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Research papers on Head injuries and long-term brain effects in contact sports

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  1. Consensus statement on concussion in sport—the 5th international conference on concussion in sport held in Berlin, October 2016

    Paul McCrory, Willem Meeuwisse, Jiří Dvořák, et al. · 2017 · British Journal of Sports Medicine · 3,339 citations

    The 2017 Concussion in Sport Group (CISG) consensus statement is designed to build on the principles outlined in the previous statements1–4 and to develop further conceptual understanding of sport-related concussion (SRC) using an expert consensus-based approach. This document is developed for physicians and healthcare providers who are involved in athlete care, whether at a recreational, elite or professional level. While agreement exists on the principal messages conveyed by this document, the authors acknowledge that the science of SRC is evolving and therefore individual management and return-to-play decisions remain in the realm of clinical judgement. This consensus document reflects th

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  2. Consensus statement on concussion in sport: the 4th International Conference on Concussion in Sport held in Zurich, November 2012

    Paul McCrory, Willem Meeuwisse, Mark Aubry, et al. · 2013 · British Journal of Sports Medicine · 2,595 citations

    This paper is a revision and update of the recommendations developed following the 1st (Vienna 2001), 2nd (Prague 2004) and 3rd (Zurich 2008) International Consensus Conferences on Concussion in Sport and is based on the deliberations at the 4th International Conference on Concussion in Sport held in Zurich, November 2012.1–3 \n \nThe new 2012 Zurich Consensus statement is designed to build on the principles outlined in the previous documents and to develop further conceptual understanding of this problem using a formal consensus-based approach. A detailed description of the consensus process is outlined at the end of this document under the Background section. This document is developed pri

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  3. The spectrum of disease in chronic traumatic encephalopathy

    Ann C. McKee, Thor D. Stein, Christopher J. Nowinski, et al. · 2012 · Brain · 2,108 citations

    Chronic traumatic encephalopathy is a progressive tauopathy that occurs as a consequence of repetitive mild traumatic brain injury. We analysed post-mortem brains obtained from a cohort of 85 subjects with histories of repetitive mild traumatic brain injury and found evidence of chronic traumatic encephalopathy in 68 subjects: all males, ranging in age from 17 to 98 years (mean 59.5 years), including 64 athletes, 21 military veterans (86% of whom were also athletes) and one individual who engaged in self-injurious head banging behaviour. Eighteen age- and gender-matched individuals without a history of repetitive mild traumatic brain injury served as control subjects. In chronic traumatic en

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  4. American Medical Society for Sports Medicine position statement: concussion in sport

    Kimberly G. Harmon, Jonathan A. Drezner, Matthew Gammons, et al. · 2012 · British Journal of Sports Medicine · 1,428 citations

    PURPOSE OF THE STATEMENT: ▸ To provide an evidence-based, best practises summary to assist physicians with the evaluation and management of sports concussion. ▸ To establish the level of evidence, knowledge gaps and areas requiring additional research. IMPORTANCE OF AN AMSSM STATEMENT: ▸ Sports medicine physicians are frequently involved in the care of patients with sports concussion. ▸ Sports medicine physicians are specifically trained to provide care along the continuum of sports concussion from the acute injury to return-to-play (RTP) decisions. ▸ The care of athletes with sports concussion is ideally performed by healthcare professionals with specific training and experience in the asse

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  5. Consensus statement on concussion in sport: the 6th International Conference on Concussion in Sport–Amsterdam, October 2022

    Jon Patricios, Kathryn Schneider, Jiří Dvořák, et al. · 2023 · British Journal of Sports Medicine · 1,141 citations

    For over two decades, the Concussion in Sport Group has held meetings and developed five international statements on concussion in sport. This 6th statement summarises the processes and outcomes of the 6th International Conference on Concussion in Sport held in Amsterdam on 27-30 October 2022 and should be read in conjunction with the (1) methodology paper that outlines the consensus process in detail and (2) 10 systematic reviews that informed the conference outcomes. Over 3½ years, author groups conducted systematic reviews of predetermined priority topics relevant to concussion in sport. The format of the conference, expert panel meetings and workshops to revise or develop new clinical as

