry says, noting the tragedy of only being able to identify the disease after death. “The early step to treating CTE is identifying it early. We don’t want it to get to a state where people have progressed really far with the disease and have all these cognitive issues. If we can catch it early we can find ways to treat it and stave off these later things and help in recovery.”

Imagine the possibility of current hockey players being able to detect the early stages of CTE as they can a torn knee ligament — or genetic disorders such as Multiple Sclerosis (which ended Bryan Bickell’s career) or Malignant Hyperthermia (which ended Cody Hodgson’s). Along with the ability to detect CTE, researchers are hopeful that they can develop ways to help reduce its debilitating symptoms or prevent it entirely.

But if — as a great deal of research suggests is the case — a sizeable number of current players are found to have CTE, what will that mean for the game itself?

Will players retire? Will doctors force them to? What responsibility will the league have? What if star players and not only enforcers show signs of CTE? How will that change the narrative?

And what will it mean for the future of the game, if the disease no longer carries the distance that comes with the current limitation of only being able to detect it in the dead? That the disease did exist in the brain of a dead player, for some reason, seems to hit a lot less hard than would the irrefutable understanding that it does in the brain of the star player you’re watching on a Saturday night.

The existence of brain trauma in sports is not new, of course. But our understanding of it is. Concussions have been a topic of immense concern in the minor hockey levels for at least two decades. But researchers believe that concussions aren’t the only problem. It’s repeated impact to the head, over and over. It’s easy to see that kind of impact demonstrated on the line in a football game. But how dangerous are the impacts that occur in every collision on the ice?

“Right now when people ask me, ‘How do I not get CTE?’, I tell them, ‘Don’t get hit in the head,’” Cherry says. “But what we’re trying to do in the future is to have that treatment so we can mitigate it before it even occurs.”

Researchers also know that some people are more prone to CTE than others, though it’s not clear which people or why. But will parents be willing to let their children find out what side of the genetic coin their kids fall?

These questions already swirl around the game, of course. They are raised in every discussion about the potential class-action lawsuit the NHL faces from a slew of former players who claim the league didn’t do enough to protect them from or make them aware of the dangers of head injuries while they played. They spike with each new study that connects brain trauma to contact sports. Recently, they were raised by Hall of Fame player Ken Dryden, who explored the need for safety measures in his new book, Game Change: The Life and Death of Steve Montador, and the future of hockey.

Prime Time Sports
Ken Dryden talks 'Game Change', and future of hockey
October 19 2017

The questions exist, but they fade in and out of hockey discourse. We grow tired of the discussion — or dismiss it outright – until the next time Sidney Crosby is crumpled on the ice, or a former player is found dead after years of unbearable symptoms of severe head trauma. But if the rapid advancements in our understanding of CTE continue — and if indeed, the disease can soon be detected in people who are still alive — it could have a fundamental impact on the game.

“There’s still a lot to know when it comes to this disease,” Cherry says. “People have been studying Alzheimer’s for 100 years now. We’ve been studying CTE for 15.”

But while we still don’t have the complete CTE picture, we may not be far from better understanding its relationship to hockey — and that could change the game forever.

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