Skip to main content Skip to main navigation menu Skip to site footer
  • Register
  • Login
  • Menu
  • Home
  • Current
  • Archives
  • Announcements
  • About
    • About the Journal
    • Submissions
    • Editorial Team
    • Privacy Statement
    • Contact
  • Register
  • Login

Quality in Sport

CTE in Athletes: Understanding the Long-Term Effects of Repetitive Head Injuries
  • Home
  • /
  • CTE in Athletes: Understanding the Long-Term Effects of Repetitive Head Injuries
  1. Home /
  2. Archives /
  3. Vol. 41 (2025) /
  4. Medical Sciences

CTE in Athletes: Understanding the Long-Term Effects of Repetitive Head Injuries

Authors

  • Weronika Sepioło polish https://orcid.org/0009-0007-3060-5966
  • Mikołaj Lewandoswki https://orcid.org/0009-0001-8533-0660
  • Zofia Kwiatkowska https://orcid.org/0009-0002-4895-9002
  • Wojciech Kurkiewicz https://orcid.org/0009-0000-0137-1311
  • Oskar Woźniak https://orcid.org/0009-0006-1016-0720
  • Jowita Mikulska https://orcid.org/0009-0004-4176-8195
  • Joanna Wąsik https://orcid.org/0009-0004-9415-0508
  • Kacper Gryboś https://orcid.org/0009-0007-9598-8494
  • Julia Kiełbratowska https://orcid.org/0009-0005-3328-5502

DOI:

https://doi.org/10.12775/QS.2025.41.60250

Keywords

CTE in athletes, repetitive head impacts, tau protein, encephalopathy, traumatic brain injury

Abstract

Introduction and Purpose
Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease linked to repeated head injuries such as concussions and sub-concussive impacts [19]. Initially observed in retired boxers with behavioral and cognitive symptoms, it was called “punch-drunk syndrome” [3,9,16]. CTE is mostly found in athletes from contact sports (e.g., football, boxing, hockey, rugby) and in military personnel [1,3,9,13,19]. While most reported cases involve male athletes, anyone exposed to repetitive head injury (RHI) is at risk [2,10,13]. Due to increasing awareness of its long-term effects on brain health, CTE is now a critical topic in sports medicine, neurology, and public health.

Material and Methods
A literature review was conducted using PubMed, focusing on studies published up to the end of 2023. Keywords included: “CTE in athletes,” “repetitive head impacts,” “tau protein,” “encephalopathy,” and “CTE.” Studies were selected based on their focus on long-term effects of RHI, CTE pathology, and prevention strategies.

Results
The review highlights the connection between repeated brain trauma and CTE in athletes. Ongoing research aims to uncover its biological mechanisms and develop early diagnostic tools and targeted treatments. Long-term studies tracking athletes are vital for identifying causes and modifiable risk factors.

Conclusions
CTE illustrates the complex link between repeated head trauma and brain health decline. While progress has been made, diagnosis, treatment, and prevention remain difficult. Continued research and collaboration among clinicians, researchers, sports organizations, and policymakers are essential to reduce risks and protect athlete well-being.

References

1. McKee, A.C., Stein, T.D., Huber, B.R. et al. Chronic traumatic encephalopathy (CTE):

criteria for neuropathological diagnosis and relationship to repetitive head impacts. Acta

Neuropathol 145, 371–394 (2023). https://doi.org/10.1007/s00401-023-02540-w

2. Suter, C.M., Affleck, A.J., Pearce, A.J. et al. Chronic traumatic encephalopathy in a

female ex-professional Australian rules footballer. Acta Neuropathol 146, 547–549

(2023). https://doi.org/10.1007/s00401-023-02610-z

3. de Sena Barbosa MG, Francisco GGOA, de Souza RLV, de Souza JMA, Almeida

Carneiro R, Rabelo NN, Chaurasia B. Chronic traumatic encephalopathy in athletes,

players, boxers and military: systematic review. Ann Med Surg (Lond). 2024 Oct

24;86(12):7238-7247. doi: 10.1097/MS9.0000000000002693. PMID: 39649931;

PMCID: PMC11623818.

4. van Amerongen, S., Kamps, S., Kaijser, K.K.M. et al. me and TDP-43 pathology in a

former professional soccer player with dementia: a clinicopathological case report and

review of the literature. acta neuropathol commun 11, 77 (2023).

https://doi.org/10.1186/s40478-023-01572-3

5. van Amerongen, S., Pulukuri, S.V., Tuz-Zahra, F. et al. Inflammatory biomarkers for

neurobehavioral dysregulation in former American football players: findings from the

DIAGNOSE CTE Research Project. J Neuroinflammation 21, 46 (2024).

https://doi.org/10.1186/s12974-024-03034-6

6. McKee AC, Mez J, Abdolmohammadi B, et al. Neuropathologic and Clinical Findings in

Young Contact Sport Athletes Exposed to Repetitive Head Impacts. JAMA Neurol.

