NEWARK, N.J. — As the NHL grapples with the disputed effects of head injuries in hockey, Ben Lovejoy made what can be considered a positive contribution last month, becomming the first active NHL player to pledge to donate his brain to CTE research.

With his announcement, made by the Concussion Legacy Foundation on Dec. 7, the 33-year-old Devils defenseman joined the more than 2,500 former athletes and military veterans who have pledged to donate their brains to the Boston University CTE Research Center since 2008. But NHL players by and large have been reluctant to join the fight. And with the league still in the dawn of understanding head trauma within the sport, Lovejoy has become a pioneer in helping raise awareness about the options players have.

He said his interest in donating his brain emerged three or four years ago, but it manifested when he read an article that the NHLPA sent over the summer.

“The first headline on the email in June or July was that no active NHL player had pledged to donate their brain to CTE research," Lovejoy told Sporting News in a recent interview. “There are about 200 NFL players who are currently playing that have done that, and no NHL player. I saw that and I immediately forwarded it to my agent and said, 'Can you figure out how do I do this?'"

Chronic Traumatic Encephalopathy, commonly known as CTE, is a progressive degenerative brain disease found in people with a history of repetitive brain trauma. Symptoms include memory loss, impulse control problems, aggression, depression, anxiety and progressive dementia.

Known as punch drunk syndrome in its infancy, CTE was first described in the 1920s as a disease known to impact boxers. Today, it is most commonly associated with its controversial connection to football, a link that was made clear by the findings of neuropathologist Dr. Ann McKee, the director of BU’s CTE Research Center.

In July, McKee published her report that examined 111 brains of former NFL players and found 110 of them to have CTE, from linemen to punters.
Currently, the disease can only be diagnosed after death, though active research is aimed at learning how to identify CTE in the living. In November, a paper published in the journal Neurosurgery ​reported that brain scan technology​ is able to diagnose CTE in the living, though scientists caution that more research is needed to corroborate the results.

In total, neuropathology has been conducted on the brains of 16 hockey players, nine of whom were diagnosed with the disease.
“We’re not nearly as far in hockey [research] as we are in football because we just don’t have the same numbers,” McKee ​told ESPN.com.
With a limited scope of research due to a lack of donations, the resulting data offers a slanted view of the disease and its prevalence.

Even with the more robust statistics on football players, McKee noted the bias within the current donor sources and the impact it has on the research data.
“Families don’t donate brains of their loved ones unless they’re concerned about the person. So all the players in this study, on some level, were symptomatic. That leaves you with a very skewed population,” McKee said ​in an interview with NPR.

A disputed link between CTE and hockey


In addition to BU’s CTE Research Center, the Canadian Concussion Centre has also conducted studies on the brains of former NHL players. Among those studied, the most notable and controversial cases are Steve Montador, who died in 2015, and Todd Ewen, who died in 2016.

A former defenseman, Montador was found dead in his home at age 35 just one year into his NHL retirement. During the Vancouver native’s 10 seasons in the league, he was no stranger to fights and suffered numerous concussions that eventually ended his career.

According to his family, Montador had been suffering from CTE symptoms that included depression, memory loss, vertigo, insomnia and nausea. ​He planned on donating his brain ​and was found to have CTE upon testing. His son was born four days after his death.

The NHL released a statement expressing its sorrow regarding Montador’s premature death, but the last sentence of the release stated, “We do not agree that the reports and allegations made today establish any link between Steve’s death and his NHL career.”

When NHL commissioner Gary Bettman was asked about the autopsy report that revealed Montador was living with CTE, he responded with a strong declaration that there is no established connection between the brain disease and playing in the NHL.

Fast forward a year, former enforcer Todd Ewen, 45, shot himself in the head and died. Ewen spent 11 seasons in the NHL, racking up 1,911 career penalty minutes, and his family donated his brain to research after his death. It came as a shock to many when studies revealed Ewen did not have CTE.

Five months after the results of Ewen’s autopsy were released, Bettman referenced the case in a 24-page response to Sen. Richard Blumenthal of Connecticut. Blumenthal wrote Bettman a nine-question letter regarding the league’s stance on concussions and CTE, as well as the safety of the sport on all levels.

Blumenthal’s first question was, “Do you believe there is a link between CTE and hockey?”

