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A kind-of-sort-of Bob Probert follow-up from deputy commissioner Bill Daly

Updated 3x at 6:50 PM with the full press release, a CBC posted a video discussing this story in depth and a note from the Free Press’s George Sipple stating that Probert’s drug abuse did not affect the results of the study of his brain: On the heels of yesterday’s twin bombshells from the New York Times and Globe and Mail, which stated that Boston University researchers discovered that former Red Wings enforcer Bob Probert’s brain showed signs of chronic traumatic encephalopathy, a degenerative neurological condition found in persons who have suffered repeated traumatic brain injuries, NHL deputy commissioner Bill Daly filed a somewhat predictable reply to the Associated Press’s request for an official NHL response to the news:

“The findings are interesting and certainly something we’ll add to a much broader body of knowledge,” NHL Deputy Commissioner Bill Daly told The Associated Press in an e-mail. “But we’re not going to react or make changes based on findings related to one player, especially when it’s impossible to identify or isolate one of many variables that may have factored into the conclusions reached, and when there is no real ‘control group’ to compare his results to.”

The detailed findings of Probert’s brain tissue won’t be released until they are submitted to an academic medical journal. His family requested the diagnosis be made public so awareness could be raised of the dangers of brain trauma in sports and encourage greater efforts to make sports safer for the brain, [the Sports Legacy Institute] said.

“The diagnosis of CTE in Probert’s brain is not necessarily an indictment of hockey, as he received brain trauma during hockey fights as well as outside of sports, including a major car accident,” [Sports Legacy Institute’s co-founder and chief executive officer Chris] Nowinski said. “Reggie Fleming, the only other NHL player diagnosed with CTE, also was an enforcer, so we need further study before this research can truly inform that ongoing, and important, debate.”

Fleming died in 2009 at the age of 73 with dementia, after 30 years of worsening behavioral and cognitive difficulties.

Dani Probert said her husband showed a mental decline in his 40s, displayed new and growing problems with short-term memory, attention and a short temper. Those are all symptoms consistent with those showed by other athletes with CTE. During the last year of Probert’s life, Dani Probert said her husband told her he thought he had three or four “significant concussions.” But when talking about “getting his bell rung,” which the institute says is a concussion by definition, Probert told his wife that his total jumped to “over a dozen.”

Update 6:50 PM: The Windsor Star posted the full press release regarding CTE’s findings:

FOR IMMEDIATE RELEASE, March 3, 2011

Contact: Gina DiGravio, 617-638-8480, gina.digravio@bmc.org

BOSTON UNIVERSITY RESEARCHERS REPORT NHL STAR BOB PROBERT HAD

CHRONIC TRAUMATIC ENCEPHALOPATHY

2nd Former NHL Player Diagnosed with CTE

AT A GLANCE

Bob Probert’s family donated his brain to BU researchers after his death from heart disease at age 45.

Probert is the second former NHL player diagnosed with CTE post-mortem.

CTE is a degenerative brain disorder caused by repeated brain trauma, including concussions and multiple blows to the head, such as those found in contact sports.

(BOSTON) – The Sports Legacy Institute (SLI) announced today that researchers at the Center for the Study of Traumatic Encephalopathy (CSTE) at Boston University School of Medicine (BUSM) have discovered Bob Probert, a recently deceased former National Hockey League (NHL) player, had the degenerative brain disease Chronic Traumatic Encephalopathy (CTE) when he died of a heart attack in 2010 at age 45, becoming the second former hockey player diagnosed with the disease.

Probert played left wing for 16 seasons in the NHL, including nine for the Detroit Red Wings and seven for the Chicago Blackhawks. He was best known as an enforcer, standing 5th all-time in penalty minutes in the NHL with 3,300 and fighting in more than 200 fights, although he scored 163 goals, had 221 assists, and was named to the 1987-88 NHL All-Star team for his playmaking abilities.

