Chronic traumatic encephalopathy: A potential late effect of sport-related concussive and subconcussive head trauma
Open accessAbstract
Chronic traumatic encephalopathy (CTE) is a form of neurodegeneration believed to result from repeated head injuries. Originally termed dementia pugilistica because of its association with boxing, the neuropathology of CTE was first described by Corsellis in 1973 in a case series of 15 retired boxers. CTE has recently been found to occur after other causes of repeated head trauma, suggesting that any repeated blows to the head, such as those that occur in American football, hockey, soccer, professional wrestling, and physical abuse, can also lead to neurodegenerative changes. These changes often include cerebral atrophy, cavum septi pellucidi with fenestrations, shrinkage of the mammillary bodies, dense tau immunoreactive inclusions (neurofibrillary tangles, glial tangles, and neuropil neurites), and, in some cases, a TDP-43 proteinopathy. In association with these pathologic changes, disordered memory and executive functioning, behavioral and personality disturbances (eg, apathy, depression, irritability, impulsiveness, suicidality), parkinsonism, and, occasionally, motor neuron disease are seen in affected individuals. No formal clinical or pathologic diagnostic criteria for CTE currently exist, but the distinctive neuropathologic profile of the disorder lends promise for future research into its prevention, diagnosis, and treatment.
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The clinical syndrome of CTE includes behavioral, mood, and cognitive dysfunction as well as occasional extrapyramidal motor symptoms.
“The clinical syndrome of CTE continues to be refined but includes behavioral, mood, and cognitive dysfunction as well as occasional motor symptoms that are typically extrapyramidal (1,2).”
From Chronic Traumatic Encephalopathy Within an Amyotrophic Lateral Sclerosis Brain Bank Cohort (2018) · cites this paper as [2]
The prevailing theory of CTE, often expressed in articles as fact, is that it is a distinct and unique neurodegenerative disease.
“In conclusion, the prevailing theory of CTE, often expressed in articles as fact, is that it is a distinct (1, 3, 9-11) and unique (10) neurodegenerative disease (9-13).”
From Mild Chronic Traumatic Encephalopathy Neuropathology in People With No Known Participation in Contact Sports or History of Repetitive Neurotrauma (2019) · cites this paper as [1]
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Walt, G. S., Burris, H. M., Brady, C. B., Spencer, K. R., Alvarez, V. E., Huber, B. R., Guilderson, L., Abdul Rauf, N., Collins, D., Singh, T., et al. (2018) · Journal of Neuropathology & Experimental Neurology · doi:10.1093/jnen/nly092 · Cited by 45 · see citing works
Self-citationPost-Concussion Symptom Reporting after Multiple Mild Traumatic Brain Injuries
Silverberg, N. D., Lange, R. T., Millis, S. R., Rose, A., Hopp, G., Leach, S., & Iverson, G. L. (2013) · Journal of Neurotrauma · doi:10.1089/neu.2012.2827 · Cited by 38 · see citing works
Antonius, D., Mathew, N., Picano, J., Hinds, A., Cogswell, A., Olympia, J., Brooks, T., DiGiacomo, M., Baker, J., Willer, B., et al. (2014) · The Journal of Neuropsychiatry and Clinical Neurosciences · doi:10.1176/appi.neuropsych.13090201 · Cited by 14 · see citing works
- Authors
- Gavett, B. E., Stern, R. A., & McKee, A. C.
- Affiliations
- Boston University (US)
- Corresponding author
- McKee, Ann C.
- Venue
- Clinics in Sports Medicine
- Publisher
- Elsevier BV
- Published
- 2011-01
- Volume
- 30
- Issue
- 1
- Pages
- 179-188
- ISSN
- 0278-5919 (ISSN-L)
- PMC
- PMC2995699
- OpenAlex
- W2151373091
- Cited by
- 696
- References
- 63
- Citations by year
- 2026: 10 · 2025: 15 · 2024: 25 · 2023: 23 · 2022: 39 · 2021: 44 · 2020: 46 · 2019: 44 · 2018: 51 · 2017: 52 · 2016: 65 · 2015: 73 · 2014: 74 · 2013: 66 · 2012: 42
- FWCI
- 4.77
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- Clinics in Sports Medicine (publishedVersion)
- PubMed (publishedVersion)
- Europe PMC (PubMed Central) (acceptedVersion)
- PubMed Central (acceptedVersion)
- Funders
- U.S. Department of Veterans Affairs
- National Operating Committee on Standards for Athletic Equipment
- National Institute on Aging (0572063345–5, 0572063345, P30AG013846, P30-AG13846))
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
- Keywords
- chronic traumatic encephalopathy, sports-related concussion, subconcussive impacts, repetitive mild traumatic brain injury, neurodegeneration, tau pathology, TDP-43, axonal injury, executive dysfunction, parkinsonian signs, biomarkers, American football, professional wrestling, head banging, physical abuse, epilepsy
- MeSH terms
- Athletic Injuries, Brain Concussion, Chronic Disease, DNA-Binding Proteins, Humans, Risk Factors, Sports, Time Factors, Amyloid beta-Peptides, Brain Injury, Chronic
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Registry, retraction, Cites and statistics results are computed, not judged, with one exception: a printed reference that no index lists is read once by a model before it counts as a citation error. Claims are extracted by a model and kept only when their quote appears verbatim in the text; each cited source is then checked, with a model’s help, for whether it says what the claim relies on. Those verdicts can be wrong — read the claim’s quote and the cited source before relying on one.
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