Concussion History and Cognitive Function in Retired Professional Hockey Players Interview with:

Brian Levine, Ph.D., C.Psych, ABPP-cn Senior Scientist, Rotman Research Institute, Baycrest Professor, Departments of Psychology and Medicine (Neurology) University of Toro

Dr. Brian Levine

Brian Levine, Ph.D., C.Psych, ABPP-cn
Senior Scientist, Rotman Research Institute, Baycrest
Professor, Departments of Psychology and Medicine (Neurology)
University of Toronto What is the background for this study?

Response: There is growing concern about the effects of concussion on brain function with aging. Retired professional athletes provide a unique perspective on this question, as many of them have a high concussion exposure before retirement in their 20’s or 30’s. Yet much of the research on professional athletes has been in post-mortem samples. There is a need for more research in retired athletes during life. What are the main findings?

Response: In the present study, we conducted comprehensive neuropsychological assessment in a sample of 33 retired professional ice-hockey players and 18 age-matched comparison subjects. Overall, we found only subtle evidence for lower cognitive function in the alumni group relative to the comparison group, limited to tests of executive function and intelligence. There were no differences on tests of memory, attention, speeded information processing, or perceptual abilities. Conversely, the alumni group had elevated endorsement of cognitive, emotional, and behavioral impairment on self-report questionnaires relative to the comparison group.

We found that concussion history was related to performance on tests of executive function, but not to self-reported symptoms on the questionnaires. Possession of the apolipoprotien ε4 allele, normally associated with pathological brain aging and dementia, on the other hand, was associated with psychiatric symptoms but not to cognitive symptoms. Finally, there was no evidence to support an “accelerated” aging in alumni whereby older alumni were more impaired than expected on the basis of age alone. What should readers take away from your report?

Response: Concussions and traumatic brain injury in general are significant healthcare issues. The profile of impairment in retired professional athletes is complex, with a high degree of subjective impairment and psychological distress.

On the other hand, our objective test results suggest that the degree of cognitive impairment is not as high as might be predicted from post-mortem studies, possibly due to recruitment bias. What recommendations do you have for future research as a result of this study?

Response: Longitudinal designs are the most powerful method for tracking changes in brain function over time. We are currently conducting followup testing on our participants. We are also preparing manuscripts concerning brain imaging findings for these participants. Understanding of mechanisms and individual variability in outcome with concussion and brain aging requires a comprehensive multidisciplinary approach. Thank you for your contribution to the community.


Carrie Esopenko, Tiffany W Chow, Maria Carmela Tartaglia, Agnes Bacopulos, Priya Kumar, Malcolm A Binns, James L Kennedy, Daniel J Müller, Brian Levine. Cognitive and psychosocial function in retired professional hockey players. Journal of Neurology, Neurosurgery & Psychiatry, 2017; jnnp-2016-315260 DOI: 10.1136/jnnp-2016-315260

Note: Content is Not intended as medical advice. Please consult your health care provider regarding your specific medical condition and questions.

More Medical Research Interviews on

[wysija_form id=”5″]



Last Updated on April 19, 2017 by Marie Benz MD FAAD