CTE Present in Brain Donations of Young Athletes With Repetitive Head Injuries

Regardless of their chronic traumatic encephalopathy (CTE) status, young brain donors who experienced repetitive head impacts (RHI) exhibited significant neuropsychological symptoms, according to study results published in JAMA Neurology.

Researchers conducted a case series analyzing brain donors who died before age 30 involved in contact sports and reported on the neuropathological and clinical symptomatology of these individuals.

A total of 152 deceased brain donor patients were analyzed and CTE was diagnosed in 63 of these patients (41.4%; median [IQR] age, 26 [24-27]). Out of the 63 brain donors who were diagnosed with CTE, 95.2% (60 individuals) were found to have mild CTE, classified as stages I or II.

Out of the 152 brain donors, 11 (7.2%) were female and 141 (92.8%) were male. In terms of racial background, 1 (0.7%) identified as American Indian or Alaska Native, 27 (17.8%) as Black, 111 (73.0%) as White, and 13 (8.6%) had missing or other race information.

Brain donors diagnosed with CTE tended to be older (mean difference, 3.92 years; 95% CI, 2.74-5.10 years; P <.001). They were also more likely to identify as Black (16 [25.4%]; P =.047).

Moreover, individuals with CTE exhibited a higher level of education (28 [44.4%] compared with 17 [19.1%] donors with a college degree or higher; P <.001). However, there were no significant differences in the cause of death between those with CTE. Suicide remained the most common cause, followed by unintentional overdose.

Out of the 128 amateur athletes, 45 (35.2%) were found to have CTE. Similarly, among the 63 donors with CTE, 45 (71.4%) were amateurs. The group of amateur athletes consisted mainly of football players (78 [60.9%]), soccer players (22 [17.2%]), hockey players (10 [7.8%]), and wrestlers (9 [7.0%]).

Out of the 63 athletes diagnosed with CTE, 45 (71.4%) were male participants involved in amateur sports such as American football (78 [60.9%]), hockey (10 [7.8%]), , soccer (22 [17.2%]), and wrestling (9 [7.0%]).A single female athlete with CTE played collegiate soccer.

Among those who played football, individuals with CTE had a significantly longer playing career compared to those without CTE, (mean difference, 2.81 years, 95% CI, 1.15-4.48 years).

There was a significantly higher prevalence of cavum septum pellucidum (26 [63.4%] vs 19 [30.2%]; P <.001), enlargement of the frontal horns of the lateral ventricles (17 [41.4%] vs 13 [20.4%]; P =.02), and a thalamic notch (5 [11.9%] vs 1 [1.5%]; P =.03) in individuals with CTE compared with those without CTE.

Perivascular pigment-laden macrophages in the frontal subcortical white matter were significantly more prevalent in individuals with CTE (94.5%) compared with those without CTE (70.3%; P <0.001).

Among the 92 football players, the duration of football play was found to have a significant association with CTE status (odds ratio [OR], 1.20; 95% CI, 1.07-1.34; P =.002) and the presence of perivascular macrophages in the frontal white matter (OR, 1.26; 95% CI, 1.08-1.47; P =0.003).

However, it was not linked to ventricular enlargement, cavum septum pellucidum, thalamic notch abnormalities, or white matter rarefaction.

The study’s findings may be limited as it does not assess the incidence or prevalence of CTE in the general population or young contact sport athletes and others exposed to repetitive head impacts.

The researchers concluded, “Future studies comparing RHI-naive with RHI-exposed young brain donors will help isolate the clinical and neuropathologic effects of RHIs independent of CTE.”

Disclosure: Multiple study authors declared affiliations with biotech, pharmaceutical, and/or device companies. Please see the original reference for a full list of authors’ disclosures.

This article originally appeared on Neurology Advisor