Correction to: Chronic traumatic encephalopathy in two former Australian National Rugby League players

Buckland, Michael E.; Sy, Joanne; Szentmariay, Istvan; Kullen, Alexandra; Lee, Maggie; Harding, Anthony John; Halliday, Glenda M.; Suter, Catherine M.

doi:10.1186/s40478-019-0772-9

Cited by 5 publications

(6 citation statements)

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“…In 2005 and 2006, the identification of p-tau pathology in middle-aged American football players by Omalu et al brought worldwide awareness to chronic traumatic encephalopathy (CTE) and to the concept that repetitive head trauma sustained in modern day contact sports could trigger the same neurodegenerative disorder as boxing ( 16 ). Today, CTE pathology has been reported in other contact sports including soccer ( 17–19 ), ice hockey ( 20 ), wrestling ( 21 ), rugby ( 19 , 22 , 23 ), baseball ( 17 ), mixed martial arts, bull-riding; in military-related activities, including exposure to explosive blasts ( 24 , 25 ); in repetitive head trauma resulting from physical abuse ( 26 ), “head banging” ( 15 ), poorly controlled epilepsy ( 15 ), and “dwarf-throwing” ( 27 ), and even demonstrated following exposure to a single moderate or severe TBI ( 28–30 ).…”

Section: Introductionmentioning

confidence: 99%

“…The panel also defined a pathognomonic lesion of CTE as “an accumulation of abnormal hyperphosphorylated tau (p-tau) in neurons and astroglia distributed around small blood vessels at the depths of cortical sulci and in an irregular pattern.” In addition, the group defined supportive but nonspecific p-tau-immunoreactive features of CTE ( Table 1 ). Since their publication, the NINDS/NIBIB criteria for the neuropathological diagnosis of CTE have been widely adopted and used in neuropathological evaluation of CTE in diverse research brain banks and autopsy cohorts ( 18 , 23 , 32–39 ).…”

Section: Introductionmentioning

confidence: 99%

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The Second NINDS/NIBIB Consensus Meeting to Define Neuropathological Criteria for the Diagnosis of Chronic Traumatic Encephalopathy

Bieniek

Cairns

Crary

et al. 2021

Journal of Neuropathology &Amp; Experimental Neurology

185

239

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Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder associated with exposure to head trauma. In 2015, a panel of neuropathologists funded by the NINDS/NIBIB defined preliminary consensus neuropathological criteria for CTE, including the pathognomonic lesion of CTE as “an accumulation of abnormal hyperphosphorylated tau (p-tau) in neurons and astroglia distributed around small blood vessels at the depths of cortical sulci and in an irregular pattern,” based on review of 25 tauopathy cases. In 2016, the consensus panel met again to review and refine the preliminary criteria, with consideration around the minimum threshold for diagnosis and the reproducibility of a proposed pathological staging scheme. Eight neuropathologists evaluated 27 cases of tauopathies (17 CTE cases), blinded to clinical and demographic information. Generalized estimating equation analyses showed a statistically significant association between the raters and CTE diagnosis for both the blinded (OR = 72.11, 95% CI = 19.5–267.0) and unblinded rounds (OR = 256.91, 95% CI = 63.6–1558.6). Based on the challenges in assigning CTE stage, the panel proposed a working protocol including a minimum threshold for CTE diagnosis and an algorithm for the assessment of CTE severity as “Low CTE” or “High CTE” for use in future clinical, pathological, and molecular studies.

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Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

The Second NINDS/NIBIB Consensus Meeting to Define Neuropathological Criteria for the Diagnosis of Chronic Traumatic Encephalopathy

Bieniek

Cairns

Crary

et al. 2021

Journal of Neuropathology &Amp; Experimental Neurology

185

239

View full text Add to dashboard Cite

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“…Although CTE was described almost 100 years ago, it was only less than 20 years ago when Dr. Bennet Omalu began a powerful program to raise awareness of its importance, public burden, and increased impact on affected people’s wellbeing, as well as increased mortality rates, all of which culminated with the premiere of the American biographical sports drama film, “Concussion”, in 2015. It is now understood that this condition is not as uncommon as we thought before and that it can occur in athletes involved in contact sports, such as boxing, martial arts, American football, and rugby, as well as soccer, water polo, and ice hockey [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 ]. Furthermore, it was described in military personnel with a yet unsolved correlation with post-traumatic stress disorder (PTSD) [ 11 , 12 ].…”

