CTE in Hockey

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Re: CTE in Hockey

Post by rainier2 » Tue Nov 12, 2019 7:54 pm

A Preliminary Study of Early-Onset Dementia of Former Professional Football and Hockey Players

Participants: Twenty-two retired professional hockey and football athletes (average age 56 years) and 21 age-matched noncontact sport athlete controls.

Conclusion: None of the retired contact sport athletes qualified as having early-onset dementia consistent with chronic traumatic encephalopathy. There were no remarkable differences in imaging, cognition, behavior, or executive function from noncontact sport athletes. The results underscore an apparent disconnect between public perceptions and evidence-based conclusions about the inevitability of chronic traumatic encephalopathy and the potential neurodegenerative effect on former athletes from contact sports.

https://journals.lww.com/headtraumareha ... _of.9.aspx

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Re: CTE in Hockey

Post by rainier2 » Tue Nov 12, 2019 7:58 pm

No Linear Association Between Number of Concussions or Years Played and Cognitive Outcomes in Retired NFL Players.

METHOD: Thirty-five retired NFL players over the age of 50 who had sustained at least one concussion completed a clinical interview and brief neuropsychological battery. Correlational analyses were conducted between exposure variables [number of total concussions, concussions with loss of consciousness (LOC), and years played] and cognitive performance as characterized by cognitive composite scores based on performance on neuropsychological measures (attention/processing speed, language, memory, and overall composite scores).

CONCLUSIONS: We did not find a significant linear association between cognitive outcomes and either number of total concussions, concussions with LOC, or years played in the NFL. These findings do not support a dose-response relationship between sports-related exposure to head impacts and cognitive outcomes later in life. Rather, the findings suggest that cognitive difficulties experienced by some retired players later in life are not directly linearly associated with quantified exposure to head impacts sustained throughout a football career, but related to factors or combinations of factors that have yet to be elucidated.

https://www.ncbi.nlm.nih.gov/pubmed/30844072 (March 2019)

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Re: CTE in Hockey

Post by rainier2 » Tue Nov 12, 2019 8:03 pm

Is football bad for the brain? We know little about the long-term effects of concussions

by Munro Cullum, Ph.D., a neuropsychologist at UT Southwestern Medical Center’s Peter O’Donnell Jr. Brain Institute in Dallas.

"As a neuropsychologist, I applaud the increased attention that has led to improved protocols for diagnosing sports-related concussions and removing athletes from play until they have fully recovered. But I worry that the pendulum has swung too far. The reality is that we still don’t know who is most likely to suffer a concussion, who will take longer to recover, how anatomic or genetic differences influence concussions, and who may be at risk of prolonged symptoms or developing cognitive problems later in life."

"Rather than allowing fear to deprive children of the benefits of sports participation, let’s allow science to define the risks and help us make informed decisions."

https://www.statnews.com/2019/09/27/con ... m-effects/ (Sept. 2019)

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CTE Risk More Than Doubles after Just Three Years of Playing Football, says new study

Post by greybeard58 » Wed Nov 13, 2019 11:21 am

CTE Risk More Than Doubles after Just Three Years of Playing Football, says new study

For every year of absorbing the pounding and repeated head collisions that come with playing American tackle football, a person’s risk of developing chronic traumatic encephalopathy (CTE), a devastating neurodegenerative disease, increases by 30 percent. And for every 2.6 years of play, the risk of developing CTE doubles. These new findings from an analysis of 266 deceased former amateur and professional football players—reported in Annals of Neurology by a team of researchers from the Boston University CTE Center—are the first to quantify the strength of the link between playing tackle football and developing CTE.

In a critical distinction between many previous CTE studies, the analysis included dozens of brains of former football players who did not have CTE. That sizable control group provided enough data for the researchers to be confident in their discovery that there is a strong relationship between CTE risk and the number of years a person plays football.

“This study is a testament to the hundreds of families who have donated their loved one’s brain…. It is only because of this support that we can confidently estimate the strength of the relationship between duration of [football] play and risk of CTE,” says the study’s corresponding author Ann McKee, a William Fairfield Warren Distinguished Professor and a School of Medicine professor, director of the BU CTE Center, and chief of neuropathology at VA Boston Healthcare System.

The large number of brain donations has provided the researchers with a big enough sample size (the CTE Center has amassed about 700 brains in total), that they can draw statistically relevant conclusions from their analyses.

“While we don’t yet know the absolute risk of developing CTE among American football players, we now can quantify that each year of play increases the odds of developing CTE by 30 percent,” says lead author Jesse Mez, a MED assistant professor, director of BU’s Alzheimer’s Disease Center Clinical Core, and a CTE Center researcher. “We hope that these findings will guide players, family members, and physicians in making informed decisions regarding play.”

As part of their analysis, the researchers also looked at other potential variables, including the total number of concussions, football positions played, a person’s age at first exposure to tackle football, their participation in other contact sports, their race, and the presence of other diseases, to see whether those factors had any influence on a person’s CTE risk, or if they were diagnosed with CTE, the severity of their CTE symptoms. They found no associations between these other variables and CTE risk or severity.

But the researchers did find that among players with a CTE diagnosis, their odds of developing severe symptoms of the disease doubled for every additional 5.3 years of football played. Those who played tackle football fewer than 4.5 years were 10 times less likely to develop CTE than those who played longer, although several men who played four years or fewer were diagnosed with CTE, including three whose only contact sport was football. Those who sustained the longest careers, playing more than 14.5 years, were 10 times more likely to develop CTE than those who played fewer years. But the researchers noted that several players with football careers longer than 15 years did not have evidence of CTE.

The average length of players’ careers in the National Football League is 3.3 years. But the premature and sudden retirements of a number of stars in the league, including Indianapolis Colts quarterback Andrew Luck, Detroit Lions receiver Calvin Johnson, and New England Patriots tight end Rob Gronkowski, have put renewed attention on the toll the game takes on players’ bodies.

