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Modern Chronic Traumatic Encephalopathy in Retired Athletes: What is the Evidence?

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Abstract

It has been theorized that a career in contact sports may be associated with long-term neurodegenerative changes. This idea dates as far back as the 1920s, was initially reported in boxers, colloquially termed ‘punch drunk,’ later more formally termed dementia pugilistica (DP), and now coined chronic traumatic encephalopathy (CTE). Despite considerable ongoing interest on this topic, there is so far only limited evidence showing an association between sport-related concussion (SRC) and increased risk for late-life cognitive and neuropsychiatric impairment, with no causality or risk factors yet determined. The modern CTE description is nevertheless proposed as a unique tauopathy with characteristic pathological stages occurring in retired athletes who have experienced previous repetitive brain trauma. This review highlights the principal issues that so far preclude firm conclusions about the association of athletic head trauma and neurodegenerative diseases of any type. We consider alternative interpretations that may contribute to the clinical progressive neurological findings in some athletes and recommend carefully-controlled epidemiological work to overcome current limitations in this area of research and stimulate future research.

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Financial Disclosures

Portions of this research were presented at the annual meeting of Alzheimer's Association International Conference, Vancouver, Canada. Dr. Randolph is the author of the RBANS, and receives royalty payments from the publisher and copyright holder of the test, Pearson, Inc.

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Authors and Affiliations

  1. Department of Neurology, NYU School of Medicine, New York, NY, USA

    Stella Karantzoulis

  2. Department of Neurology, Loyola University Medical Center, Maywood, IL, USA

    Christopher Randolph

  3. New York University Langone Medical University, 145 East 32nd Street, 2nd Floor, New York, NY, 10016, USA

    Stella Karantzoulis

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Correspondence to Stella Karantzoulis.

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Karantzoulis, S., Randolph, C. Modern Chronic Traumatic Encephalopathy in Retired Athletes: What is the Evidence?. Neuropsychol Rev 23, 350–360 (2013). https://doi.org/10.1007/s11065-013-9243-4

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