NYTimes: Autopsy Shows the N.H.L.’s Todd Ewen Did Not Have C.T.E.


By JOHN BRANCH FEB. 10, 2016 When the former N.H.L. enforcer Todd Ewen died in September, reportedly of a self­inflicted gunshot, his brain was sent to researchers. Years of memory loss and undiagnosed depression led to speculation that Ewen, 49, had chronic traumatic encephalopathy, a degenerative brain disease caused by repeated blows to the head. On Wednesday, researchers in Toronto announced that Ewen did not have C.T.E., upending presumptions about the disease and raising more questions about why some athletes get it and others do not, even those displaying some of C.T.E.’s classic symptoms. “These results indicate that in some athletes, multiple concussions do not lead to the development of C.T.E.,” said Dr. Lili­Naz Hazrati, the neuropathologist who conducted the autopsy. “Our findings continue to show that concussions can affect the brain in different ways. This underlines the need to not only continue this research, but also be cautious about drawing any definitive conclusions about C.T.E. until we have more data.” C.T.E., which can be diagnosed only posthumously, has been found in other N.H.L. players, including the enforcers Derek Boogaard, Bob Probert and Steve Montador. “Every time it was announced that a fellow player had C.T.E., Todd would say, ‘If they had C.T.E., I know I have C.T.E.,’ ” Kelli Ewen, Todd Ewen’s widow, said in a statement through the Krembil Neuroscience Centre’s Canadian Concussion Centre in Toronto, which conducted the tests. “He was terrified by the thought of a future living with a degenerative disease that could rob him of his quality of life and cause him to be a burden to his family.” Ewen, from Saskatchewan, played 11 seasons in the N.H.L. with St. Louis, Montreal, Anaheim and San Jose, ending his career in 1997. He played 518 regular­season games and had 36 goals and 1,911 penalty minutes. While concern over C.T.E. has grown exponentially in recent years, especially among football players, vexing questions persist. Researchers do not know why one athlete might not show any signs of C.T.E. while the brain of another with a similar career and injury history displays extensive damage. Researchers at Boston University have found C.T.E. in 90 of the 94 brains of former N.F.L. players that they have studied, including that of quarterback Ken Stabler, an announcement made last week, days before he was elected to the Pro Football Hall of Fame. For decades, the disease that came to be called C.T.E. was found in boxers. Researchers in recent years have also found it in those who played soccer, rugby and other contact sports. But because most of those brains were donated by families searching to understand why their loved one’s behavior changed so radically in later years, and reliable testing can be done only posthumously, no one is sure of the actual incidence rate. Research shows that C.T.E. is caused by repeated blows to the head, even subconcussive ones. A study by the Mayo Clinic, released in the fall, found C.T.E. in 21 of 66 men who played contact sports, mostly football, but found no traces of the disease in 198 brains of men who had no exposure to contact sports. The Mayo Clinic said it was unclear whether brain changes in the athletes had caused any changes in behavior. The Canadian Concussion Centre said that it had examined the brains of 20 former athletes and had found C.T.E. or other neurodegenerative diseases in about half. “We were very surprised by the results, as we were sure Todd must have had C.T.E.,” Kelli Ewen said in the statement. “We hope that anyone suffering from the effects of concussion takes heart that their symptoms are not an automatic diagnosis of C.T.E. Depression coupled with other disorders can have many of the same symptoms of C.T.E.” A version of this article appears in print on February 11, 2016, on page B12 of the New York edition with the headline: Surprising Find: N.H.L. Enforcer Did Not Have C.T.E. . © 2016 The New York Times Company