The BU team drew their findings from analyzing the brains of 223 football players with CTE, and 43 without, from the brain banks at the Veterans Affairs-Boston University-Concussion Legacy Foundation and the Framingham Heart Study, both of which are directed by McKee. Family members of the deceased provided information about the amount of time that the brain donors spent playing football or other contact sports while they were alive. For former professional players, an online database also was consulted. All of the brains underwent a complete neuropathological evaluation—the researchers were not made aware of the clinical history of any of the donors before examination—and CTE diagnoses were made using well-established criteria.

A major concern of doing CTE research utilizing brain banks is that brain donors—who may pledge their brain tissue based on neurological symptoms they’ve experienced during life—may not be representative of the general population. These factors may bias the relationships being investigated by researchers. But McKee, Mez, and their collaborators show in this latest study that the strength of the relationship between CTE and years of football played remained consistent even after they factored in these potentially biasing factors.

Although CTE currently can only be diagnosed after death, Mez says, “these findings move us closer to diagnosing CTE in life, which is critical for testing potential therapies and for guiding clinical care.”

This study was funded by the National Institutes of Health, the Department of Defense, the Department of Veterans Affairs, the Alzheimer’s Association, the National Operating Committee on Standards for Athletic Equipment, the Nick & Lynn Buoniconti CTE Research Fund, the Concussion Legacy Foundation, the Andlinger Family Foundation, WWE, and the National Football League.

CTE Risk More Than Doubles after Just Three Years of Playing Football
BU researchers discover a strong link between time of football play and rising chance of getting the disease
Read more: https://www.bu.edu/articles/2019/cte-football/

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Pain, agony and years of duress: how hockey families handle chronic brain injuries

Post by greybeard58 » Thu Nov 28, 2019 10:55 am

Pain, agony and years of duress: how hockey families handle chronic brain injuries

Jennifer Belak Liang remembers her car phone ringing as she was picking up her daughters Alex and Andie from school one day in August 2011. It was the agent for her husband, hockey player Wade Belak.

On speaker phone, the agent asked her if she had spoken to her husband that day.

She hadn't. It was the second phone call she received asking that question and it filled her with dread.

"Wade is really hurt," the agent said.

"It was awful. I was called by multiple friends … they knew before I knew. But they didn't know what to say," Belak Liang said of the day she lost her husband to suicide.

Belak's suicide was the third death in a cluster of tragic and sudden deaths of NHL enforcers, including Derek Boogaard, 28, and Rick Rypien, 27. All had been tasked with fighting on ice and all suffered multiple hits to the head. There have been other deaths of players since, including Steve Montador and Todd Ewen.

Now, the wives of some of the retired hockey enforcers are in their own fight, taking on the NHL and commissioner Gary Bettman. They want the league to acknowledge there's a link between fights and head injuries on the ice and long-term effects like degenerative brain disease. They also want more support for families struggling with symptoms of traumatic brain injury.

"My husband had CTE. He was showing signs of CTE. He took his own life," said Belak Liang. "It's going to be many more... It's [an] injustice to everyone else out there, I think, for them not to admit that this can happen."

Wade Belak had recently retired from his 14-year career with the National Hockey League and was in Toronto in the summer of 2011 rehearsing for the show Battle of the Blades — the CBC reality show that pairs hockey players with figure skaters. At approximately 1:30 p.m. on Aug. 31, he ended his life.

After the loss of her husband, Jennifer Belak Liang struggled with feelings of isolation and guilt.

"I was drowning, blaming myself," she said in an interview with The Fifth Estate.

At the time, she knew little of chronic traumatic encephalopathy (CTE), a progressive degenerative disease. Her husband had asked that in the event of his death, his brain be tested for the disease. She fulfilled his wish, and he was diagnosed with CTE.

Since the loss of her husband, Belak Liang, who has since remarried, tries to offer support to others facing tragic loss of loved ones.

'Knew his role'

As an NHL enforcer who played 14 seasons in the NHL, Belak "knew his role," said Belak Liang. "He didn't love it, but he was fine with it [because] he wanted to stay within the NHL and have his career.

"He told me: 'I can't stay here unless I fight.' "

While many hockey players can make millions during their career, brain trauma and concussions can take a toll, especially for those who played the role of an enforcer — a role now being phased out.

It was during her husband's last years with the Nashville Predators that Belak Liang noticed a shift in his behavior.

"It started about five years before he passed. He just got really introverted, really quiet at home. When the kids were screeching or making noises, I could see him not able to handle it, which was not like him."

About eight months before he died, Belak noticed a decline in her husband's memory. He'd use his phone to help remember daily tasks, including taking pictures of groceries he had to buy.

'Through sickness and in health'

Many experts say concussions can often lead to a cycle of substance abuse, depression, memory loss, even suicide.

Daniel Carcillo, 35, from King City, Ont., has won two Stanley Cups with the Chicago Blackhawks, and was known as Car Bomb for his reckless fighting style on ice. He now battles depression and suicidal thoughts.

Carcillo said his wife, Ela Bulawa, has been burdened. "But I think that's what marriage and loving somebody is all about, right? Through sickness and in health."

While he was in his final NHL season with the Chicago Blackhawks in 2015, Carcillo suffered great personal loss: the passing of his grandfather, as well as his best friend and teammate, Steve Montador, who was found to have CTE.

Carcillo, who had seven concussions during his NHL career, wonders if he could become another statistic. "Wade had CTE. Are these reaffirmations that I'm going to have CTE?... "There's a pretty good chance."

Recognizing the signs

Once retired, players can often feel abandoned and without support. Carcillo said he has felt that way. But he's taken steps to heal: functional neurology therapy, acupuncture, proper nutrition and diet. He speaks publicly, often on social media, about traumatic brain injury and the impact it can have.

"I'm very, very proud of Daniel, from where he has been, and where he is now," Bulawa said.

