Last week, the NHL's alumni association announced it had formed a partnership with one of the world's top neuroscience centres, the Rotman Research Institute at Baycrest in Toronto, to study up to 100 former players for signs of mental health changes as they age.
The study will involve analyzing former NHLers' brains with in-depth cognitive tests and magnetic resonance imaging, a process that will be completed for every participant every three years with the hopes that results can be produced two or three years from now.
I sat down with Baycrest senior scientist Brian Levine yesterday to talk about the study, with the results of our Q&A below. He said what he is attempting to do is answer the question of "Does playing in the NHL affect your brain health later in life?"
Q: What prompted Baycrest to get involved with NHL Alumni and study their brains?
BL: We already do a lot of work in aging and my work in addition to aging and dementia includes head injuries and brain imaging. Baycrest has had this long-standing involvement already with NHL Alumni for fundraising and the Gordie and Colleen Howe Fund. It was very natural for the connection of hey why don't we take the opportunity, let's get together and involve them in our research.
Q: Do you have any idea what you might find in closely examining former players' brains?
BL: A lot of times we do a study and we have a hypothesis, we have a really strong idea of what we're going to find. I'm characterizing this as more of an exploratory study. We have a pretty good idea of the factors involved in brain health. We don't know how they all interact.
Diet, exercise, taking care of yourself, stress, all of those things affect brain health. We know that head injuries are related to brain health, especially as they relate to aging. We know that genetics is related to brain health. There's now recent research showing that there are certain genes that increase the chance of getting dementia if you've had a head injury. They interact. So the risk is even greater.
This is an opportunity for us to put all of these things together in a set of high-performance athletes and analyze all of these factors together.
Q: Some of the NHL Alumni seem skeptical that head injuries are tied to developing dementia and other later issues. What do you think the study might show?
BL: As a scientist, we leave our expectations and our biases at the door. Our goal really is to get at the best version or the closest to the truth as possible. I know that there is skepticism [from some players] There's also groups that say there is a connection.
We try to answer the question as best we can without any kind of preconception or bias. That's why we're being very comprehensive in our testing. One hypothesis is that if you've been banged around a lot and knocked out a few times, it might affect your brain health in the future. Well, there's some evidence to support that and there's some case studies out there that are very dramatic that we've heard about.
But not everyone that gets dementia has had a head injury in their past. So we really want to get the full range of factors.
Q: It could be there's no relation between playing in the NHL and these later issues?
BL: That's why we do the research. If we knew the answer in advance, there'd be no point in doing it.
Q: Are there other similar studies that have pointed you in a direction with your own approach?
BL: There are but there hasn't been anything that I know of that's that comprehensive and longitudinal. This is a long-term commitment. There's always good quality research coming out that's suggestive and informative, but these are not simple questions and we don't expect there to be a simple answer.
Q: How long will it take to get results from something like this?
BL: There are two ways of doing this kind of research. There's the longitudinal method, where you follow people over time, and there's what we call the cross-sectional method, where you take a group of people, let's say by ages, and you test people in their 40s, 50s, 60s and 70s. We can do the cross-sectional method now [on former players]and look at people across the age span and I think get some pretty good results within say two, three years. Just give us enough time to collect the data, analyze it. That will give us some preliminary answers.
There will always be a limitation in that, which is people will say you're comparing an 85-year-old guy that played without a helmet, had a whole different life and lived in a whole different context, to a 60-year-old guy. We acknowledge those limitations and that's why we do the longitudinal study, which is much more of a commitment to do.
We're doing both. We're studying players, looking between individuals, young and old, and also the control group is important. We also want to know out of people who weren't NHL players, how many of them will develop something? We can do all that, rapidly, in a cross-sectional study. And then we take everyone and we track them every three years and we watch them over time.
Q: Is this something you believe will be maintained with the NHL Alumni over decades?
BL: Yes, I do. That's the idea. We feel we can get results that will be very informative and important because of what we're doing in two, three years. But the longitudinal aspect will give us even higher quality data over time.
Q: What do you think of all of the coverage of concussions in hockey and these issues? Does there need to be more research done?
BL: Of course. I've read what's going on, I follow what's going on and as a scientist, we don't go by what the media says. We pay attention to it, it's intriguing, but that isn't the place we look to for answers in terms of what we think is going on.
There's a lot of guesswork involved. At every stage there's guesswork involved. I don't want to criticize the media, I don't want to criticize the NHL. I'm just a scientist that sees an interesting question and that gets me excited. Let's answer this question. That's really exciting.