2023;80(10):1037–1050. doi:10.1001/jamaneurol.2023.2907

7. Alosco, M.L., Mariani, M.L., Adler, C.H. et al. Developing methods to detect and

diagnose chronic traumatic encephalopathy during life: rationale, design, and

methodology for the DIAGNOSE CTE Research Project. Alz Res Therapy 13, 136

(2021). https://doi.org/10.1186/s13195-021-00872-x

8. Atherton K, Han X, Chung J, et al. Association of APOE Genotypes and Chronic

Traumatic Encephalopathy. JAMA Neurol. 2022;79(8):787–796.

doi:10.1001/jamaneurol.2022.1634

9. Bastgen, T., Evers, J., Oedekoven, C. et al. Repetitive head injuries in German American

football players do not change blood-based biomarker candidates for CTE during a single

season. Neurol. Res. Pract. 6, 13 (2024). https://doi.org/10.1186/s42466-024-00307-6

10. Tiemensma, M., Byard, R.W., Vink, R. et al. Chronic traumatic encephalopathy (CTE)

in the context of longstanding intimate partner violence. Acta Neuropathol 148, 1 (2024).

https://doi.org/10.1007/s00401-024-02757-3

11. Fesharaki-Zadeh A (2019) Chronic Traumatic Encephalopathy: A Brief Overview. Front.

Neurol. 10:713. https://doi.org/10.3389/fneur.2019.00713

12. Zamzam M, Sinan K, Mohilldean H, Hasan S, Saleh ES. The Correlations Between

Concussions and Chronic Traumatic Encephalopathy (CTE) in the National Football

League: Why Does Society Keep Promoting Sports With High CTE Rates? Cureus. 2024

Jul 11;16(7):e64359. doi: 10.7759/cureus.64359. PMID: 39131037; PMCID:

PMC11316672.

13. McKee, A.C., Stein, T.D., Kiernan, P.T. and Alvarez, V.E. (2015), CTE Neuropathology.

Brain Pathology, 25: 350-364. https://doi.org/10.1111/bpa.12248

14. Ann C. McKee, Thor D. Stein, Christopher J. Nowinski, Robert A. Stern, Daniel H.

Daneshvar, Victor E. Alvarez, Hyo-Soon Lee, Garth Hall, Sydney M. Wojtowicz,

Christine M. Baugh, David O. Riley, Caroline A. Kubilus, Kerry A. Cormier, Matthew A.

Jacobs, Brett R. Martin, Carmela R. Abraham, Tsuneya Ikezu, Robert Ross Reichard,

Benjamin L. Wolozin, Andrew E. Budson, Lee E. Goldstein, Neil W. Kowall, Robert C.

Cantu, The spectrum of disease in chronic traumatic encephalopathy, Brain, Volume 136,

Issue 1, January 2013, Pages 43–64, https://doi.org/10.1093/brain/aws307

15. VanItallie TB. Traumatic brain injury (TBI) in collision sports: Possible mechanisms of

transformation into chronic traumatic encephalopathy (CTE). Metabolism. 2019

Nov;100S:153943. doi: 10.1016/j.metabol.2019.07.007. PMID: 31610856.

16. Smith DH, Johnson VE, Trojanowski JQ, Stewart W. Chronic traumatic encephalopathy -

confusion and controversies. Nat Rev Neurol. 2019 Mar;15(3):179-183. doi:

10.1038/s41582-018-0114-8. PMID: 30664683; PMCID: PMC6532781.

17. Pierre K, Molina V, Shukla S, Avila A, Fong N, Nguyen J, Lucke-Wold B. Chronic

traumatic encephalopathy: Diagnostic updates and advances. AIMS Neurosci. 2022 Dec

19;9(4):519-535. doi: 10.3934/Neuroscience.2022030. PMID: 36660076; PMCID:

PMC9826753.