They have started a foundation called Chapter 5, which aims to provide support to retired players and their families, especially players who are suffering post-concussion syndrome, anxiety and depression.

"They put their whole lives into playing hockey and being the best of the best. And once it's over, then what?" said Bulawa. "It shouldn't just be,'Oh, that's it, sorry guys. See ya later.' "

Carcillo and Bulawa have learned to recognize signs of his depression returning, for example sleeping in, impulse control issues, loss of appetite and withdrawal from friends and family.

Blurry vision and headaches

Todd Ewen played hockey in the era when even after getting rocked on the ice, players were sent back out again. Both he and his wife, Kelli, believed he experienced head trauma because he had symptoms: blurry vision, headaches and sleeplessness.

After playing 11 seasons in the NHL, Todd Ewen retired in 1997. He became a real estate agent, was a musician, patented several inventions and coached the St. Louis University Billikens.

But Ewen was struggling. He became aggressive with Kelli. Depression, memory loss and confusion plagued him.

By 2013, he gave up coaching because he couldn't remember plays and was missing practices.

"We didn't know who we had. One day we had the sad Todd, the mad Todd, the angry Todd. We had no idea what was going on. This man suffered for years like this, our family suffered for years like this," his wife said.

They wondered if he could have Alzeimher's or Parkinson's disease, but with the loss of Rypien, Boogaard and Belak in 2011, Ewen began to wonder if he could have CTE. He told Kelli one day that he didn't want to be a burden. At the time, she did not realize the weight of his words.

On Sept. 19, 2015, Kelli Ewen found her husband in the basement of their home near St. Louis. He was 49 when he killed himself.

The Ewen family was contacted by the Canadian Concussion Centre in Toronto asking to study Todd's brain.

"I knew something was wrong. And I thought maybe this is the answer. I read the articles about [CTE]. I could just check off the boxes, just one after another. And I thought this has to be it."

But neuropathologist Dr. Lili-Naz Hazrati at the centre told Kelli her husband did not have CTE. She was devastated and desperate for an explanation and said she asked the doctor to retest his brain, but Hazrati declined.

Class action lawsuit

In 2018, a class action lawsuit between more than 300 retired players and the NHL was settled. Players had accused the league of failing to protect them from head injuries or warn them of the risks involved with playing.

Ewen's negative CTE results were used as an example in the lawsuit of how media hype could lead a person to kill themselves because of fear of having CTE.

Bettman wrote: "This, sadly, is precisely the type of tragedy that can result when plaintiffs' lawyers and their media consultants jump ahead of the medical community and assert, without reliable scientific support, that there is a causal link between concussions and CTE."

Kelli Ewen said she was was extremely hurt, and believed they were using her husband for the benefit of the lawsuit.

The NHL announced an $18.9-million US settlement — $22,000 US per player and medical expense coverage up to $75,000 per person. However, there was no acknowledgement of liability for the players' assertions.

Carcillo refused to participate in the settlement.

Another test

Kelli Ewen couldn't live with the results from the Canadian Concussion Centre. She arranged to have samples of her husband's brain sent to Dr. Ann McKee, a neuropathologist and director of Boston University's CTE Center.

Her research, much of which has involved professional athletes, focuses on the long-term effects of all kinds of brain injury, which can include CTE. Currently, CTE can only be diagnosed with an autopsy.

While there is no known treatment, the hope is research from Boston University's brain bank will one day allow the detection of the disease in life, "while there's still a chance to do something about it," McKee said.

In late 2018, McKee revealed her own conclusions to Kelli Ewen, stating her instincts were correct: her husband did, in fact, have CTE.

"[Gary Bettman] still stands by the [original] findings, which I find mind-boggling," Kelli Ewen said.

'It's not about money'

Kelli Ewen filed a lawsuit against the NHL on April 30, 2019, challenging the league's dismissal of a link between hits to the head during hockey games and CTE . She wants to bring awareness to concussions and CTE and the suffering families go through when they don't understand the symptoms they're seeing with their husbands.

"It's not about money, you know? It's about the pain, the agony, the years of duress," she said.

"I feel like it's the NHL's responsibility to stand up and take care of these players that this great game of hockey was built on; these fighters that gave, essentially, their lives for the NHL. And it's time for them to step up and admit and help them get the help they need."

The day after Kelli Ewen's lawsuit was filed, Bettman appeared before a Commons subcommittee in Ottawa regarding sports-related concussions and safety.

Bettman questioned any direct link between multiple hockey concussions and CTE, saying "in short, I don't believe based on everything I've been told — and if anybody has information to the contrary, we'd be happy to hear it — other than some anecdotal evidence, there has not been that conclusive link."

"Our players like the way the NHL game is played and understand the implications of playing a physical contact sport at the highest professional level in the world," he said.

"At the end of the day we view ourselves as a family, and our resources are available to the members of our family."

Jennifer Belak Liang, Kelli Ewen and the Carcillo family would disagree.

"It's crazy to me that they won't admit anything. It's sad," Belak Liang said.

"At least admit it's real," said Ewen. "That would go a long way with a lot of the families."

The Fifth Estate requested an interview with Bettman to address the wives' concerns, but the only response was: "Thank you for your inquiry. We will not be participating."

At a sports conference in Toronto last week, The Fifth Estate's Bob McKeown approached Bettman. All he would say was: "How are you? Nice to see you. I gotta go."

Pain, agony and 'years of duress': How hockey wives are fighting back over players' chronic brain injuries
Women also want more support for families struggling with symptoms
Read more: https://www.cbc.ca/news/canada/hockey-p ... -1.5370444

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"Here’s the documentary that Gary Bettman doesn’t want you to see"

Post by greybeard58 » Tue Dec 03, 2019 12:15 pm

"Here’s the documentary that Gary Bettman doesn’t want you to see"

Sports Agent/Lawyer Allan Walsh: "Here’s the documentary by the Fifth Estate that Gary Bettman doesn’t want you to see. This is an honest, in-depth look at NHL players with traumatic brain injuries and the impact on their families. A group of wives are fighting back.”

