Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy following Repetitive Head Injury

By Ann C. McKee, R. Cantu, Christopher J. Nowinski, E. Hedley‐Whyte, B. Gavett, A. Budson, Veronica E. Santini, Hyo-Soon Lee, Caroline A. Kubilus, R. Stern. Journal of Neuropathology and Experimental Neurology, 2009

2,161 citations recorded by the source corpus.

Since the 1920s, it has been known that the repetitive brain trauma associated with boxing may produce a progressive neurological deterioration, originally termed dementia pugilistica, and more recently, chronic traumatic encephalopathy (CTE). We review 48 cases of neuropathologically verified CTE recorded in the literature and document the detailed findings of CTE in 3 professionalathletes, 1 football player and 2 boxers. Clinically, CTE is associated with memory disturbances, behavioral and personality changes, parkinsonism, and speech and gait abnormalities. Neuropathologically, CTE is characterized by atrophy of the cerebral hemispheres, medial temporal lobe, thalamus, mammillary bodies, and brainstem, with ventricular dilatation and a fenestrated cavum septum pellucidum. Microscopically, there are extensive tau-immunoreactive neurofibrillary tangles, astrocytic tangles, and spindle-shaped and threadlike neurites throughout the brain. The neurofibrillary degeneration of CTE is distinguished from other tauopathies by preferential involvement of the superficial cortical layers, irregular patchy distribution in the frontal and temporal cortices, propensity for sulcal depths, prominent perivascular, periventricular, and subpial distribution, and marked accumulation of tau-immunoreactive astrocytes. Deposition of &bgr;-amyloid, most commonly as diffuse plaques, occurs in fewer than half the cases. Chronic traumatic encephalopathy is a neuropathologically distinct slowly progressive tauopathy with a clear environmental etiology.

Subfields: Epidemiology, Neurology

View Paper: https://www.semanticscholar.org/paper/7fb8ae8737940e02bb81c6e93e26a1513ff58b60

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Citations in the corpus

Pathology of Neurodegenerative Diseases. (2017, background): “This condition has drawn increasing attention for its connection to repetitive head injury associated with contact sports, such as American football (McKee et al. 2009).”
Primary age-related tauopathy (PART): a common pathology associated with human aging (2014, background): “For example, it is notable that chronic traumatic encephalopathy generally presents pathologically as a non-Aβ tauopathy with features that overlap pathologically with PART [95], and in the future markers may be developed to better discriminate between disorders in which NFTs develop in similar brai”
Traumatic brain injuries (2016, background): “[H3] Pathology of mild CTE Neuropathology of CTE includes both gross alterations, with cavum septum pellucidum or septal fenestrations being common pathological findings, and microscopical changes in the form of accumulation of (PHF)-tau aggregates in neurons and astroglia, neurofibrillary tangle fo”
The neuropathology and neurobiology of traumatic brain injury. (2012, neutral): “In addition to neurofibrillary tangles, neuropil treads and glial tangles are also elements of CTE (McKee et al., 2009).”
American Medical Society for Sports Medicine position statement: concussion in sport (2012, background): “Recent studies have described the histopathological ﬁ ndings of CTE in the postmortem analysis of athlete ’ s brain tissue 197 – 201 The typical symptoms and behaviours preceding death in athletes with CTE suggest a link between neurobehavioural patterns and the neuroanatomical areas of the brain…”
The Temple University Hospital EEG Data Corpus (2016, background): “Secondly, there is an increased awareness on brain injury owing to both the inﬂux of injured warﬁghters and numerous high-proﬁle athletes found to have chronic brain damage (McKee et al., 2009; Stern et al., 2011).”
National Athletic Trainers' Association position statement: management of sport concussion. (2014, background): “Results of surveys 51–53, 198 of former professional athletes, however, have suggested the potential for”
Chronic Traumatic Encephalopathy: A Potential Late Effect of Sport-Related Concussive and Subconcussive Head Trauma (2011, background): “Although neuritic plaques are typically abundant in AD and are essential to the diagnosis, Ab plaques in CTE, when they occur, are less dense and predominantly diffuse.(11) Despite the fairly minor role Ab plaques seem to play in the neuropathologic manifestation of CTE, the role of Ab in the pathog”