Probert was diagnosed with CTE by neuropathologist and CSTE co-director Ann McKee, MD, the director of the largest CTE “brain bank” in the world, located at the Bedford VA Medical Center. CTE can only be diagnosed by examining brain tissue post-mortem. Probert is the second former NHL player diagnosed with CTE after Reggie Fleming, who died in 2009 at the age of 73 with dementia, following 30 years of worsening behavioral and cognitive difficulties. The CSTE brain bank contains 68 specimens, including the brain of former NFL player Dave Duerson, who committed suicide two weeks ago. McKee now has completed the analysis of the brains of 40 former athletes, and more than 30 have shown signs of CTE, including 13 of 14 former NFL players, as well as college and high school football players, hockey players, professional wrestlers and boxers.

“We are only beginning to appreciate the consequences of brain trauma in sports,” said SLI Co-founder and CEO Chris Nowinski. “Early evidence indicates that the historical decision not to discourage contact to the head was an enormous mistake, and we hope aggressive changes continue to be made to protect athletes, especially at the youth level.” The CSTE is a collaboration between Boston University and the non-profit Sports Legacy Institute.

The details of Probert’s brain tissue analysis are embargoed pending submission to an academic medical journal. However the Probert family requested the diagnosis be made public in an effort to raise awareness of the dangers of brain trauma in sports and encourage greater efforts to make sports safer for the brain.

Probert’s wife of 17 years, Dani Probert, said, “Bob told me he wanted to donate his brain to Boston University after learning about the research on 60 Minutes. His sole motivation was to make sports safer for our children. Bob was a great husband and father, and we miss him every day.”

Born and raised in Windsor, Ontario, Canada, from a young age Probert struggled with substance abuse, including alcohol and cocaine, and made multiple trips to rehabilitation throughout his career. However, Dani Probert noted that her husband exhibited a mental decline in his 40s, displaying new and growing problems with short-term memory, attention and a short-fuse, which are symptoms consistent with the clinical picture of CTE displayed by other athletes.

Currently, there is a robust discussion of the issue of concussions and brain trauma in hockey. The significance of Probert’s diagnosis in that debate is unclear. “The diagnosis of CTE in Probert’s brain is not necessarily an indictment of hockey, as he received brain trauma during hockey fights as well as outside of sports, including a major car accident,” said Nowinski. “Reggie Fleming, the only other NHL player diagnosed with CTE, also was an enforcer, so we need further study before this research can truly inform that ongoing, and important, debate.”

In discussions during the last year of his life, Dani Probert noted Bob believed he had three or four “significant concussions,” although when he counted what he considered “getting his bell rung,” which by definition are concussions, he suffered “over a dozen.”

Former hockey players hope this research will continue to inform policy to protect the brains of current and future hockey players. Keith Primeau, a retired NHL star who is one of more than 300 athletes who are part of a longitudinal study of brain trauma at the BU CSTE that includes brain donation, said, “Hockey continues to make positive steps to protect players from concussion and brain trauma, and I hope the findings from the study of my friend Bob Probert will accelerate that momentum throughout all levels of the game.”

CTE, originally referred to as “dementia pugilistica” because it was believed to only affect boxers, is a progressive brain disease believed to be caused by repetitive trauma to the brain, including concussions or subconcussive blows. However, it is likely that there are other not-yet-discovered additional factors, such as genetic predisposition, that put certain individuals at greater risk of developing this neurodegenerative disease. CTE is characterized by deposits of an abnormal protein called tau in the form of neurofibrillary tangles, glial tangles, and neuropil threads throughout the brain, and, in some cases, the presence of another protein – associated with motor neuron disease – known as TDP-43. These abnormal proteins are associated with the impaired functioning and eventual death of brain cells. Early on, CTE sufferers may display symptoms such as memory impairment, emotional instability, erratic behavior, depression, and problems with impulse control. CTE may eventually progress to full-blown dementia. Although similar to Alzheimer’s disease, CTE is pathologically distinct, and it is the only known preventable cause of dementia.


