DEFINITION

• Chronic traumatic encephalopathy (CTE) is a progressive tauopathy resulting from repetitive head impacts.[1] Historically described in boxers, CTE is now identified in various contact sports (football, rugby, soccer), military personnel, and other individuals with repetitive brain trauma exposure.
• Historical context
  • CTE was originally studied in boxers in the 1920s by a forensic pathologist, Martland, who coined the term “Punch Drunk Syndrome.”[2]
  • In 1937, the term evolved and Millspaugh coined "Dementia Puglistica" to describe the posttraumatic sequelae of boxing.[3]
  • In 1962, the term was further amended by Courville who named it “the psychopathic deterioration of pugilists.”[4]
  • In 1973, the neuropathology of CTE was first described by Corsellis in a case series of 15 retired boxers.[5]
  • In 2005, Omalu’s autopsy report of former National Football League (NFL) player Mike Webster led to a greater emphasis on studying repetitive head trauma and concern for CTE as a result of playing American football.[6]
• New 2023 neuropatholical criteria:[7] The minimum threshold for postmortem neuropathological diagnosis of CTE is the presence of a single pathognomonic lesion—perivascular accumulation of hyperphosphorylated tau (p-tau) in neurons, astrocytes, and neurites, particularly in the depths of cortical sulci.