18. Maas AIR, Menon DK, Manley GT, Abrams M, Åkerlund C, Andelic N, Aries M,

Bashford T, Bell MJ, Bodien YG, Brett BL, Büki A, Chesnut RM, Citerio G, Clark D,

Clasby B, Cooper DJ, Czeiter E, Czosnyka M, Dams-O'Connor K, De Keyser V, Diaz-

Arrastia R, Ercole A, van Essen TA, Falvey É, Ferguson AR, Figaji A, Fitzgerald M,

Foreman B, Gantner D, Gao G, Giacino J, Gravesteijn B, Guiza F, Gupta D, Gurnell M,

Haagsma JA, Hammond FM, Hawryluk G, Hutchinson P, van der Jagt M, Jain S, Jain S,

Jiang JY, Kent H, Kolias A, Kompanje EJO, Lecky F, Lingsma HF, Maegele M, Majdan

M, Markowitz A, McCrea M, Meyfroidt G, Mikolić A, Mondello S, Mukherjee P, Nelson

D, Nelson LD, Newcombe V, Okonkwo D, Orešič M, Peul W, Pisică D, Polinder S,

Ponsford J, Puybasset L, Raj R, Robba C, Røe C, Rosand J, Schueler P, Sharp DJ,

Smielewski P, Stein MB, von Steinbüchel N, Stewart W, Steyerberg EW, Stocchetti N,

Temkin N, Tenovuo O, Theadom A, Thomas I, Espin AT, Turgeon AF, Unterberg A,

Van Praag D, van Veen E, Verheyden J, Vyvere TV, Wang KKW, Wiegers EJA,

Williams WH, Wilson L, Wisniewski SR, Younsi A, Yue JK, Yuh EL, Zeiler FA,

Zeldovich M, Zemek R; InTBIR Participants and Investigators. Traumatic brain injury:

progress and challenges in prevention, clinical care, and research. Lancet Neurol. 2022

Nov;21(11):1004-1060. doi: 10.1016/S1474-4422(22)00309-X. Epub 2022 Sep 29.

Erratum in: Lancet Neurol. 2022 Dec;21(12):e10. doi: 10.1016/S1474-4422(22)00411-2.

PMID: 36183712; PMCID: PMC10427240.

19. Safinia C, Bershad EM, Clark HB, SantaCruz K, Alakbarova N, Suarez JI, Divani AA.

Chronic Traumatic Encephalopathy in Athletes Involved with High-impact Sports. J Vasc

Interv Neurol. 2016 Oct;9(2):34-48. PMID: 27829969; PMCID: PMC5094259.

20. Mez J, Daneshvar DH, Abdolmohammadi B, Chua AS, Alosco ML, Kiernan PT, Evers

L, Marshall L, Martin BM, Palmisano JN, Nowinski CJ, Mahar I, Cherry JD, Alvarez

VE, Dwyer B, Huber BR, Stein TD, Goldstein LE, Katz DI, Cantu RC, Au R, Kowall

NW, Stern RA, McClean MD, Weuve J, Tripodis Y, McKee AC. Duration of American

Football Play and Chronic Traumatic Encephalopathy. Ann Neurol. 2020 Jan;87(1):116-

131. doi: 10.1002/ana.25611. Epub 2019 Nov 23. PMID: 31589352; PMCID:

PMC6973077.

21. Saulle M, Greenwald BD. Chronic traumatic encephalopathy: a review. Rehabil Res

Pract. 2012;2012:816069. doi: 10.1155/2012/816069. Epub 2012 Apr 10. PMID:

22567320; PMCID: PMC3337491.

22. Pan, J., Connolly, I. D., Dangelmajer, S., Kintzing, J., Ho, A. L., & Grant, G. (2016).

Sports-related brain injuries: connecting pathology to diagnosis. Neurosurgical Focus

FOC, 40(4), E14. https://doi.org/10.3171/2016.1.FOCUS15607

23. Alosco ML, Culhane J, Mez J. Neuroimaging Biomarkers of Chronic Traumatic

Encephalopathy: Targets for the Academic Memory Disorders Clinic. Neurotherapeutics.

2021 Apr;18(2):772-791. doi: 10.1007/s13311-021-01028-3. Epub 2021 Apr 13. PMID:

33847906; PMCID: PMC8423967.

24. Stewart W, Allinson K, Al-Sarraj S, Bachmeier C, Barlow K, Belli A, Burns MP, Carson

A, Crawford F, Dams-O'Connor K, Diaz-Arrastia R, Dixon CE, Edlow BL, Ferguson S,

Fischl B, Folkerth RD, Gentleman S, Giza CC, Grady MS, Helmy A, Herceg M, Holton

JL, Howell D, Hutchinson PJ, Iacono D, Iglesias JE, Ikonomovic MD, Johnson VE,

Keene CD, Kofler JK, Koliatsos VE, Lee EB, Levin H, Lifshitz J, Ling H, Loane DJ,

Love S, Maas AI, Marklund N, Master CL, McElvenny DM, Meaney DF, Menon DK,

Montine TJ, Mouzon B, Mufson EJ, Ojo JO, Prins M, Revesz T, Ritchie CW, Smith C,

Sylvester R, Tang CY, Trojanowski JQ, Urankar K, Vink R, Wellington C, Wilde EA,

Wilson L, Yeates K, Smith DH. Primum non nocere: a call for balance when reporting on

CTE. Lancet Neurol. 2019 Mar;18(3):231-233. doi: 10.1016/S1474-4422(19)30020-1.

