It has long been recognized that repeated impacts to the head, as occurs in professional boxing, results in a neurodegenerative disease that was initially called dementia pugilistica and is now referred by the more descriptive term of chronic traumatic encephalopathy (CTE).1 This recognition, which led the American Medical Association to call for a ban on the sport,2 was paralleled by a decline in the sport's popularity, at least among the mainstream culture in the United States. More recently, the growing awareness that CTE also occurs in retired professional football players has received widespread attention in the national media and in the scientific literature.3 Of particular concern is the possibility that serious neurologic sequelae of repeated mild traumatic brain injuries (MTBIs) are not limited to professional football players but may also occur in amateur collegiate athletes and even adolescent and younger players. Initiatives such as the recent donation by the National Football League (NFL) of $30 million to the Foundation for the National Institutes of Health hold out the promise that critical research in the relationship between MTBIs (also commonly referred to as concussions) and neurodegenerative disorders will be forthcoming in the near future. Beyond the pathologic recognition that CTE occurs in some NFL veterans, careful prospective epidemiologic studies are needed to answer critical questions, such as the following: what is the true incidence of CTE, what factors are associated with increased risk for neurodegeneration, and, most importantly, what can be done to ameliorate risk or prevent neurologic disability? Because the symptoms of CTE, such as irritability, depression, and cognitive problems, are protean and nonspecific, biomarkers and neuroimaging to complement the clinical examination will likely be essential and will improve the accuracy of the diagnosis during the lifetime of the individual and will be used to follow the natural history of the illness. It is in this light that the report by Hart et al4 in this issue of the journal merits attention.
Thank you for submitting a comment on this article. It will be reviewed by JAMA Neurology editors. You will be notified when your comment has been published. Comments should not exceed 500 words of text and 10 references.
Do not submit personal medical questions or information that could identify a specific patient, questions about a particular case, or general inquiries to an author. Only content that has not been published, posted, or submitted elsewhere should be submitted. By submitting this Comment, you and any coauthors transfer copyright to the journal if your Comment is posted.
* = Required Field
Disclosure of Any Conflicts of Interest*
Indicate all relevant conflicts of interest of each author below, including all relevant financial interests, activities, and relationships within the past 3 years including, but not limited to, employment, affiliation, grants or funding, consultancies, honoraria or payment, speakers’ bureaus, stock ownership or options, expert testimony, royalties, donation of medical equipment, or patents planned, pending, or issued. If all authors have none, check "No potential conflicts or relevant financial interests" in the box below. Please also indicate any funding received in support of this work. The information will be posted with your response.
Some tools below are only available to our subscribers or users with an online account.
Download citation file:
Web of Science® Times Cited: 1
Customize your page view by dragging & repositioning the boxes below.
More Listings atJAMACareerCenter.com >
Enter your username and email address. We'll send you a link to reset your password.
Enter your username and email address. We'll send instructions on how to reset your password to the email address we have on record.
Athens and Shibboleth are access management services that provide single sign-on to protected resources. They replace the multiple user names and passwords necessary to access subscription-based content with a single user name and password that can be entered once per session. It operates independently of a user's location or IP address. If your institution uses Athens or Shibboleth authentication, please contact your site administrator to receive your user name and password.