Chronic traumatic encephalopathy in professional sports: Retrospective and prospective views

Abstract

Primary objective: The purposes of this paper are to review: (1) the history of chronic traumatic encephalopathy (CTE) in sports, (2) the similarities and differences between historic and current definitions of CTE, (3) recent epidemiology and cohort studies of CTE and (4) controversies regarding the current CTE positions.

Research design: Not applicable.

Methods and procedures: Selective review of published articles relevant to CTE.

Main outcome and results: The current definitions of CTE have evolved from its original definition and now rely heavily on the post-mortem detection of hyperphosphorylated tau for diagnosis. As of 2013, there is a blended cohort of 110 professional athletes diagnosed with CTE. It is being assumed that concussions and/or sub-concussive impacts in contact sports are the sole cause of CTE.

Conclusions: There are multiple causes of abnormal tau protein deposition in the human brain and the pathogenesis of CTE may not be related solely to concussion and/or sub-concussive injury. In all likelihood, the causes of CTE are a multivariate, as opposed to a univariate, phenomenon.

• Chronic traumatic encephalopathy
• concussion
• sports
• traumatic brain injury

Declaration of interest

Dr Solomon receives royalties from book sales. He receives consulting fees for clinical services from the Nashville Predators and the Tennessee Titans. He is a member of the ImPACT Professional Advisory Board and receives free use of the ImPACT test when beta testing, as well as expense reimbursement for attendance at Board meetings. Dr Zuckerman has no competing interests to disclose.