In his reply, Bettman referenced the active class-action lawsuit filed by former NHL players and their families against the league for its alleged failure to warn players about the short and long-term effects of repeated head trauma and concussions. He blamed the media for hyping up unsupported fear of CTE and retold Ewen’s story, asserting that public opinion had built hasty assumptions on an unsteady foundation of scientific evidence.

“The science regarding CTE, including on the asserted ‘link’ to concussions that you reference, remains nascent, particularly with respect to what causes CTE and whether it can be diagnosed by specific clinical symptoms,” ​Bettman wrote. "The relationship between concussions and the asserted clinical symptoms of CTE remains unknown... The NHL chooses to be guided on this very serious subject by the medical consensus of expert examining the science, not the media hype driven in part by plaintiffs’ counsel.”

Lessons learned from the NFL


The correlation between the NHL and the NFL’s handling of concussions and CTE is an easy line to draw. It was March of 2016 when the NFL acknowledged the link between football and CTE, thereafter settling its countless concussion lawsuits for $1 billion.

After years of mismanaged concussion research, increased rates of early player retirement and a juggernaut of a class action lawsuit, the NFL, to some degree, compromised. It’s worth noting that as part of the settlement, the NFL admitted no fault, and avoided disclosing the details of what and when it knew about the ramifications of concussions.

Lower donation rates in hockey have naturally tempered its priority within the NHL and the NHLPA due to the lack of tangible scientific data. The nature of the game is also a factor, since the frequency of concussions is not as high in hockey as it is in football.

“It’s not a systematic study, but just anecdotally looking at the players that have come into our brain bank compared to the football players, in general I think the hockey players have less CTE, or a milder CTE,” McKee said in the ESPN.com interview. “But again, this is based on very few numbers and this could change. But I haven’t had the experience of seeing many, many advanced CTE cases in hockey like I have in football.”

While it currently doesn’t seem to plague the NHL as pervasively as the NFL, there is plenty of evidence to validate hockey’s issue with concussions and head trauma. Jeff Parker, a retired five-year NHL veteran who died in September at age 53, had said ​he thought he was playing for a different team​ after his head got caught in the glass.

Former Devils enforcer Mike Peluso has said he’s learned to deal with his symptoms, but on his worst days, ​he has trouble remembering the names of friends and family,​ and struggles to find the proper words to finish sentences.

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Larry Zeidel, one of the first hockey players whose brain was studied at BU, was known to always carry a copy of the Wall Street Journal under his arm as a player. But upon retirement, he became a man who ​received complaints from neighbors who saw him outdoors in a state of undress.
Concerns over the NHL’s inperfect concussion protocol crop up several times each season after a spotter inevitably fails to remove a player from a game after suffering an apparent concussion. Earlier this season, Sharks defenseman Marc-Edouard Vlasic ​shed light on the baseline tests​ that the league administers in November.

“It’s just a written test. In order for me to fail that, I’d have to be in a coma. ... The baseline cannot show how I’m feeling,” Vlasic said. “I could easily do it if I’m concussed.”

Lovejoy's endgame


Answers for questions about cause, frequency and diagnosis of CTE within hockey begins with players like Lovejoy, Shawn McEachern, Bob Sweeney and Ted Drury who pledge to donate their brains, adding numbers that the research desperately needs to progress.

Though Lovejoy made a compelling step in the right direction with his pledge, he doesn’t intend to champion the cause within the NHL or entice others to follow in his footsteps.

“This is strictly about science. This is strictly about finding a cure and making the game of ice hockey safer down the line for future generations. When my daughters want to play hockey, I want the game to be even safer than it is now,” Lovejoy said. “The people at BU have told me that if I live until I’m 90 years old, they’re hopefully not going to need my brain and that’s what I’m focused on.”

“This is a very personal decision. I’m not parading around, pressuring other guys to pledge," Lovejoy said. "This is my body. If guys have questions — and people have had questions — they have sort of come to me individually and asked why I was doing it and how I was doing it. Everybody’s been very supportive, but I’m doing this to help research. If other guys would like information on how to donate, I will pass that along but this is my decision."

It remains to be seen whether Lovejoy’s pledge will inspire similar contributions from other active players throughout the league. The broader picture of CTE, head trauma and the NHL is a complicated web that’s far from becomming untangled. There is, however, simplicity in the hope that down the road, BU’s CTE Research Center won’t need the brain of a 90-year-old Lovejoy