Epub 2019 Feb 12. Erratum in: Lancet Neurol. 2019 Apr;18(4):e3. doi: 10.1016/S1474-

4422(19)30075-4. PMID: 30784550; PMCID: PMC6594011.

25. Pierre K, Dyson K, Dagra A, Williams E, Porche K, Lucke-Wold B. Chronic Traumatic

Encephalopathy: Update on Current Clinical Diagnosis and Management. Biomedicines.

2021 Apr 12;9(4):415. doi: 10.3390/biomedicines9040415. PMID: 33921385; PMCID:

PMC8069746.

Quality in Sport

Downloads

  • PDF

Published

2025-05-12

How to Cite

1.
SEPIOŁO, Weronika, LEWANDOSWKI, Mikołaj, KWIATKOWSKA, Zofia, KURKIEWICZ, Wojciech, WOŹNIAK, Oskar, MIKULSKA, Jowita, WĄSIK, Joanna, GRYBOŚ, Kacper and KIEŁBRATOWSKA, Julia. CTE in Athletes: Understanding the Long-Term Effects of Repetitive Head Injuries. Quality in Sport. Online. 12 May 2025. Vol. 41, p. 60250. [Accessed 28 June 2025]. DOI 10.12775/QS.2025.41.60250.
  • ISO 690
  • ACM
  • ACS
  • APA
  • ABNT
  • Chicago
  • Harvard
  • IEEE
  • MLA
  • Turabian
  • Vancouver
Download Citation
  • Endnote/Zotero/Mendeley (RIS)
  • BibTeX

Issue

Vol. 41 (2025)

Section

Medical Sciences

License

Copyright (c) 2025 Weronika Sepioło, Mikołaj Lewandoswki, Zofia Kwiatkowska, Wojciech Kurkiewicz, Oskar Woźniak, Jowita Mikulska, Joanna Wąsik, Kacper Gryboś, Julia Kiełbratowska

Creative Commons License

This work is licensed under a Creative Commons Attribution-NonCommercial-ShareAlike 4.0 International License.

Stats

Number of views and downloads: 123
Number of citations: 0

Search

Search

Browse

  • Browse Author Index
  • Issue archive

User

User

Current Issue

  • Atom logo
  • RSS2 logo
  • RSS1 logo

Information

  • For Readers
  • For Authors
  • For Librarians

Newsletter

Subscribe Unsubscribe

Tags

Search using one of provided tags:

CTE in athletes, repetitive head impacts, tau protein, encephalopathy, traumatic brain injury
Up

Akademicka Platforma Czasopism

Najlepsze czasopisma naukowe i akademickie w jednym miejscu

apcz.umk.pl

Partners

  • Akademia Ignatianum w Krakowie
  • Akademickie Towarzystwo Andragogiczne
  • Fundacja Copernicus na rzecz Rozwoju Badań Naukowych
  • Instytut Historii im. Tadeusza Manteuffla Polskiej Akademii Nauk
  • Instytut Kultur Śródziemnomorskich i Orientalnych PAN
  • Instytut Tomistyczny
  • Karmelitański Instytut Duchowości w Krakowie
  • Ministerstwo Kultury i Dziedzictwa Narodowego
  • Państwowa Akademia Nauk Stosowanych w Krośnie
  • Państwowa Akademia Nauk Stosowanych we Włocławku
  • Państwowa Wyższa Szkoła Zawodowa im. Stanisława Pigonia w Krośnie
  • Polska Fundacja Przemysłu Kosmicznego
  • Polskie Towarzystwo Ekonomiczne
  • Polskie Towarzystwo Ludoznawcze
  • Towarzystwo Miłośników Torunia
  • Towarzystwo Naukowe w Toruniu
  • Uniwersytet im. Adama Mickiewicza w Poznaniu
  • Uniwersytet Komisji Edukacji Narodowej w Krakowie
  • Uniwersytet Mikołaja Kopernika
  • Uniwersytet w Białymstoku
  • Uniwersytet Warszawski
  • Wojewódzka Biblioteka Publiczna - Książnica Kopernikańska
  • Wyższe Seminarium Duchowne w Pelplinie / Wydawnictwo Diecezjalne „Bernardinum" w Pelplinie

© 2021- Nicolaus Copernicus University Accessibility statement Shop