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Chronic traumatic encephalopathy is a common co-morbidity, but less frequent primary dementia in former soccer and rugby players
Open accessAbstract
Chronic traumatic encephalopathy (CTE) is reported at high prevalence in selected autopsy case series of former contact sports athletes. Nevertheless, the contribution of CTE pathology to clinical presentation and its interaction with co-morbid neurodegenerative pathologies remain unclear. To address these issues, we performed comprehensive neuropathology assessments on the brains of former athletes with dementia and considered these findings together with detailed clinical histories to derive an integrated clinicopathological diagnosis for each case. Consecutive, autopsy-acquired brains from former soccer and rugby players with dementia were assessed for neurodegenerative pathologies using established and preliminary consensus protocols. Thereafter, next of kin interviews were conducted to obtain detailed accounts of the patient's clinical presentation and course of disease to inform a final, integrated clinicopathological diagnosis. Neuropathologic change consistent with CTE (CTE-NC) was confirmed in five of seven former soccer and three of four former rugby players' brains, invariably in combination with mixed, often multiple neurodegenerative pathologies. However, in just three cases was the integrated dementia diagnosis consistent with CTE, the remainder having alternate diagnoses, with the most frequent integrated diagnosis Alzheimer's disease (AD) (four cases; one as mixed AD and vascular dementia). This consecutive autopsy series identifies neuropathologic change consistent with preliminary diagnostic criteria for CTE (CTE-NC) in a high proportion of former soccer and rugby players dying with dementia. However, in the majority, CTE-NC appears as a co-morbidity rather than the primary, dementia causing pathology. As such, we suggest that while CTE-NC might be common in former athletes with dementia, in many cases its clinical significance remains uncertain.
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“Furthermore, the authors concluded that the clinical significance of CTE-pathology remains uncertain, and that it is likely a co-morbidity rather than the cause of dementia in former athletes [83].”
From DNA repair deficiency and senescence in concussed professional athletes involved in contact sports (2019) · cites this paper as [83]
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“Although CTE-consistent pathology was found in 73% of cases, all of these presented with multiple mixed neurodegenerative pathologies, most notably AD-consistent pathology.”
From DNA repair deficiency and senescence in concussed professional athletes involved in contact sports (2019) · cites this paper as [83]
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Metadata
- Authors
- Lee, E. B., Kinch, K., Johnson, V. E., Trojanowski, J. Q., Smith, D. H., & Stewart, W.
- Affiliations
- University of Pennsylvania (US)
- Queen Elizabeth University Hospital (GB)
- ORCID
- Venue
- Acta Neuropathologica
- Published
- 2019-06-01
- Volume
- 138
- Issue
- 3
- Pages
- 389-399
- ISSN
- 0001-6322 (ISSN-L)
- 1432-0533
- PMC
- PMC6689293
- OpenAlex
- W2947253577
- Cited by
- 157
- References
- 51
- Citations by year
- 2026: 7 · 2025: 23 · 2024: 12 · 2023: 29 · 2022: 19 · 2021: 26 · 2020: 34 · 2019: 4
- FWCI
- 15.80
- Type
- journal article
- Language
- en
- Open access
- hybrid
- doi.org
- Locations
- Acta Neuropathologica (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- ENLIGHTEN (Jurnal Bimbingan dan Konseling Islam) (acceptedVersion, cc-by-sa)
- Funders
- National Institute of Neurological Disorders and Stroke (R01NS092398, R01NS094003, R01NS038104)
- The Football Association
- Topics
- Health Sciences › Medicine › Clinical Neurology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Psychiatry and Mental health › Dementia and Cognitive Impairment Research
- Life Sciences › Neuroscience › Cellular and Molecular Neuroscience › Alzheimer's disease research and treatments
- Keywords
- chronic traumatic encephalopathy, dementia, comorbidities, Alzheimer's disease, clinicopathological diagnosis, contact sports, neuropathology
- MeSH terms
- Chronic Traumatic Encephalopathy, Aged, Athletic Injuries, Dementia, Football, Humans, Male, Middle Aged, Soccer, Comorbidity
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