When Athletes Ask About Chronic Traumatic Encephalopathy

Athletes exposed to repetitive head impacts (RHI) may seek clinical evaluation because of concerns about chronic traumatic encephalopathy (CTE), a neuropathologically defined disease that cannot currently be diagnosed during life. As public awareness of CTE has expanded, clinicians face challenges communicating diagnostic uncertainty, interpreting non-specific symptoms, and addressing concerns about future neurological health. This Current Opinion examines the widening gap between public expectations and scientific capability and considers its implications for athlete-centered care. We discuss how clinicians can acknowledge uncertainty without dismissing patients' concerns, identify potentially treatable contributors to symptoms without prematurely attributing them to neurodegenerative disease, and use shared decision-making to guide individualized evaluation and management. We also consider how concerns about CTE may influence decisions about continued participation and return-to-sport among current athletes. Meeting these challenges requires coordinated interdisciplinary care, evidence-based communication, and clinical approaches that prioritize meaningful intervention even when diagnostic certainty remains unavailable.