The CSTE (http://www.bu.edu/cste/) was founded in 2008 and is the leading center in the world studying the long-term effects of repetitive brain trauma in sports and the military. The CSTE was created as a collaboration between Boston University (BU), Sports Legacy Institute (SLI) and the Department of Veterans Affairs. Co-directors of the BU CSTE include Robert Cantu, MD, a clinical professor of neurosurgery at BUSM; Ann McKee, MD, an associate professor of neurology and pathology at BUSM; Chris Nowinski; and Robert Stern, PhD, an associate professor of neurology at BUSM. The mission of the CSTE is to conduct state-of-the-art research of CTE, including its neuropathology and pathogenesis, the clinical presentation, biomarkers, and course, the genetics and other risk factors for CTE, and ways of preventing and treating this cause of dementia. Brain trauma is increasingly seen as a public health crisis due to the discovery of CTE in a number of recently deceased athletes, most of whom have been studied at the CSTE. The CSTE’s groundbreaking research created a dramatic change in the understanding of and response to brain trauma and concussions in all sports, especially football. The BU CSTE has received grants from the National Institute on Aging and the National Operating Committee on Standards in Athletic Equipment (NOCSAE), and has received an unrestricted gift from the NFL.

Sports Legacy Institute is a 501(c)(3) nonprofit corporation founded in 2007 to advance the study, treatment and prevention of the effects of brain trauma in athletes and other at-risk groups. SLI partnered with Boston University School of Medicine to form the Center for the Study of Traumatic Encephalopathy in 2008. (http://www.sportslegacy.org)

CSTE co-directors Cantu, McKee, Stern, and Nowinski serve on the NFL Players Association Mackey/White Traumatic Brain Injury Committee, which includes, and is chaired by, CSTE registry member Sean Morey. In addition, Cantu serves as a senior advisor to the newly created NFL Head, Neck and Spine Committee.

Former Wing Keith Primeau also spoke to the Free Press’s George Sipple about living with post-concussion symptoms, as well as Dr. Robert Cantu as to whether Probert’s drug abuse had an effect on his CTE:

Probert struggled with years of substance abuse, including alcohol and cocaine, but Cantu said “there’s no proof, as of today, that drugs or alcohol have influence on whether one develops CTE. No link … as of today. And steroids don’t cause CTE, either.”


Cantu said boxing is the sport with the largest number of athletes found to have CTE, followed by football. As for changes he’d like to see in hockey, Cantu said: “I’d like to see all purposeful hits to the head eliminated. If a hit starts on a chest or shoulder or somebody ducks and then accidentally gets hit in the head, I don’t think that’s a penalty. But when you deliberately line up someone’s head to be hit with any part of your body, to me, that has to be eliminated.”

And fighting?

“It cries for really looking at fighting,” Cantu said. “Both these guys we’ve got in our registry were fighters. If they didn’t fight, maybe they wouldn’t have it.”

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Comments

Avatar

Just so it’s very clear, Bob Probert didn’t die from brain trauma.  He died from heart complications.  Probert abused drugs for a long time.  And even when he kicked that habit, he abused alcohol and was known to smoke two packs a day.  Unfortunately, Probert indulged in some extremely poor habits.  And those are the primary contributors to his death… not hockey fights.  RIP Probie.

Posted by Sig from DC on 03/03/11 at 05:51 PM ET

HockeyTownTodd's avatar

Dani Probert said her husband showed a mental decline in his 40s, displayed new and growing problems with short-term memory, attention and a short temper. Those are all symptoms consistent with those showed by other athletes with CTE. During the last year of Probert’s life, Dani Probert said her husband told her he thought he had three or four “significant concussions.” But when talking about “getting his bell rung,” which the institute says is a concussion by definition, Probert told his wife that his total jumped to “over a dozen.”

Those are also the symptoms of the established side effects (affects ?) of over 300 prescribed medications.  Many casually prescribed for Blood pressure, Cholesterol lowering, and Depression.

Posted by HockeyTownTodd on 03/03/11 at 06:17 PM ET

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And those are the primary contributors to his death… not hockey fights.”
Posted by Sig from DC on 03/03/11 at 03:51 PM ET

Thanks Doc, please sign up for an account and keep us up to date on all of your patients in the future.


