Concomitant progressive supranuclear palsy and chronic traumatic encephalopathy in a boxer
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We report the case of a 75-year-old ex-professional boxer who developed diplopia and eye movement abnormalities in his 60's followed by memory impairment, low mood and recurrent falls. Examination shortly before death revealed hypomimia, dysarthria, vertical supranuclear gaze palsy and impaired postural reflexes. Pathological examination demonstrated 4-repeat tau neuronal and glial lesions, including tufted astrocytes, consistent with a diagnosis of progressive supranuclear palsy. In addition, neurofibrillary tangles composed of mixed 3-repeat and 4-repeat tau and astrocytic tangles in a distribution highly suggestive of chronic traumatic encephalopathy were observed together with limbic TDP-43 pathology. Possible mechanisms for the co-occurrence of these two tau pathologies are discussed.
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It is well established that a large percentage of former athletes identified as having CTE neuropathology also have neuropathology associated with age related neurodegenerative diseases such as AD, PD, Lewy body disease, hippocampal sclerosis, and ALS to the extent that they meet full neuropathological criteria for an alternative, well-characterized neurodegenerative disease.
“It is now well established that a large percentage of former athletes identified as having CTE neuropathology also have neuropathology associated with age related neurodegenerative diseases such as AD, PD, Lewy body disease, hippocampal sclerosis, and ALS [14, 41–44] to the extent that they meet full neuropathological criteria for an alternative, well-characterized neurodegenerative disease [16].”
From The Need to Separate Chronic Traumatic Encephalopathy Neuropathology from Clinical Features (2017) · cites this paper as [42]
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The problem of mild traumatic brain injury in persons of hazardous occupations
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van Amerongen, S., Kamps, S., Kaijser, K. K. M., Pijnenburg, Y. A. L., Scheltens, P., Teunissen, C. E., Barkhof, F., Ossenkoppele, R., Rozemüller, A. J. M., Stern, R. A., et al. (2023) · Figshare · doi:10.6084/m9.figshare.22792784
- Authors
- Ling, H., Kara, E., Revesz, T., Lees, A. J., Plant, G. T., Martino, D., Houlden, H., Hardy, J., & Holton, J. L.
- Affiliations
- National Hospital for Neurology and Neurosurgery (GB)
- UCL Queen Square Institute of Neurology (GB)
- Queen Mary University of London (GB)
- Corresponding author
- Holton, Janice L
- ORCID
- Venue
- Acta Neuropathologica Communications
- Published
- 2014-02-21
- Volume
- 2
- Issue
- 1
- Pages
- 24-24
- ISSN
- 2051-5960 (ISSN-L)
- PMC
- PMC3996066
- OpenAlex
- W2150268059
- Cited by
- 27
- References
- 62
- Citations by year
- 2025: 4 · 2023: 4 · 2022: 3 · 2021: 1 · 2020: 2 · 2019: 1 · 2017: 3 · 2016: 2 · 2015: 4 · 2014: 3
- FWCI
- 2.67
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Licence
- Locations
- Acta Neuropathologica Communications (publishedVersion, cc-by)
- Europe PMC (PubMed Central) (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- UCL Discovery (University College London) (submittedVersion)
- Funders
- Wellcome Trust (WT089698, 089698)
- National Institute for Health and Care Research
- University College London
- University College London Hospitals NHS Foundation Trust
- Medical Research Council (MC_G1000735, MR/J004758/1)
- Reta Lila Weston Institute of Neurological Studies, UCL Queen Square Institute of Neurology,University College London
- Topics
- Health Sciences › Medicine › Physiology › Alzheimer's disease research and treatments
- Health Sciences › Medicine › Neurology › Parkinson's Disease Mechanisms and Treatments
- Health Sciences › Medicine › Epidemiology › Traumatic Brain Injury Research
- Keywords
- progressive supranuclear palsy, chronic traumatic encephalopathy, tau pathology, TDP-43, tufted astrocytes, neurofibrillary tangles, supranuclear gaze palsy, diplopia, memory impairment, falls, hypomimia, dysarthria, postural reflexes
- MeSH terms
- Leucine-Rich Repeat Serine-Threonine Protein Kinase-2, Progranulins, Aged, Humans, Male, Supranuclear Palsy, Progressive, tau Proteins, Protein Serine-Threonine Kinases, Brain Injury, Chronic, Intercellular Signaling Peptides and Proteins
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