Behind the facade of glamour and wealth, the wives of some retired hockey enforcers are in their own fierce fight. They want the NHL to acknowledge that there's a link between fights, and head injuries on the ice and long-term effects like degenerative brain disease. Women like Jennifer Belak and Kelli Ewen whose husbands Wade Belak and Todd Ewen took their own lives are part of that fight but so too is Ela Carcillo. She is married to recently retired player Daniel Carcillo who says he wonders if he will become one of the sad statistics.

Hockey Fight: Wives Reveal The Cost of Concussions - The Fifth Estate
Watch at: https://www.youtube.com/watch?time_cont ... e=emb_logo

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Minnesota judge rules former 'Miracle on Ice' star mentally ill and dangerous

Post by greybeard58 » Wed Dec 04, 2019 11:45 pm

Minnesota judge rules former 'Miracle on Ice' star mentally ill and dangerous
Former U.S. Olympic hockey player Mark Pavelich was ordered committed to a secure treatment facility.
By Pam Louwagie Star Tribune DECEMBER 4, 2019 — 9:30PM

A Minnesota district judge ruled Wednesday that former “Miracle on Ice” U.S. Olympic hockey player Mark Pavelich is mentally ill and dangerous and ordered him committed to a secure treatment facility.

Pavelich, 61, of Lutsen, Minn., will get another hearing in February to determine whether he should remain committed for an indeterminate period of time.

Pavelich faced criminal charges that he beat a friend with a metal pole in August after a day of fishing. Charging documents alleged that he had accused the friend of “spiking his beer” and that his friend suffered cracked ribs, a bruised kidney and a fractured vertebra, as well as bruises.

Judge Michael Cuzzo found Pavelich incompetent to stand trial, however, concluding based on an expert report that Pavelich was “incapable of participating in the defense due to mental illness or deficiency.” The criminal case was put on hold while the state moved to civilly commit him to treatment.

Two clinical psychologists who examined the former hockey star found Pavelich to have post-traumatic stress disorder, as well as other conditions, according to Cuzzo’s order. Both found that he lacked insight into his mental illness and opposed treatment. Both considered him to be mentally ill and dangerous.

According to the order, psychologist Chris Bowerman found Pavelich to have delusions and paranoia, including a delusion that family, friends and neighbors tried to poison him. Bowerman noted that Pavelich’s responses escalated from damaging property to inflicting harm on another person.

Psychologist Jacqueline Buffington found Pavelich suffers from “mild neurocognitive disorder due to traumatic brain injury with behavioral disturbance (psychotic symptoms, aggression),” and opined that his condition is likely related to head injuries suffered over his lifetime.

Buffington also found that Pavelich sometimes “responded irrelevantly” to questions and struggled to express himself. She said it reflects a “mild anomic aphasia,” or communication difficulty that “usually results from damage to the brain,” according to the order.
The findings revealed in the court documents reflect what some of Pavelich’s family members have said in the past. They are convinced that Pavelich suffers from CTE, or chronic traumatic encephalopathy, after repeated concussions and blows while playing in the NHL. They said they started seeing changes in him a few years ago and had tried to get help for him, but that he had refused.

His sister, Jean Gevik, has called his case “heartbreaking.”

“He’s been an amazing brother. Fun. Loving,” she has said. “This has been a total change.”

The NHL has faced criticism for its handling of head injuries despite a long list of rules, studies and league-player committees focused on enhancing player safety. The league reached a court settlement last year with hundreds of retired players who claimed harm from head injuries while playing, but the NHL admitted no fault or wrongdoing. Pavelich did not make a claim, his sister has said.

Pavelich assisted on Mike Eruzione’s winning goal in a stunning upset of the heavily favored Soviet Union in their medal-round game of the 1980 Olympic hockey tournament, referred to as the “Miracle on Ice.” Team USA went on to defeat Finland to win the gold.

Pavelich played with the New York Rangers for five seasons and briefly joined the Minnesota North Stars and San Jose Sharks. Out of the game since 1992, he has lived quietly in Cook County.

His wife, Kara, died in an accidental fall from a balcony at their home in 2012, and several years later, Pavelich sold his gold medal for more than $250,000 in an auction.

Pam Louwagie is a regional reporter and Duluth Bureau Chief for the Star Tribune. She previously covered courts and legal affairs and was on the newspaper's investigative team. She now writes frequently about a variety of topics in northeast Minnesota and around the state and region.

pam.louwagie@startribune.com 612-673-7102 pamlouwagie

Minnesota judge rules former 'Miracle on Ice' star mentally ill and dangerous. http://strib.mn/38535ag

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Re: CTE in Hockey

Post by O-townClown » Thu Dec 05, 2019 6:34 pm

so sad for anyone to go through
Be kind. Rewind.

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Tau pathology in the medial temporal lobe of athletes with chronic traumatic encephalopathy

Post by greybeard58 » Sat Jan 04, 2020 12:49 am

Tau pathology in the medial temporal lobe of athletes with chronic traumatic encephalopathy: a chronic effects of neurotrauma consortium study | Acta Neuropathologica Communications | Full Text

https://actaneurocomms.biomedcentral.co ... 019-0861-9

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A broken star: Family hopes Olympic hockey player Mark Pavelich's story helps others

Post by greybeard58 » Sun Feb 09, 2020 3:53 pm

Broken Star

He was once an American sports hero, a high-flying playmaker from Minnesota’s Iron Range who competed with the best hockey players in the world.

Forty years ago this month, Mark Pavelich was thrust into the international spotlight when he passed the puck to a U.S. Olympic teammate for the game-winning goal over the powerful Soviet Union in an epic matchup forever remembered as the “Miracle on Ice.” Two days later, the U.S. won gold.

But now, on a gray wintry day in the Cook County courthouse, Pavelich’s glory days were a distant memory.