Posted by HockeyTownTodd on 03/03/11 at 04:17 PM ET

Justin Strelzyk
Andre Waters
Dave Duerson
Reggie Fleming

Posted by NathanBC on 03/03/11 at 06:23 PM ET

George Malik's avatar

A truck full of hard living, hard partying and hard playing all contributed to Probert’s death.

I don’t think that you can say that one thing over the other killed him other than heart disease as it’s the most obvious cause, but brain damage from CTE is not the kind of brain damage that can be confused with that caused by substance abuse.

It was Bob Probert’s wish to donate his brain to Boston University so that it could be studied to determine whether concussions and concussive force to his head shortened his career and reduced the quality of his day-to-day life, and these results simply further what is a science in its infancy, and will hopefully lead to the kind of research that advances the protection of all athletes heads…

Even when they’re fighters. This isn’t about eliminating fighting.

It’s about reducing the occurrences and misdiagnoses of concussions in the NHL, regardless of their cause.

Posted by George Malik from South Lyon, MI on 03/03/11 at 06:31 PM ET

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Nathan—- don’t be a tard.

Probert died of heart attack.  What’s the malfunction?

Posted by Sig from DC on 03/03/11 at 06:36 PM ET

HockeyTownTodd's avatar

Posted by NathanBC

There was no slight intended regarding the findings.
Just wanted to point out that the symptoms Dani described are more common than just for concussions.

Posted by HockeyTownTodd on 03/03/11 at 06:39 PM ET

Avatar

And those are the primary contributors to his death… not hockey fights.”
Posted by Sig from DC on 03/03/11 at 04:36 PM ET

Again, thanks doc. I don’t see anybody saying he died of brain trauma. Drugs and alcohol often are masking deeper-seeded mental problems, especially for a mid-aged man with a good family and a stable home, post-hockey.


Posted by HockeyTownTodd on 03/03/11 at 04:39 PM ET

And I was just pointing out that there’s greater evidence for the argument that his ‘problems’ are more closely linked to his concussions than drugs and alcohol. The amount of athletes in violent sports showing these symptoms compared to people who don’t, point to a connection for the athletes.

While Probert didn’t appear to suffer depression and showed no signs of dementia, he had a long history of drug abuse and legal troubles. “There’s no evidence brought to our attention linking alcohol and drug abuse (to CTE).” Nowinski notes Probert started drinking and abusing drugs at an early age. “It’s the chicken and the egg. Was it the brain trauma suffered as a young hockey player that led him to substance abuse issues? Are they completely unrelated?”
http://canadasrock.ca/2011/03/dani-probert-university-researchers-learn-tough-guy-had-cte-audio/

Posted by NathanBC on 03/03/11 at 06:54 PM ET

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So what I’m saying is that I see your two reactions as mirroring those of Bill Daly’s, which mirror the NFL’s up to 2009.

Posted by NathanBC on 03/03/11 at 06:56 PM ET

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HTT—- Malik’s assertion that Day’s reply was “somewhat predictable” is facetious.  And, of course, it doesn’t take long before certain media outlets (e.g. see ESPN article) start attempting to link this finding to fighting.  It’s a hot button, polarizing topic.  And it pains me when opponents/proponents of fighting use anecdotal evidence to back their stance (see Damien Cox—- he does it all the time).  Daly’s response essentially says that the NHL won’t be making changes based on a finding that says very little about the causes of those concussions.  That’s fair in my opinion. Non-fighters get concussed all the time.  Most of Lindros’ concussions weren’t from fights as an example.  Sid the Kid… an accidental elbow.  Sorry for that anecdotal evidence!  But let one fighter have CTE and the anti-fight rally starts to organize.

Posted by Sig from DC on 03/03/11 at 06:57 PM ET

Down River Dan's avatar

“But we’re not going to react or make changes based on findings related to one player, especially when it’s impossible to identify or isolate one of many variables that may have factored into the conclusions reached, and when there is no real ‘control group’ to compare his results to.”


