CTE study of 77 dead hockey players: Risk for brain disease increased with each year played

Rick Sobey, Boston Herald on Dec 6, 2024

Published in Hockey

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BOSTON — Another CTE study is exposing the dangers of repetitive head impacts for athletes.

The largest study ever of CTE in dead hockey players found that the odds of having chronic traumatic encephalopathy significantly increased with longer careers.

The Boston University CTE Center study of 77 dead male ice hockey players showed that the risk for the brain disease jumped by 34% with each year played.

Eighteen of the 19 dead National Hockey League players who were studied had CTE — a neurodegenerative disease caused by repeated traumatic brain injuries, and most frequently found in former contact sport athletes exposed to repetitive head impacts.

While many think of CTE risk as limited to hockey enforcers, this study makes it clear that all male ice hockey players are at risk.

“Ice hockey players with longer careers not only were more likely to have CTE, but they also had more severe disease,” said corresponding author Jesse Mez, co-director of clinical research at the BU CTE Center.

“We hope this data will help inspire changes to make the game safer as well as help former ice hockey players impacted by CTE get the care they need,” added Mez, who’s an associate professor of neurology at BU Chobanian & Avedisian School of Medicine.

The researchers studied male brain donors who had been amateur and professional ice hockey players. They found 96% (27 of 28) of pro players had CTE (18 of 19 NHL players, and all nine non-NHL pros); 46% of college, juniors and semi-pro players (13 of 28); and 10% (2 of 21) of youth and high school players.

Among enforcers, the researchers found that 18 of 22 had CTE, but the difference between enforcers and non-enforcers was not statistically significant after accounting for years of play.

“Enforcers have dominated the CTE conversation, but our findings provide the most evidence for the cumulative amount of play as the predominant risk factor for CTE,” Mez said. “Enforcers had about twice the odds of developing CTE, but the takeaway here is that non-enforcers are getting CTE as well.

“Ice hockey players skate quickly, and checking leads to impacts with other players, the ice, boards and glass,” Mez added. “We think years of play is a proxy for these impacts that are harder to measure directly, but are likely what are leading to the disease.”

After football and rugby, ice hockey is the third major sport to show a dose-response relationship between years of play and CTE risk, further strengthening the evidence that repetitive head impacts cause CTE.

The risk for CTE among female ice hockey players remains unknown, and because the rules around checking differ, the results should not be generalized to female ice hockey players.

The researchers stressed that the CTE data reported in this study should not be construed as the prevalence of CTE in the target population, as families whose loved ones are symptomatic are more likely to donate their brains.