His once-thick brown hair was tousled and silver, the star-spangled uniform of the 1980 Olympic team replaced by a faded striped jailhouse jumper. Charged with beating a neighbor with a metal pole, the 61-year-old sat handcuffed before a judge as he listened to psychologists opine that he was so mentally ill he couldn’t be trusted with his own safety.

It was a heartbreaking fall for his family and friends to see. This wasn’t the kind, generous introvert they knew, the quiet, solitary man who wasn’t apt to pick a fight. This was a Mark Pavelich they didn’t recognize — someone who, in recent years, had started to act confused, paranoid and borderline threatening. And it left them wondering: Was the game that had given Pavelich so much purpose and joy through the years also destroying him?

Too many hits, too many blows to the head, too many collisions while battling for loose pucks on rinks from Eveleth to New York City have led Pavelich’s family to believe he suffers from chronic traumatic encephalopathy (CTE), a degenerative disease that can manifest in violence, impulsiveness and paranoia.

This spring, months after sending Pavelich to a secure state facility for mental health treatment, a judge is expected to decide whether his condition has improved to the point where he is no longer deemed dangerous.

Pavelich, speaking by phone from the facility, said recently that he felt he shouldn’t grant an interview while the determination is pending. “It’s just too tricky here,” he said.

In the meantime, his family is working to call attention to his plight and that of other athletes forever damaged by the games they played.

“Maybe his story is supposed to help a lot of people,” said Jean Gevik, Pavelich’s sister. “That’s what I’m hoping.”


Mark Pavelich declared as a young boy that he was going to be an Olympian.

“It wasn’t a question,” Gevik said. “He was going to make it work.”

Growing up in Eveleth, where hockey reigns supreme, Pavelich skated on the lake in front of his house as well as at a rink a quarter mile away. He rose before dawn to practice, and he often stayed late after other players left to work on stickhandling drills or to practice passing the puck from skate to stick. On some school nights, his parents practically had to drag him home.

A big Bobby Orr fan, he and teammate Ronn Tomassoni persuaded the manager at the U.S. Hockey Hall of Fame in Eveleth to let them watch hours of NHL highlights, both boys mesmerized by the smooth-skating Boston Bruins defenseman.

What Pavelich lacked in stature, at 5 feet 8 inches tall, he worked to make up with finesse, speed and grit. Though he didn’t pick fights on the ice, friends said, he never shied away from action. “A lot of guys don’t want to be the first person in the corner because you know you’re going to get hit,” Tomassoni said. But Pavelich “wasn’t going to shy away from the physicality of the game.”

Teammates saw early on that Pavelich was a cut above. “He just skated so smooth. His skates never left the ice,” said Peter Gilliam, a high school teammate. “He just glided.”

And yet, Gilliam and others said, Pavelich was an unselfish player, a center with a sixth sense for finding open wingers for a quick pass and a shot on goal.

“He would have an empty net after beating two defensemen … and give me the goal,” Gilliam said. “People … need to know how gentle Mark was.”

Pavelich’s life was jolted at age 18 when he was involved in a hunting accident that killed his friend. Ricky Holgers, 15, was hit by a ricocheting bullet, his brother Mike Holgers recalled. Pavelich had pulled the trigger. He raced about a mile through the woods to call an ambulance, then ran back to help his brother carry Holgers out, Gevik said. Later, he disappeared into the forest, distraught. A search party found him curled up by a tree, covered in blood, Gevik said.

After that, nobody talked much about it, Gevik said.

“You didn’t know how to deal with tragedy back then,” she said. “You just kind of brushed it under the rug and hoped it went away.”

Holgers’ family remained friends with Pavelich. And Pavelich forged ahead.

He earned a spot on the University of Minnesota Duluth team, where he won All-America honors before going on to star for the 1980 U.S. Olympic team under coach Herb Brooks.

NHL teams later shied away from Pavelich, his small size a big factor. So he learned to fly an airplane and played guitar in a band, often covering the Rolling Stones. He played hockey in Switzerland for a while.

Then Brooks became head coach of the New York Rangers and gave Pavelich a shot at the NHL.

“I don’t care how big or small he is, he can play,” Brooks was quoted as saying in Pavelich’s second year with the Rangers.

Pavelich scored 99 goals in his first three of five seasons with the team. He played in more than 350 NHL games in a career that spanned seven seasons.

“He was knocked down often,” a Star Tribune article said at the time, but “he always got up.”

Pavelich played hockey because he loved the game, not because he was seeking glory, friends, family and former teammates said.

He was quiet around strangers but opened up to those close to him. He was generous with his time and the good fortune that hockey and real estate development brought him, sending signed memorabilia to the children of friends and relatives, buying bonds for nieces and nephews, and showing up at friends’ fundraisers.

He was playful, too, friends and family said. He and a brother pranked his sisters on one of their frequent trips to the Boundary Waters by rustling in the woods to scare them into thinking there was a bear in camp. Afterward, he cracked up laughing.

“When you got to know him well and he felt that he knew you well … it would be a lot of fun,” said John Harrington, a fellow Iron Ranger and college and Olympic teammate.

Though Pavelich was described in media reports as a recluse in his post-hockey life, those close to him say he simply preferred fishing and hunting and spending time outdoors with his dogs.

“He’s always shunned the spotlight, and he’s had some pretty big spotlights on him. But he’s never wanted that,” Tomassoni said. “I think a lot of people misconstrued that shyness maybe for arrogance in some ways … he’s the furthest thing from arrogant.”

Confusion and contradiction

Relatives started noticing changes in Pavelich after his wife — a gifted pianist and painter — died in what was deemed a tragic accident in 2012. Kara Pavelich fell about 15 feet from a small bedroom balcony onto rocks on the couple’s property in Lutsen, apparently trying to get cellphone reception while Mark was taking a nap. He told responders that he woke up and found her on the ground.

“They were like peas and carrots,” Gevik said. “He was lost.”