Bill Daly said this?

Cuz it sure sounds like the usual BS that comes out of LiL gary’s pie-hole. 

Must be the Law school training????????

Posted by Down River Dan on 03/03/11 at 07:04 PM ET

J.J. from Kansas's avatar

Nathan, I don’t think anybody around here is denying that Probert’s hockey career had a lot to do with the findings released.

Seemed to me an exploration of all of the facts.

Posted by J.J. from Kansas on 03/03/11 at 07:08 PM ET

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Nathan, my OP wasn’t met for a man of your understanding of Probert’s history.  I’m sure you’ve read his autobiography, etc., etc.  But not everyone has.  And since Probert made his money with his fists and chin, and the anti-fight crowd preys on news like this, that is why I wrote what I wrote. 

- Doc Sig

Posted by Sig from DC on 03/03/11 at 07:10 PM ET

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“In my heart of hearts, I don’t believe fighting is what did this to Bob,” Dani Probert told The New York Times. “It was hockey—all the checking and hits, things like that.”

Posted by Sig from DC on 03/03/11 at 07:13 PM ET

Avatar

Just so it’s very clear, I’m not an “eliminate fighting” guy whatsoever. I’m getting closer to a “ban all head hits” guy though. A little bit closer.

Sorry Doc, I don’t mean to poop on purposeful posts.

Posted by NathanBC on 03/03/11 at 07:32 PM ET

MarkK's avatar

there is no real ‘control group’ to compare his results to.”/i]

An appropriate control here would be a brain of someone who didnt play hockey.  You know.. a normal brain, that doesnt have chronic traumatic encephalopathy from repeated trauma.  This is where you can’t obfuscate.  The old name for the clinical findings of chronic traumataic enephalopathy was dementia pugilistica - discovered in boxers. It’s not brain surgery, but it’s close… so you can’t expect a talking head to grasp the implications.

A traumatized brain looks a hell of a lot different than one chronically exposed to casually prescribed medications.  A pathologist clearly made the diagnosis, and the difference would be clear to any first year medical student. It takes on a whole different meaning when you put the structural damage together with the symptoms.

The loss of function is a separate issue than his death.  Just because he died from a heart attack doesn’t mean there’s no problem with the fact that he was suffering from symptoms of dementia in his 40s.  Someone looks at all these fancy pictures and puts it together. You get the same type of damage that you see in a 90 year old with Alzheimer’s.

Posted by MarkK from Maryland on 03/03/11 at 08:51 PM ET

George Malik's avatar

Read the updates. Drug abuse did not affect Probert’s CTE.

Posted by George Malik from South Lyon, MI on 03/03/11 at 08:53 PM ET

MarkK's avatar

“There’s no evidence brought to our attention linking alcohol and drug abuse (to CTE).”

That’s what I meant to say, NathanBC.

Posted by MarkK from Maryland on 03/03/11 at 08:56 PM ET

MarkK's avatar

Obviously I’m not qualified to use italics.

Posted by MarkK from Maryland on 03/03/11 at 08:56 PM ET

George Malik's avatar

should help…

Posted by George Malik from South Lyon, MI on 03/03/11 at 10:27 PM ET

PaulinMiamiBeach's avatar

I don’t think that you can say that one thing over the other killed him

as far as I know, death certificates list the IMMEDIATE cause of death - meaning what was the final thing that went wrong that resulted in your death.

many factors can build up over time and I don’t think anyone has any illusions that Probert wasn’t hard on his body inside and out over the years.

Posted by PaulinMiamiBeach on 03/04/11 at 12:54 AM ET

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The Malik Report is a destination for all things Red Wings-related. I offer biased, perhaps unprofessional-at-times and verbose coverage of my favorite team, their prospects and developmental affiliates. I've joined the Kukla's Korner family with five years of blogging under my belt, and I hope you'll find almost everything you need to follow your Red Wings at a place where all opinions are created equal and we're all friends, talking about hockey and the team we love to follow.