Assessing the Limitations and Biases in the Current Understanding of Chronic Traumatic Encephalopathy
Abstract
Chronic traumatic encephalopathy (CTE) is considered to be a progressive neurodegenerative disease caused by mild traumatic brain injury (mTBI). Recently there has been a significant amount of media attention surrounding the commonness of CTE in professional athletes, particularly American football, based on several postmortem case series. However, despite the persuasive claims made by the media about CTE, research on the disease and the effects of mTBI in general remain in its infancy. Commonly cited case series studying CTE are limited by methodological biases, pathological inconsistencies, insufficient clinical data, and a reliance on inherently biased postmortem data. These case series do not allow for the collection of any epidemiological data and are not representative of the general population. The exaggerated assumptions and assertions taken from these studies run the risk of creating a self-fulfilling prophecy for individuals who believe they are at risk and have the potential to negatively influence sports-related policymaking. This review outlines the status and limitations of recent CTE case series and calls for future prospective, longitudinal studies to further characterize the pathological and clinical hallmarks of CTE.
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A major gap in understanding mTBI-associated brain dysfunction is the discordance between pathology load and severity of symptoms, often in younger individuals: cases with head trauma often have microscopic foci of proteinopathy yet present with severe and diverse symptoms.
“However, a major gap in knowledge in our understanding of mTBI-associated brain dysfunction is the discordance between the pathology load and severity of symptoms, often in younger individuals: cases with a history of head trauma often have microscopic foci of proteinopathy, yet present with severe and diverse symptoms [134].”
From DNA repair deficiency and senescence in concussed professional athletes involved in contact sports (2019) · cites this paper as [134]
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- Authors
- Schwab, N., & Hazrati, L.-N.
- Affiliations
- University of Toronto (CA)
- Corresponding author
- Hazrati, Lili-Naz
- ORCID
- Hazrati, Lili-Naz
- Venue
- Journal of Alzheimer’s Disease
- Publisher
- SAGE Publications
- Published
- 2018-06-28
- Volume
- 64
- Issue
- 4
- Pages
- 1067-1076
- ISSN
- 1387-2877 (ISSN-L)
- 1875-8908
- OpenAlex
- W2883180045
- Semantic Scholar
- 29a0607f007a24ea57dec7f0b95b08fd8eea7ea2
- Cited by
- 18
- References
- 34
- Citations by year
- 2026: 2 · 2025: 3 · 2024: 1 · 2023: 2 · 2022: 1 · 2021: 1 · 2020: 1 · 2019: 7
- FWCI
- 0.32
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- Journal of Alzheimer s Disease (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 › Pulmonary and Respiratory Medicine › Automotive and Human Injury Biomechanics
- Keywords
- chronic traumatic encephalopathy, mild traumatic brain injury
- MeSH terms
- Chronic Traumatic Encephalopathy, Adolescent, Adult, Brain, Female, Humans, Male, Middle Aged, Trauma Severity Indices, Bias, Young Adult
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