Pavelich’s brother-in-law, Mark DeCenzo, remembers loading some of Kara’s paintings into his car to take to Pavelich’s mother’s house, as he said Pavelich had requested. A few years later, Pavelich questioned him about it, he said.

“He thought I was stealing stuff,” DeCenzo said. “That was probably the first time I saw something that made me wonder what was going on. … He lost sight of what transpired.”

Gevik remembers being frustrated by her brother’s puzzling inconsistencies, too.

Mark had decided to sell one of Kara’s paintings that had been hanging in an exhibit, saying he couldn’t bear to look at it, Gevik recalled. Thinking he might change his mind, Gevik and her husband planned to buy it so that Mark could have it later, she said.

“Pretty soon it was ‘Jean, I didn’t want to sell that,’ ” Gevik recalled.

He had been similarly perplexing when he decided to sell his Olympic gold medal and other memorabilia in 2014, Gevik said. He wanted to pay off the mortgage for his daughter’s house, he told the family, but kept changing his mind on how much he wanted, to the point where the auctioneer called Gevik.

“What I saw is a lot of confusion and a lot of contradiction,” Gevik said.

A psychology major, Gevik talked with her brother about getting help, she said, but he didn’t want to hear it. He grew angry instead. She ended up going to counseling, she said, trying to figure out what to do.

It was her counselor, she said, who first suggested that Mark might have CTE.

Growing concern

The calls came into the sheriff’s office sporadically over a few years. Mark Pavelich was acting strangely, and his neighbors and family members who called said they were worried. They wanted law enforcement to be aware of what was happening.

Pavelich had accused a neighbor of dumping sludge into his car fuel tank, one caller said. Another believed Pavelich had taken a sledgehammer to a neighbor’s boat.

One relative who telephoned said Pavelich was convinced that cookies from a neighbor were poisonous, and he was keeping them in his freezer as proof.

Then, last summer, a Lutsen resident called to report that he had been attacked with a metal pole and identified Pavelich as the aggressor.

Pavelich was booked into the Cook County jail on assault and weapons charges. A criminal complaint described Pavelich as accusing the neighbor of spiking his beer. The victim suffered two cracked ribs, a bruised kidney and a fractured vertebra, the complaint said.

In October, Pavelich was found incompetent to stand trial on the charges. Later, a psychologist who examined him for civil commitment proceedings determined that he suffered from post-traumatic stress disorder as well as mild neurocognitive disorder due to traumatic brain injury, saying his condition is “likely related” to the head injuries sustained over his lifetime.

DeCenzo and other family members can’t help but wonder whether the trauma of losing his wife so suddenly — and grieving and living alone after that — made his underlying illness unmanageable.

“My guess is … he was probably fighting it and she was probably the stabilizer,” DeCenzo said. “Somebody at home to keep you grounded.”

Diagnosis tricky

That is a possible scenario, said Dr. Bennet Omalu, a pathologist who has done research on CTE but was not familiar with the details of the Pavelich case.

“With all types of diseases, when you have social support, your disease is better managed,” Omalu said, adding that social stressors “are more likely to aggravate your underlying brain disease.”

While CTE can be confirmed only in an autopsy, scientists are working on a test to detect proteins associated with the disease in living people.

But doctors in some cases are now making a presumptive diagnosis of CTE, as they do in other types of dementia, Omalu said, relying on the standard of a “reasonable degree of certainty — meaning more likely than not.”

CTE is not the only type of brain damage an athlete can suffer, Omalu said. And if someone’s family has a history of mental illness, high-impact sports can increase the likelihood of manifesting mental illness, he said.

“Maybe with treatment … medication, his symptoms can subside,” Omalu said.

Pavelich’s family is hoping he will be released from the state facility where he has been housed since a judge found him “mentally ill and dangerous” in December.

A hearing to make a final determination on whether he should remain civilly committed indefinitely is expected to be held this spring.

In the meantime, some former NHL players are working with Pavelich to establish a therapeutic retreat ranch where players, their families and others struggling with mental illness and brain disease can go for counseling, animal therapy and other programs, as well as supporting research on CTE. They have started a fundraising campaign on GoFundMe.

“You’re a good person your whole life …” Gevik said, her voice trailing off as she teared up thinking about what’s happened to her brother.

Now, she said, she just hopes something good can come from it.

“I told him, ‘We can help a lot of people this way.’ ”

A broken star: Family hopes Olympic hockey player Mark Pavelich's story helps others
Read more: http://www.startribune.com/a-broken-sta ... 567696722/

Jack O'Callahan, left, and Mark Pavelich of the 1980 U.S. ice hockey team talked during the "Relive the Miracle" reunion at Herb Brooks Arena on Saturday, Feb. 21, 2015, in Lake Placid, N.Y.
— Mike Groll - Associated Pres

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College football player researched CTE and later died by suicide. Brain study gave his parents answers.

Post by greybeard58 » Tue Feb 18, 2020 3:25 pm

College football player researched CTE and later died by suicide. Brain study gave his parents answers.
Dana Hunsinger Benbow
Evan Hansen with his parents, Mary and Chuck Hansen, two days before he died.
This story explores suicide. If you are at risk, please stop here and contact the National Suicide Prevention Lifeline for support: 1-800-273-8255

Just days before Evan Hansen walked into the woods and died by suicide, he opened his laptop and searched CTE.

The 21-year-old senior football player at Wabash College in Crawfordsville, Indiana, also searched on his computer for Jason Hairston, a former college star who played in the NFL and had just died by suicide. Hairston was later found to have CTE.

Evan's parents, Chuck and Mary Hansen, knew their son had been struggling. They didn't know to what extent. They knew he had been getting help for depression. They didn't know how deep it had gotten.

When Boston University scientists asked the Hansens if they could study their son's brain after his death, their answer was yes. Evan's brain was tested for CTE or chronic traumatic encephalopathy, a neurodegenerative disease linked to repeated blows to the head.