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  6. Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football

    Jesse Mez, Daniel H. Daneshvar, Patrick T. Kiernan, et al. · 2017 · JAMA · 1,100 citations

    Importance: Players of American football may be at increased risk of long-term neurological conditions, particularly chronic traumatic encephalopathy (CTE). Objective: To determine the neuropathological and clinical features of deceased football players with CTE. Design, Setting, and Participants: Case series of 202 football players whose brains were donated for research. Neuropathological evaluations and retrospective telephone clinical assessments (including head trauma history) with informants were performed blinded. Online questionnaires ascertained athletic and military history. Exposures: Participation in American football at any level of play. Main Outcomes and Measures: Neuropatholog

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  8. Clinical presentation of chronic traumatic encephalopathy

    Robert A. Stern, Daniel H. Daneshvar, Christine M. Baugh, et al. · 2013 · Neurology · 565 citations

    OBJECTIVE: The goal of this study was to examine the clinical presentation of chronic traumatic encephalopathy (CTE) in neuropathologically confirmed cases. METHODS: Thirty-six adult male subjects were selected from all cases of neuropathologically confirmed CTE at the Boston University Center for the Study of Traumatic Encephalopathy brain bank. Subjects were all athletes, had no comorbid neurodegenerative or motor neuron disease, and had next-of-kin informants to provide retrospective reports of the subjects' histories and clinical presentations. These interviews were conducted blind to the subjects' neuropathologic findings. RESULTS: A triad of cognitive, behavioral, and mood impairments

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  9. Role of subconcussion in repetitive mild traumatic brain injury

    Julian E. Bailes, Anthony L. Petraglia, Bennet Omalu, et al. · 2013 · Journal of neurosurgery · 552 citations

    Research now suggests that head impacts commonly occur during contact sports in which visible signs or symptoms of neurological dysfunction may not develop despite those impacts having the potential for neurological injury. Recent biophysics studies utilizing helmet accelerometers have indicated that athletes at the collegiate and high school levels sustain a surprisingly high number of head impacts ranging from several hundred to well over 1000 during the course of a season. The associated cumulative impact burdens over the course of a career are equally important. Clinical studies have also identified athletes with no readily observable symptoms but who exhibit functional impairment as mea

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  10. Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome

    Philip H. Montenigro, Christine M. Baugh, Daniel H. Daneshvar, et al. · 2014 · Alzheimer s Research & Therapy · 377 citations

    The long-term consequences of repetitive head impacts have been described since the early 20th century. Terms such as punch drunk and dementia pugilistica were first used to describe the clinical syndromes experienced by boxers. A more generic designation, chronic traumatic encephalopathy (CTE), has been employed since the mid-1900s and has been used in recent years to describe a neurodegenerative disease found not just in boxers but in American football players, other contact sport athletes, military veterans, and others with histories of repetitive brain trauma, including concussions and subconcussive trauma. This article reviews the literature of the clinical manifestations of CTE from 20

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  11. Persistent, Long-term Cerebral White Matter Changes after Sports-Related Repetitive Head Impacts

    Jeffrey J. Bazarian, Tong Zhu, Jianhui Zhong, et al. · 2014 · PLoS ONE · 301 citations

    INTRODUCTION: Repetitive head impacts (RHI) sustained in contact sports are thought to be necessary for the long-term development of chronic traumatic encephalopathy (CTE). Our objectives were to: 1) characterize the magnitude and persistence of RHI-induced white matter (WM) changes; 2) determine their relationship to kinematic measures of RHI; and 3) explore their clinical relevance. METHODS: Prospective, observational study of 10 Division III college football players and 5 non-athlete controls during the 2011-12 season. All subjects underwent diffusion tensor imaging (DTI), physiologic, cognitive, and balance testing at pre-season (Time 1), post-season (Time 2), and after 6-months of no-co

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  12. Chronic traumatic encephalopathy (CTE): criteria for neuropathological diagnosis and relationship to repetitive head impacts