Section: Introductionmentioning

confidence: 99%

A Review of the Most Recent Clinical and Neuropathological Criteria for Chronic Traumatic Encephalopathy

et al. 2023

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(1) Background: Chronic traumatic encephalopathy (CTE) is a complex pathological condition characterized by neurodegeneration, as a result of repeated head traumas. Currently, the diagnosis of CTE can only be assumed postmortem. Thus, the clinical manifestations associated with CTE are referred to as traumatic encephalopathy syndrome (TES), for which diagnostic multiple sets of criteria can be used. (2) Objectives: In this study, we aimed to present and discuss the limitations of the clinical and neuropathological diagnostic criteria for TES/CTE and to suggest a diagnostic algorithm enabling a more accurate diagnostic procedure. (3) Results: The most common diagnostic criteria for TES/CTE discriminate between possible, probable, and improbable. However, several key variations between the available diagnostic criteria suggest that the diagnosis of CTE can still only be given with postmortem neurophysiological examination. Thus, a TES/CTE diagnosis during life imposes a different level of certainty. Here, we are proposing a comprehensive algorithm of diagnosis criteria for TES/CTE based on the similarities and differences between the previous criteria. (4) Conclusions: The diagnosis of TES/CTE requires a multidisciplinary approach; thorough investigation for other neurodegenerative disorders, systemic illnesses, and/or psychiatric conditions that can account for the symptoms; and also complex investigations of patient history, psychiatric assessment, and blood and cerebrospinal fluid biomarker evaluation.

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“…Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy associated with repetitive mild head trauma, including concussion and asymptomatic subconcussive impacts. CTE was first recognized in boxers and has been identified recently in American football players, [1][2][3] ice hockey players, 4 soccer players, [5][6][7] baseball players, 4 rugby players, 8 professional wrestlers, 4 a bull rider, 9 military veterans exposed to blast, 10 and victims of assault and domestic violence. Like most neurodegenerative diseases, CTE is diagnosed conclusively only by a neuropathological examination of brain tissue.…”

mentioning

confidence: 99%

“…Since 2016, multiple international groups have used the NINDS criteria to evaluate and publish the neuropathological findings of CTE in various cohorts, including soccer players, 6,7,27 American football players, [28][29][30] a bull rider, 9 and rugby players. 8 Although some authors denounce the NINDS pathological criteria for CTE as "preliminary," [31][32][33] implying imprecision and insignificance, there is abundant evidence in the literature of their usefulness and value.…”

mentioning

confidence: 99%

The Neuropathology of Chronic Traumatic Encephalopathy: The Status of the Literature

McKee

2020

Semin Neurol

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Chronic traumatic encephalopathy (CTE) is a tauopathy associated with repetitive mild head trauma, including concussion and asymptomatic subconcussive impacts. CTE was first recognized in boxers almost a century ago and has been identified more recently in contact sports athletes, military veterans exposed to blast, and victims of domestic violence. Like most neurodegenerative diseases, CTE is diagnosed conclusively by a neuropathological examination of brain tissue. CTE is characterized by the buildup of hyperphosphorylated tau (p-tau) in neurofibrillary tangles (NFTs), neurites, and, sometimes, astrocytes, surrounding small blood vessels in a patchy distribution at the sulcal depths of the cerebral cortex. In 2015, using the McKee proposed criteria for the neuropathological diagnosis of CTE, a consensus panel of expert neuropathologists confirmed CTE as a unique neurodegenerative disease with a pathognomonic lesion and published the preliminary NINDS (National Institute of Neurological Disorders and Stroke) criteria for CTE. Since that time, the NINDS criteria for CTE have been implemented and validated in multiple international publications. Using the NINDS criteria, the largest clinicopathological series of CTE to date was reported that included 177 former American football players, including 110 (99%) of 111 former National Football League players, 48 (91%) of 53 former college football players, and 3 (21%) of 14 former high school players. Studies have also shown a significant association between cumulative exposure to repetitive head trauma, as judged by the length of American football playing career, and risk for and severity of CTE. There is also a significant relationship of the length of football playing career with p-tau pathology, inflammation, white matter rarefaction, and age at death in CTE. While p-tau pathology, inflammation, white matter rarefaction, and arteriolosclerosis contribute to dementia in CTE, whether they also influence the behavioral and mood symptoms in CTE has yet to be determined. There have been several instances of aging-related tau astrogliopathy (ARTAG), a common astrocytic pathology in the elderly, misdiagnosed as CTE in the recent literature, provoking claims that CTE pathology is present in people not known to have experienced repetitive head trauma. Although ARTAG is often found in CTE, the pathognomonic lesion of CTE is a neuronal lesion consisting of NFTs and neurites, with or without p-tau immunoreactive astrocytes. Some authors consider β-amyloid (Aβ) to be a primary feature of CTE, yet the data indicate that CTE is a primary tauopathy, with Aβ deposition a function of age and inheritance of the ApoEe4 allele. Some authors also question the progressive nature of CTE pathology, although there is clear evidence in most individuals that p-tau pathology increases in density and affects more brain regions with survival. This review is intended to outline the status of the evidence-based literature regarding CTE neuropathology and to address the misrepresentations and confusions that have arisen in recent reviews and a letter of correspondence.

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Correction to: Chronic traumatic encephalopathy in two former Australian National Rugby League players

Cited by 5 publications

References 1 publication

The Second NINDS/NIBIB Consensus Meeting to Define Neuropathological Criteria for the Diagnosis of Chronic Traumatic Encephalopathy

The Second NINDS/NIBIB Consensus Meeting to Define Neuropathological Criteria for the Diagnosis of Chronic Traumatic Encephalopathy

A Review of the Most Recent Clinical and Neuropathological Criteria for Chronic Traumatic Encephalopathy

The Neuropathology of Chronic Traumatic Encephalopathy: The Status of the Literature

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