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Long-term consequences of repetitive brain trauma: chronic traumatic encephalopathy
Stern RA, Riley DO, Daneshvar DH, Nowinski CJ, Cantu RC, McKee AC.. PM & R : the journal of injury, function, and rehabilitation, 2011-10-01
Topic: Brain proteins, microglia and lab models
Chronic traumatic encephalopathy (CTE) has been linked to participation in contact sports such as boxing and American football. CTE results in a progressive decline of memory and cognition, as well as depression, suicidal behavior, poor impulse control, aggressiveness, parkinsonism, and, eventually, dementia. In some individuals, it is associated with motor neuron disease, referred to as chronic traumatic encephalomyelopathy, which appears clinically similar to amyotrophic lateral sclerosis. Results of neuropathologic research has shown that CTE may be more common in former contact sports athletes than previously believed. It is believed that repetitive brain trauma, with or possibly without symptomatic concussion, is responsible for neurodegenerative changes highlighted by accumulations of hyperphosphorylated tau and TDP-43 proteins. Given the millions of youth, high school, collegiate, and professional athletes participating in contact sports that involve repetitive brain trauma, as well as military personnel exposed to repeated brain trauma from blast and other injuries in the military, CTE represents an important public health issue. Focused and intensive study of the risk factors and in vivo diagnosis of CTE will potentially allow for methods to prevent and treat these diseases. Research also will provide policy makers with the scientific knowledge to make appropriate guidelines regarding the prevention and treatment of brain trauma in all levels of athletic involvement as well as the military theater.
Cite this study APA, Vancouver, BibTeX · download .bib or .ris
APA 7th
Stern, R. A., Riley, D. O., Daneshvar, D. H., Nowinski, C. J., Cantu, R. C., & McKee, A. C. (2011). Long-term consequences of repetitive brain trauma: chronic traumatic encephalopathy. PM & R : the journal of injury, function, and rehabilitation. https://doi.org/10.1016/j.pmrj.2011.08.008
Vancouver
Stern RA, Riley DO, Daneshvar DH, Nowinski CJ, Cantu RC, McKee AC. Long-term consequences of repetitive brain trauma: chronic traumatic encephalopathy. PM & R : the journal of injury, function, and rehabilitation. 2011. doi:10.1016/j.pmrj.2011.08.008. PMID: 22035690.
BibTeX
@article{stern2011-22035690,
author = {Stern, R. A. and Riley, D. O. and Daneshvar, D. H. and Nowinski, C. J. and Cantu, R. C. and McKee, A. C.},
title = {{Long-term consequences of repetitive brain trauma: chronic traumatic encephalopathy}},
journal = {PM \& R : the journal of injury, function, and rehabilitation},
year = {2011},
doi = {10.1016/j.pmrj.2011.08.008},
pmid = {22035690},
url = {https://doi.org/10.1016/j.pmrj.2011.08.008}
}
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Key findings
- CTE results in a progressive decline of memory and cognition, as well as depression, suicidal behavior, poor impulse control, aggressiveness, parkinsonism, and, eventually, dementia.
- In some individuals, it is associated with motor neuron disease, referred to as chronic traumatic encephalomyelopathy, which appears clinically similar to amyotrophic lateral sclerosis.
- Results of neuropathologic research has shown that CTE may be more common in former contact sports athletes than previously believed.
Why it matters
This paper describes chronic traumatic encephalopathy, linked to repetitive brain trauma in contact sports, as a condition that can eventually lead to dementia and is marked by accumulations of hyperphosphorylated tau and TDP-43 proteins. It calls for more study of risk factors and diagnosis to potentially allow prevention and treatment, but reports no current treatment or cure.
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Study details
- Evidence strengthLow
How this study scored 48/100
Published in a peer-reviewed journal. Scored zero for study design, sample size, effect reported, studied in people and randomised / blinded because the record does not state it.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (PM & R : the journal of injury, function, and rehabilitation) |
| Journal's citation record | 1 / 4 | PM&R: journal h-index 116 (OpenAlex, 2026-10-29) |
| Study design | 0 / 12 | No study design recorded — scores zero, not guessed (not stated in the record — scored 0) |
| Strength of evidence | 1 / 5 | Rated “low” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 1 / 5 | 2011 — within 20 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 0 / 3 | No effect size reported — scores zero (not stated in the record — scored 0) |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | 6 / 7 | Cited 565 times (OpenAlex, 2026-10-10) |
| Citations per year | 4 / 5 | 33.2 citations a year over 17 year(s) since 2011 |
| Impact for its field and year | 5 / 6 | Cited 26.7× the average for papers of its field and year (OpenAlex FWCI) |
| Cited by studies here | 2 / 6 | Cited by 6 other studies in this library |
| Still being cited | 3 / 4 | Cited 60 times in 2024–2026 (2026 still in progress; OpenAlex) |
| Senior author's track record | 4 / 4 | Last-listed author Ann Carolyn McKee: h-index 104 (OpenAlex, whole career) |
| Institution's track record | 1 / 3 | Boston University: institution h-index 1,456 (OpenAlex) |
| Multi-centre collaboration | 1 / 3 | OpenAlex lists 3 institution(s) in 1 country |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 22035690) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Total | 48 / 100 | — |
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