Chronic traumatic encephalopathy in sport: a systematic review

Area of Science:

• Neuropathology
• Neuroscience
• Clinical Neurology

Background:

• Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with repetitive head trauma.
• Distinguishing between historical and contemporary descriptions of CTE is crucial for accurate diagnosis and understanding.
• Previous research has highlighted variations in clinical presentation and pathology, necessitating a critical review.

Purpose of the Study:

• To critically review chronic traumatic encephalopathy (CTE), examining its clinical presentations and neuropathology.
• To evaluate the strength of evidence supporting CTE as a distinct neurological syndrome.
• To compare and contrast 'classic' and 'modern' descriptions of CTE.

Main Methods:

• A comprehensive literature search was conducted across seven electronic databases.
• MeSH terms and keywords were used to identify relevant studies on CTE.
• Inclusion and exclusion criteria were applied to select 158 published case studies for review.

Main Results:

• Significant clinicopathological differences exist between 'classic' and 'modern' CTE syndromes.
• These differences are observed in age of onset, natural history, clinical features, and pathological findings.
• Current study methodologies preclude determination of etiology or risk factors for modern CTE.

Conclusions:

• The distinct clinicopathological features of modern CTE warrant a new nomenclature.
• Further research is essential to define the clinical phenotype and establish the etiology of modern CTE.
• Large-scale, prospective clinicopathological studies are recommended for future research.