Rangers' Boogaard suffered from degenerative brain disease before his death

Derek Boogaard, one of the National Hockey League's most aggressive players, suffered from  Chronic Traumatic Encephalopathy, or CTE, a degenerative brain disease that results from repetitive trauma to the head, an autopsy of his brain has revealed. 

Boogaard's death in May was ruled accidental after he consumed alcohol and the powerful painkiller oxycodone.

Dr. Ann McKee, co-director of the VA CSTE Brain Bank - a collaboration between Boston University, the Department of Veterans Administration, and the Sports Legacy Institute - made the discovery.  She has diagnosed more than 50 athlete brains with CTE.

Individuals affected by CTE can exhibit Alzheimer’s like symptoms, but CTE can only be diagnosed postmortem.  It’s most commonly found in athletes who suffered repeated head trauma, such as football players, boxers and hockey players.

Boogaard was one of the NHL’s most feared players. He played left wing for the Minnesota Wild from 2005 to 2010 and then joined the New York Rangers for the 2010-2011 season. He was best known as the enforcer - the player who physically, and often violently, checked a player with an offensive play. 

Boogaard was considered to be one of the toughest fighters in the NHL. In his NHL history of 277 games, he scored just three goals, had 589 penalty minutes and reportedly participated in 174 career fights.

Boogaard had been unable to play since December 2010 because of injuries from a hockey fight, including a concussion. His family said Boogaard had reportedly had his “bell rung” at least 20 times, but did not always report the hits. He was diagnosed with post-concussion syndrome twice.

Boogaard also struggled with drug addiction for the two years before his death. Since then, he had reportedly begun to act abnormally, was emotionally unstable and had problems with short-term memory and orientation. When Boogaard died, his family agreed to send his brain to the Brain Bank in hopes of finding some answers.

While there is evidence of CTE in Boogaard’s brain, Dr. Bob Stern, one of the bank’s co-directors, is quick to point out the difficulties in determining how CTE contributed to Boogaard’s addiction and behavior.

“Boogaard’s clinical history was complex, so it is unclear as to if or how much CTE contributed to his behavior, addiction or death. However, CTE appears to be a progressive disease in some individuals, so even if it was not directly affecting Boogaard’s quality of life and overall functioning before he died, it is possible it could have in the future.”

Stern couldn't say with certainty that Boogaard's position as an enforcer was a factor in the development of CTE. 

“Is it fighting? The regular play of the game? The big hits? We just don’t know what would lead to the disease, " Stern said. “We know that exposure to repetitive brain trauma is necessary to the development of the disease, but not sufficient.”

On average, according to Stern, half of all professional hockey games have some sort of fight. Stern said there is discussion within the NHL and amateur leagues to either diminish or get rid of fighting. Fighting and enforcing is unique to Canadian and American hockey; it is not allowed in the Olympics.

Chris Nowinski, another of the Bank’s co-directors, added, “Unfortunately, this finding does not contribute to our knowledge of the risks of normal hockey play for most participants, as very few hockey players engage in as many fights as Boogaard.”

“Athletes and parents should know that anyone who experiences repetitive brain trauma may be at risk to develop CTE, but we are hopeful that risk is small in hockey.” Nowinski added that two other young non-NHL professional hockey players studied did not show signs of CTE at postmortem examination.

However, the risks in hockey can’t be ignored. There is constant, fast-moving contact and fights.

As Stern said, “It’s boxing on ice.”