A year later, Chuck and Mary got their answer.

Researchers told them the folds of Evan's brain and top of his spinal column were dotted with the plaque tau — abnormal accumulations of protein that collect inside neurons. He had developed CTE, an incurable disease.

Chuck Hansen believes his son diagnosed himself.

"I think Evan thought he had CTE or some type of injury from playing football," he said. "He was kind of determined to try to figure out a solution."

Evan had been proactive about getting help for his mental health issues and had been on a few medications. Hansen said those drugs "always made him worse." Less than a month before he died, Evan was put on a new antidepressant, his dad said.

"At times it seems like he was controlling it," Hansen said. "Then there were times it was much more difficult for him."

'He was able to hide everything'
The morning he died, Sept. 10, 2018, Evan made three phone calls to 911 but hung up each time.

"He never said a word on the calls," Chuck Hansen said. "We can only guess what he was thinking."

Hansen said he realized something was wrong when he looked at the navigation signal on Evan's phone. The locator had been in the same spot for quite some time. He followed the signal and found Evan's body in the woods.

Just two days before, after a 16-13 Wabash win, Evan had walked with his parents at halftime for senior day. The family celebrated with dinner at The Creekside Lodge in Crawfordsville.

Evan, a 6-foot-1, 200-pound linebacker and team captain, was the middle son of three boys — a gentle guy off the field but a tornado on it. Hansen remembered how Evan was flashing his goofy smile as they ate dinner. They said goodbye, just as they always did.

Evan went home to his Beta Theta Pi fraternity brothers that Saturday night. On Sunday, he showed up for a meeting with his football coaches.

“He didn’t let on to anyone. Nothing,” said Hansen. “He was able to hide everything from everybody. On the outside, he is still smiling and looking to the future.”

On the inside, the charade was over.

Evan Hansen died by suicide Sept. 10. He was the captain of Wabash College's football team.
At the time of his death, Evan had been playing football for 14 years, since he was a rambunctious 7-year-old. He played varsity as a freshman at Guerin Catholic High School in Noblesville. On the field at Wabash, Evan was fearless and loved by his teammates. He liked to make up handshakes with other players and dance to celebrate on the sideline. He was a deep-thinking, kind soul, too. Evan was majoring in biology and Spanish with plans to become a nurse working in underprivileged countries.

The Hansens chose to go public with their son's story in an effort to help others, to bring awareness to the need for research on CTE.

"We are trying to shed light on a story that is kind of easy to sweep under the rug," Hansen said.

CTE can express itself in the form of memory loss, confusion, impaired judgment, impulse control problems, aggression, depression and anxiety, among other issues, said Thomas McAllister, a neuro-psych physician with Indiana University Health and an expert on CTE.

Research on how the disease affects the brain -- as well as how it affects those with CTE -- is an area that continues to be under rapid development, he said.

"At this point in time, the definitive diagnosis can still only be done after death," McAllister said. "What would be nice would be to develop some of these criteria in advance."

And McAllister cautions people not to self-diagnose CTE.

"The danger here is if people say, 'OK, I'm depressed and I'm a football player and therefore I have CTE,'" he said. "That is really not a logical inference."

Depression is treatable.

"At any age, whether you are worried about CTE or not, if you have depression, forget about the cause," he said. "It is something to get help for."

He was 'the rock of the world'
Many factors led to Evan's death, Chuck Hansen said.

"A combination of five or six things we think contributed to him dying," he said, "someone that seemed like the rock of the world."

There was the underlying CTE but also Evan's new medication. There was the stress of school and football, and Evan was extremely fatigued because he had been having trouble sleeping, his dad said. Then there was that CTE computer search that likely hit Evan hard, when he suspected he had the progressive disease.

Evan Hansen played football his entire life and started as a freshman at Wabash College.
"Someone called it a perfect storm or imperfect storm," Hansen said. "It's not one of those things alone that was enough. But all those things culminating at this one point."

Linking CTE alone to suicide isn't something scientists are ready to do, said McAllister, because such a selective group of people makes their brains available for autopsies after death.

"It's a very highly selective patient population," he said.

For the Hansens, donating Evan's brain was an effort to accomplish two goals: More CTE research and finding ways to make sports safer.

"We’re not telling people to never play football or never do any contact sports," Hansen said. "But how can it be safer and what is safe? What is safe enough?"

The Hansens said they don't blame football or Wabash in any way for their son's death.

"Our goal is not to make this a blame game," Hansen said. "It doesn’t matter. There is no money that can ever fix any of this for us."

Getting help
Crisis Text Line provides free, 24/7, confidential support via text message to people in crisis when they dial 741741.

When in doubt, reach out: National Suicide Hotline, 1-800-273-8255

For information and other resources: American Foundation for Suicide Prevention.

Follow IndyStar sports reporter Dana Benbow on Twitter: @DanaBenbow. Reach her via e-mail: dbenbow@indystar.com.

https://www.usatoday.com/story/sports/n ... 760931002/

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Re: CTE in Hockey

Post by O-townClown » Tue Feb 18, 2020 3:43 pm

Another very sad tale. Thanks for sharing. Good news is I feel concussion awareness has increased tremendously.
Be kind. Rewind.

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The fight over CTE continues 5 years after Steve Montador's death

Post by greybeard58 » Tue Mar 03, 2020 10:28 pm

The fight over CTE continues 5 years after Steve Montador's death

Steve Montador's brain smashed against the inside of his skull 19 times in the course of his hockey career, each time hard enough to cause a concussion.

Nineteen times, his brain torqued and twisted.

And after each of those times, he eventually returned to the ice to play the game he loved. But in the end, the brain injuries took a cruel toll.

Montador died five years ago, on Feb. 15, after a 14-year professional hockey career and 571 games in the National Hockey League, including stints with the Calgary Flames and Florida Panthers.

He was 35 years old and left behind a girlfriend who would give birth to their son only four days after his death. The child turned five in February.

