The news of beloved BMX athlete Dave Mirra’s suicide in February was enough to devastate his legion of fans. But a new report shared by ESPN The Magazine has tinged his passing with even greater sadness: Mirra suffered from chronic traumatic encephalopathy (CTE), a neurodegenerative disease that’s most often associated with concussions. Mirra is reportedly the first action sports athlete to be diagnosed with the condition.

Dr. Lili-Naz Hazrati, the neuropathologist who identified Mirra’s condition, told ESPN that the tau protein deposits in his brain “were indistinguishable from the kind that have been found in the brains of former football and hockey players with the same type of brain damage.” Tau proteins are considered abnormal, and when they build up, they start to kill brain cells. Symptoms include memory loss, confusion, impulse control problems, depression, and eventually full-blown dementia — but it could take decades before they start to show up.

And for those of you who followed Mirra’s career, you know he took a few hits. He suffered a skull fracture after a car crash at 19, which was then followed by countless concussions, according to ESPN, up until his retirement in 2011. At that point, TMZ claimed he fell into a deep depression without a way to mimic the adrenaline rush that came with extreme sports.

Allen Thomas, the mayor of Greenville, N.C., where Mirra resided, suspected CTE may have played a role in his death. Knowing depression and lack of impulse control were linked to CTE, “you have to give pause, think and wonder as we hear about brain trauma in football and other sports,” Thomas told USA Today.

When Hazrati made her diagnosis, she sent Mirra’s case to colleagues for confirmation, leaving off Mirra’s name and what he did for a living. Each person agreed that Mirra had CTE.

"It validates what we have been thinking about brain injuries in boxers and football players," Hazrati said. "The key is brain injury. Regardless of how you get it, through BMX or hockey, you are at risk for this."

Thoughts or feelings of suicide weren’t always considered a core clinical feature of CTE, Dr. Grant L. Iverson wrote in a 2015 article for The Journal of Neuropsychiatry and Clinical Neurosciences. It wasn’t until recently, when media outlets started to draw connections between mental health problems and former athletes and veterans diagnosed with CTE, that diagnostic features were updated to include depression, followed by cognitive impairment and anger control problems. However, the science linking depression, suicide, and the neuropathology believed to be unique to CTE is inconclusive, Iverson said.

When Mirra’s wife Lauren learned of his condition, she described personality changes to ESPN during his final year. She said at times she would look “straight through him. … And I was like, ‘Where are you? Where are you? What is wrong?’”

“This is the beginning of bringing awareness,” she said. “It would be amazing if this is something we can detect in life one day. If we can detect it, prevent it, stop it, let's do all of the above."