Late-stage CTE pathology in a retired soccer player with dementia

Chronic traumatic encephalopathy (CTE) is a syndrome that manifests with behavioral disturbance and cognitive decline in patients with repetitive head trauma.1 The syndrome was first described in boxers in the 1920s,2 but there are concerns that other athletes may be susceptible to this disease.3 A main driving force is the finding of unique pathologic changes, including characteristic aggregates of hyperphosphorylated tau and TDP-43, in the brains of patients with CTE.4 These pathologic changes have been reported in sports including boxing, American football, rugby, and ice hockey.3–5 Mild CTE pathologic changes have also been reported in 2 young soccer players,3,6 but there are no published reports in the scientific literature demonstrating late-stage CTE pathologic changes in a patient with significant soccer history and dementia. We describe such a case that supports the premise that CTE pathologic changes can occur in soccer players. Acknowledgment: The authors thank the patient and his family for donating neural tissues and the Boston University CTE Center for review of this case.