Clinical features of repetitive traumatic brain injury and chronic traumatic encephalopathy

Brain Pathol. 2015 May;25(3):304-17. doi: 10.1111/bpa.12250.

Abstract

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease characterized by a distinct pattern of hyperphosphorylated tau (p-tau). Thought to be caused by repetitive concussive and subconcussive injuries, CTE is considered largely preventable. The majority of neuropathologically confirmed cases have occurred in professional contact sport athletes (eg, boxing, football). A recent post-mortem case series has magnified concerns for the public's health following its identification in six high school level athletes. CTE is diagnosed with certainty only following a post-mortem autopsy. Efforts to define the etiology and clinical progression during life are ongoing. The goal of this article is to characterize the clinical concepts associated with short- and long-term effects of repetitive traumatic brain injury, with a special emphasis on new clinical diagnostic criteria for CTE. Utilizing these new diagnostic criteria, two cases of neuropathologically confirmed CTE, one in a professional football player and one in a professional boxer, are reported. Differences in cerebellar pathology in CTE confirmed cases in boxing and football are discussed.

Keywords: boxing; chronic traumatic encephalopathy; concussion; football; mild traumatic brain injury; neuropathology.

Publication types

  • Case Reports
  • Review

MeSH terms

  • Athletic Injuries / complications
  • Biomechanical Phenomena
  • Brain Injuries / complications*
  • Brain Injuries / etiology
  • Chronic Disease
  • Disease Progression
  • Humans
  • Male
  • Middle Aged
  • Neurodegenerative Diseases / etiology*
  • Risk Factors