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The neuropathology of chronic traumatic encephalopathy
Mckee AC, Abdolmohammadi B, Stein TD.. Handbook of clinical neurology, 2018-01-01
Topic: Brain proteins, microglia and lab models
Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy associated with repetitive head trauma, including concussion and subconcussion. CTE was first recognized in boxers nearly a century ago as "dementia pugilistica" or "punch drunk," but has been recently identified in contact sports athletes (including American football, ice hockey, soccer, baseball, rugby, boxing, and wrestling) and military veterans exposed to blast. Similar to many other neurodegenerative diseases, CTE is diagnosed conclusively only by neuropathologic examination of brain tissue. CTE is characterized by the buildup of hyperphosphorylated tau as neurofibrillary tangles, abnormal neurites, and inclusions in astrocytes around small blood vessels with a tendency to occur in clusters at the sulcal depths of the cortex. Using the McKee criteria, a consensus panel of expert neuropathologists confirmed CTE as a unique neurodegenerative disease with a pathognomonic CTE lesion that has only been found in individuals exposed to brain trauma. Recently, 177 instances of CTE were reported in a convenience sample of 202 former American football players, including 110 of 111 former National Football League players (99%), 48 of 53 former college football players (91%), and 3 of 14 former high school players (21%), by far the largest case series ever reported. Significant increases in active microglia and inflammation also occur after repetitive head impact injury and in CTE. A preliminary study showed that inflammatory cytokines were elevated in the brain tissue and cerebrospinal fluid of individuals with pathologically confirmed CTE compared to controls and individuals with Alzheimer disease, which may some day be useful in diagnosis of CTE during life. Although many fundamental questions remain to be answered regarding CTE, postmortem analysis of tissue from brain donors and tissue-based research have accelerated and expanded our current understanding of CTE and its pathogenesis. Guided by the neuropathologic findings, current research efforts are underway to develop biomarkers to diagnose CTE and effective ways to treat the disorder during life.
Key findings
- Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy associated with repetitive head trauma, including concussion and subconcussion.
- Significant increases in active microglia and inflammation also occur after repetitive head impact injury and in CTE.
- A preliminary study showed that inflammatory cytokines were elevated in the brain tissue and cerebrospinal fluid of individuals with pathologically confirmed CTE compared to controls and individuals with Alzheimer disease, which may some day be useful in diagnosis of CTE during life.
Study details
- Evidence strengthLow
How this study scored 38/100
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. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, cited by studies here, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 22 of the 58 points we could judge it on, which is 38 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (Handbook of clinical neurology) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| 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 | 2 / 5 | 2018 — within 10 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 | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | — / 6 | Not yet checked against this library's citation graph — left out of this score |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 2 / 2 | Indexed in PubMed (PMID 30482357) |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 22 / 58 | Scored on 11 of 20 parts. We have no data for the rest, so they are left out: 22 of the 58 points we could judge it on is 38 out of 100. |
| Total | 38 / 100 | — |
What each of these 20 components measures, and what this score is not →
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APA 7th
Mckee, A. C., Abdolmohammadi, B., & Stein, T. D. (2018). The neuropathology of chronic traumatic encephalopathy. Handbook of clinical neurology. https://doi.org/10.1016/b978-0-444-63954-7.00028-8
Vancouver
Mckee AC, Abdolmohammadi B, Stein TD. The neuropathology of chronic traumatic encephalopathy. Handbook of clinical neurology. 2018. doi:10.1016/b978-0-444-63954-7.00028-8. PMID: 30482357.
BibTeX
@article{mckee2018-30482357,
author = {Mckee, A. C. and Abdolmohammadi, B. and Stein, T. D.},
title = {{The neuropathology of chronic traumatic encephalopathy}},
journal = {Handbook of clinical neurology},
year = {2018},
doi = {10.1016/b978-0-444-63954-7.00028-8},
pmid = {30482357},
url = {https://doi.org/10.1016/b978-0-444-63954-7.00028-8}
}
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