Significance Younger contact sport athletes could also be in danger for long-term neuropathologic issues, together with continual traumatic encephalopathy (CTE).
Goal To characterize the neuropathologic and medical signs of younger mind donors who had been contact sport athletes.
Design, Setting, and Members This case collection analyzes findings from 152 of 156 mind donors youthful than 30 years recognized by means of the Understanding Neurologic Damage and Traumatic Encephalopathy (UNITE) Mind Financial institution who donated their brains from February 1, 2008, to September 31, 2022. Neuropathologic evaluations, retrospective phone medical assessments, and on-line questionnaires with informants had been carried out blinded. Knowledge evaluation was carried out between August 2021 and June 2023.
Exposures Repetitive head impacts from contact sports activities.
Principal Outcomes and Measures Gross and microscopic neuropathologic evaluation, together with analysis of CTE, based mostly on outlined diagnostic standards; and informant-reported athletic historical past and informant-completed scales that assess cognitive signs, temper disturbances, and neurobehavioral dysregulation.
Outcomes Among the many 152 deceased contact sports activities members (imply [SD] age, 22.97 [4.31] years; 141 [92.8%] male) included within the research, CTE was identified in 63 (41.4%; median [IQR] age, 26 [24-27] years). Of the 63 mind donors identified with CTE, 60 (95.2%) had been identified with delicate CTE (phases I or II). Mind donors who had CTE had been extra more likely to be older (imply distinction, 3.92 years; 95% CI, 2.74-5.10 years) Of the 63 athletes with CTE, 45 (71.4%) had been males who performed novice sports activities, together with American soccer, ice hockey, soccer, rugby, and wrestling; 1 girl with CTE performed collegiate soccer. For many who performed soccer, period of enjoying profession was considerably longer in these with vs with out CTE (imply distinction, 2.81 years; 95% CI, 1.15-4.48 years). Athletes with CTE had extra ventricular dilatation, cavum septum pellucidum, thalamic notching, and perivascular pigment-laden macrophages within the frontal white matter than these with out CTE. Cognitive and neurobehavioral signs had been frequent amongst all mind donors. Suicide was the most typical explanation for demise, adopted by unintentional overdose; there have been no variations in explanation for demise or medical signs based mostly on CTE standing.
Conclusions and Relevance This case collection discovered that younger mind donors uncovered to repetitive head impacts had been extremely symptomatic no matter CTE standing, and the causes of signs on this pattern are seemingly multifactorial. Future research that embrace younger mind donors unexposed to repetitive head impacts are wanted to make clear the affiliation amongst publicity, white matter and microvascular pathologic findings, CTE, and medical signs.