    Ann C. McKee, Thor D. Stein, Bertrand R. Huber, et al. · 2023 · Acta Neuropathologica · 240 citations

    Over the last 17 years, there has been a remarkable increase in scientific research concerning chronic traumatic encephalopathy (CTE). Since the publication of NINDS-NIBIB criteria for the neuropathological diagnosis of CTE in 2016, and diagnostic refinements in 2021, hundreds of contact sport athletes and others have been diagnosed at postmortem examination with CTE. CTE has been reported in amateur and professional athletes, including a bull rider, boxers, wrestlers, and American, Canadian, and Australian rules football, rugby union, rugby league, soccer, and ice hockey players. The pathology of CTE is unique, characterized by a pathognomonic lesion consisting of a perivascular accumulatio

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  13. Animal models of chronic traumatic encephalopathy

    Kelly M McAteer, Renee J Turner, Frances Corrigan · 2017 · Concussion · 21 citations

    Repeated head impacts have been suggested to be associated with the development of the neurodegenerative disorder, chronic traumatic encephalopathy (CTE). CTE is characterized by the accumulation of hyperphosphorylated tau within the brain, with accompanying cognitive and behavioral deficits. How a history of repeated head impacts can lead to the later development of CTE is not yet known, and as such appropriate animal models are required. Over the last decade a number of rodent models of repeated mild traumatic brain injury have been developed that are broadly based on traditional traumatic brain injury models, in controlled cortical impact, fluid percussion and weight drop models, with ada

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  15. Epidemiological Principles in Claims of Causality: An Enquiry into Repetitive Head Impacts (RHI) and Chronic Traumatic Encephalopathy (CTE)

    Lauren V. Fortington, J. David Cassidy, Rudolph J. Castellani, et al. · 2025 · Sports Medicine · 15 citations

    Abstract Determining whether repetitive head impacts (RHI) cause the development of chronic traumatic encephalopathy (CTE)-neuropathological change (NC) and whether pathological changes cause clinical syndromes are topics of considerable interest to the global sports medicine community. In 2022, an article was published that used the Bradford Hill criteria to evaluate the claim that RHI cause CTE. The publication garnered international media attention and has since been promoted as definitive proof that causality has been established. Our counterpoint presents an appraisal of the published article in terms of the claims made and the scientific literature used in developing those cl

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  16. Prevalence of Chronic Traumatic Encephalopathy in Athletes With Repetitive Head Impacts: A Systematic Review and Meta‐Analysis

    Bote Qi, Jingwang Tan, Dushuo Feng, et al. · 2025 · Scandinavian Journal of Medicine & Science in Sports · 12 citations

    ABSTRACT Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder associated with repetitive head impacts (RHI), which is commonly observed in athletes participating in contact sports. This systematic review and meta‐analysis aimed to provide a clearer elucidation of the prevalence, risk factors, and potential outcomes of CTE in athletes. Through a comprehensive search of PubMed, EMBASE, Web of Science, and Google Scholar (January 2015 to July 2024), we ultimately included eight eligible studies with a low risk of bias involving 1000 former contact sports athletes diagnosed by neuropathological methods. Data were analyzed in a random‐effec

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  17. ‘The highest confidence that repetitive head collisions causes chronic traumatic encephalopathy’? Analysing the scientific knowledge in the Rugby Union concussion litigation of England and Wales

    Jonathan Kilgallon · 2024 · The International Sports Law Journal · 6 citations

    Abstract295 rugby players have begun legal proceedings against World Rugby, the Rugby Football Union and the Welsh Rugby Union. The claimants report they are suffering from chronic traumatic encephalopathy. Among the allegations against the defendants is that the player safety regulations (i.e. the Pitch Side Concussion Assessment and Return to Play protocols) in place at the time of injury were done without proper medical foresight and increased the risks of concussion to players. World Rugby’s safety regulations are informed by the work of the Concussion in Sport Group which maintains that the link between collisions and concussion is unclear. However, recent studies report an unprecedente

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