Chronic traumatic encephalopathy in a professional American wrestler
Abstract
We present in this case report the tissue substrates and forensic evidence for chronic traumatic encephalopathy (CTE) in a professional American wrestler with Apolipoprotein E (apoE) genotyping. Professional wrestling is a contact-sport, with an integral risk for players to sustain repeated concussions over their careers. This case provides the first autopsy evidence of neuropathological abnormalities that accompany CTE in professional American wrestlers. A complete autopsy was performed on a 40-year-old Caucasian male, after he died unexpectedly by suicidal hanging after he had killed his wife and son. The brain showed no atrophy and no recent or remote contusions or necrosis. There was a mild to moderate neocortical neuronal dropout without any amyloid plaques. There were diffuse, sparse to frequent tau-immunoreactive Neurofibrillary Tangles and Neuropil Threads in the neocortex, subcortical ganglia, and brainstem nuclei including the substantia nigra consistent with CTE. The apoE genotype was determined to be E3/E3. Other autopsy findings included cardiomegaly, left ventricular hypertrophy, and bilateral atrioventricular dilatation; toxicologic analyses showed alprazolam and hydrocodone in the blood, and evidence of exogenous testosterone in the urine. Longitudinal studies of professional contact-sport athletes are needed to identify the differentiating characteristics of athletes who develop CTE and devise strategies for intervention.
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Chronic traumatic encephalopathy is characterized by accumulation of TAR DNA-binding protein-43 and neurofibrillary tangles of hyperphosphorylated tau beginning perivascularly, and is reported in football, wrestling, boxing, and soccer players, as well as in veterans.
“Chronic traumatic encephalopathy (CTE) is characterized by accumulation of TAR DNA-binding protein-43 (TDP43) and neurofibrillary tangles of hyperphosphorylated tau beginning perivascularly (54), and is reported in football (454, 455), wrestling (455), boxing (325), and soccer (366) players, as well as in veterans (237).”
From Blood-Brain Barrier: From Physiology to Disease and Back (2019) · cites this paper as [455]
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- Authors
- Omalu, B. I., Fitzsimmons, R. P., Hammers, J., & Bailes, J.
- Affiliations
- San Joaquin General Hospital (US)
- Office of Chief Medical Examiner (US)
- West Virginia University (US)
- Corresponding author
- Omalu, Bennet I.
- ORCID
- Bailes, Julian
- Venue
- Journal of Forensic Nursing
- Published
- 2010-09
- Volume
- 6
- Issue
- 3
- Pages
- 130-136
- ISSN
- 1556-3693 (ISSN-L)
- OpenAlex
- W1996332875
- Cited by
- 155
- References
- 2
- Citations by year
- 2026: 1 · 2025: 6 · 2024: 2 · 2023: 8 · 2022: 9 · 2021: 10 · 2020: 4 · 2019: 13 · 2018: 12 · 2017: 9 · 2016: 13 · 2015: 20 · 2014: 15 · 2013: 16 · 2012: 8
- FWCI
- 7.67
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Forensic Nursing (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Health Sciences › Medicine › Neurology › Traumatic Brain Injury and Neurovascular Disturbances
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Keywords
- chronic traumatic encephalopathy, professional wrestling, repeated concussions, contact sports, neuropathology, neuropil threads, APOE genotype, autopsy findings, cardiomegaly, substance use
- MeSH terms
- Adult, Apolipoproteins E, Autopsy, Brain Concussion, Depression, Genotype, Homicide, Humans, Immunohistochemistry, Male, Risk Factors, Suicide, Testosterone, Wrestling, Fatal Outcome, Genetic Predisposition to Disease, Brain Injury, Chronic, Anabolic Agents, Forensic Nursing
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