An autopsy found Montador's brain had been ravaged by the degenerative brain disease, chronic traumatic encephalopathy (CTE). The only known risk factor for developing CTE is repetitive blows to the head.

Montador, born in Vancouver and raised in Mississauga, was a beloved teammate who played a physical brand of hockey and wasn't afraid to drop the gloves.

After his competitive days were over and his life moved away from the ice, Montador paid the price for all his concussions.

Paul Montador was there to witness his son's downfall. Steve had depression, anxiety, substance use issues, headaches, chronic pain and difficulty sleeping. He became forgetful and struggled to control his emotions and decision-making processes.

"Fortunately he never became violent, but he was very forgetful and then his executive function, his decision-making was erratic and illogical and exaggerated," Paul Montador said. "He became aware ,and everyone else around him became aware, that this was becoming a very serious problem."

Paul remembers a small moment from his son's struggles that highlighted the depth of pain Steve was experiencing.

"He would spend 24 hours [a day] in his bedroom. I was sitting in his living room during that episode. And I was reading the newspaper," Montador said. "He came into the kitchen area and I turned the page in the newspaper and he looked over and he said, 'Dad, please don't do that,' in a very quiet voice. And I said, 'don't do what, Steve?' And he said, 'don't turn the newspaper like that. It kills me.'"

Paul Montador thinks the National Hockey League didn't do enough to protect his son and to educate him about concussions and the possibility of developing CTE. And that's why he's continuing with a lawsuit against the NHL originally started by Steve in the months before he died.

"His intention and therefore my intention and the family's intention in continuing with the court case is to make a difference in the NHL and hold them accountable for the lack of attention that they've paid to this matter," Montador said.

In a motion to dismiss the claim, the NHL's lawyers wrote that claims like Montador's fall within the scope of the collective agreement and should be addressed via arbitration. The motion also denies the NHL had a duty to study the long-term effects of concussions or to refrain from promoting violence in the game.

This isn't the first time the NHL has faced a lawsuit concerning traumatic brain injuries. In 2018, the league settled a lawsuit with 318 players for $18.9 million in payments and medical treatment. The league did not acknowledge any liability in the settlement.

Montador was originally part of the proposed class action, but his estate chose not to accept the settlement. Neither did his former Chicago Blackhawks teammate, Daniel Carcillo, or Boston Bruin Nick Boynton. Now, each of those three players will face the NHL at trial in federal court in the coming months. In Montador's case, depositions are due by the end of May.

The NHL did not respond to multiple requests for comment on this story.

The NHL's defense

The NHL has become accustomed to facing these kinds of tough questions, surrounding concussions, CTE, and the death of some of its former players like Steve Montador.

Derek Boogard, Todd Ewen and Bob Probert are just a few of the players who have died young, post-playing career. All three of them, along with Montador, were found to have been living with CTE. Even Hockey Hall of Famer Stan Mikita was recently diagnosed with CTE after his death.

Throughout the process of defending itself against claims that the league has not adequately educated or protected players from brain injuries and their fallout, the NHL has consistently referred to a medical research paper called the Consensus Statement on Concussion in Sport.

The consensus statement is written by a panel of 36 experts in the field of concussion medicine and it says a cause-and-effect relationship has not been established between sports-related concussions and CTE. But critics say that simply isn't true, pointing to more than 200 studies from Boston University and many more around the world that have found CTE in post-mortem autopsies of athletes. The only experience common to the subjects of those studies was receiving repetitive blows to the head.

The conference which produces the consensus statement is sponsored by large sports organizations including the International Olympic Committee (IOC), and world soccer body FIFA.

Critics of the consensus paper say big sports organizations are highly represented among authors of the statement. Thirty-two of the 36 panellists who wrote the statement have direct relationships with organizations like the NHL, National Football League, National Collegiate Athletic Association, the International Olympic Committee and more. Many of the affiliations existed at the time of the statement being written. Others developed in the years following the conference, while others predate it.

In his 2019 testimony to the parliamentary subcommittee on sports-related concussion in Canada, NHL commissioner Gary Bettman referred to the consensus statement six times.

Bettman was asked by Liberal MP Darren Fisher: "What is your belief now and what is the league's position these days on whether there is a link between CTE and concussions?"

"I'm not sure that the premise that the link is clear now is one that the scientific and medical communities have embraced," Bettman replied. "The consensus statement, which was subscribed to by 36 practitioners in the field, again has continued to say that there has yet to be the ability to draw the conclusion that one will lead to the other."

The NHL's reliance on the consensus statement was also noted in its defense of the lawsuit from former players that was eventually settled.

"All of the consensus statements played a significant role in the NHL's defense of the case and in particular the defense to our argument that the NHL failed to warn the players of the long-term neurological consequences of repetitive head trauma" said Stuart Davidson, co-lead counsel for the plaintiffs in the NHL case.

"They also relied on the statements … where the panel concluded that a cause-and-effect relationship had not yet been demonstrated between CTE and concussions in sports."

"When I see a player being punched or hit violently … it's emotionally difficult.," he said. "It upsets me because I immediately flash forward to the potential tremendous negative risk that that player … could be subject to. And I would like for no one else to go through what my son went through."

And while a new consensus statement on concussion in sport is expected in 2021, It will be interesting to see whether the NHL continues to employ the last consensus paper in its case against the Montador family and Carcillo and Boynton in U.S. Federal Court, expected to begin in the coming months.

Brain Trust is a CBC Vancouver series that investigates the world of concussions, CTE and the medical research that informs their treatment.'I would like for no one else to go through what my son went through'

Steve Montador's dad, Paul, continues to be concerned about the way the NHL deals with traumatic brain injuries.

"There are still people out there who deny CTE and it hurts me," he said.

The fight over CTE continues 5 years after Steve Montador's death
Former NHLer's family is taking the league to court
Read more: https://www.cbc.ca/news/canada/british- ... -1.5482657

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