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me was first described in 1928 by a forensic pathologist harrison stanford martland who was the chief medical examiner of essex county in newark new jersey in a journal of the american medical association article in which he noted the tremors slowed movement confusion and speech problems typical of the condition 91 the term punch drunk was replaced with dementia pugilistica in 1937 by j a millsbaugh as he felt the term was condescending to former boxers 92 the initial diagnosis of dementia pugilistica was derived from the latin word for boxer pugil akin to pugnus fist pugnāre to fight 93 94 other terms for the condition have included chronic boxer s encephalopathy traumatic boxer s encephalopathy boxer s dementia pugilistic dementia chronic traumatic brain injury associated with boxing ctbi b and punch drunk syndrome 3 neurologist macdonald critchley wrote a 1949 paper titled punch drunk syndromes the chronic traumatic encephalopathy of boxers 95 cte was first recognized as affecting individuals who took considerable blows to the head but was believed to be confined to boxers and not other athletes as evidence pertaining to the clinical and neuropathological consequences of repeated mild head trauma grew it became clear that this pattern of neurodegeneration was not restricted to boxers and the term chronic traumatic encephalopathy became most widely used 96 97 in 2002 pathologist bennet omalu 98 performed an autopsy on prominent american football player mike webster omalu expected the autopsy to reveal a brain affected by alzheimer s 99 instead after fixing and dissecting the brain omalu observed abnormal proteins tangles that distinguish cte from alzheimer s disease omalu concluded that webster was the first person to be officially diagnosed with cte citation needed a famous case of cte is that of former nfl player aaron hernandez 100 two years into a jail sentence for murder hernandez was found dead after he hanged himself in his cell an autopsy found stage 3 cte a severity rarely seen at his age of 27 at death 101 in october 2022 the united states national institutes of health formally acknowledged there was a causal link between repeated blows to the head and cte 102 research edit in 2005 forensic pathologist bennet omalu along with colleagues in the department of pathology at the university of pittsburgh published a paper chronic traumatic encephalopathy in a national football league player in the journal neurosurgery based on analysis of the brain of deceased former nfl center mike webster this was then followed by a paper on a second case in 2006 describing similar pathology based on findings in the brain of former nfl player terry long 103 in 2008 the center for the study of traumatic encephalopathy at the bu school of medicine now the bu cte center started the va bu clf brain bank at the bedford veterans administration hospital to analyze the effects of cte and other neurodegenerative diseases on the brain and spinal cord of athletes military veterans and civilians 31 104 to date the va bu clf brain bank is the largest cte tissue repository in the world with over 1000 brain donors 32 105 on 21 december 2009 the national football league players association announced that it would collaborate with the bu cte center to support the center s study of repetitive brain trauma in athletes 106 additionally in 2010 the national football league gave the bu cte center a 1 million gift with no strings attached 107 108 in 2008 twelve living athletes active and retired including hockey players pat lafontaine and noah welch as well as former nfl star ted johnson committed to donate their brains to va bu clf brain bank after their deaths 109 in 2009 nfl pro bowlers matt birk lofa tatupu and sean morey pledged to donate their brains to the va bu clf brain bank 110 in 2010 20 more nfl players and former players pledged to join the va bu clf brain donation registry including chicago bears linebacker hunter hillenmeyer hall of famers mike haynes and zach thomas pro bowlers kyle turley and conrad dobler super bowl champion don hasselbeck and former pro players lew carpenter and todd hendricks in 2010 professional wrestlers mick foley booker t and matt morgan also agreed to donate their brains upon their deaths also in 2010 mls player taylor twellman who had to retire from the new england revolution because of post concussion symptoms agreed to donate his brain upon his death as of 2010 the va bu clf brain donation registry consists of over 250 current and former athletes 111 in 2011 former north queensland cowboys player shaun valentine became the first australian national rugby league player to agree to donate his brain upon his death in response to recent concerns about the effects of concussions on rugby league players who do not use helmets also in 2011 boxer micky ward whose career inspired the film the fighter agreed to donate his brain upon his death in 2018 nascar driver dale earnhardt jr who retired in 2017 citing multiple concussions became the first auto racing competitor to agree to donate his brain upon his death 112 in related research the center for the study of retired athletes which is part of the department of exercise and sport science at the university of north carolina at chapel hill is conducting research funded by national football league charities to study former football players a population with a high prevalence of exposure to prior mild traumatic brain injury mtbi and sub concussive impacts in order to investigate the association between increased football exposure and recurrent mtbi and neurodegenerative disorders such as cognitive impairment and alzheimer s disease ad 113 in february 2011 former nfl player dave duerson committed suicide via a gunshot to his chest thus leaving his brain intact 114 duerson left text messages to loved ones asking that his brain be donated to research for cte 115 the family got in touch with representatives of the boston university center studying the condition said robert stern the co director of the research group stern said duerson s gift was the first time of which he was aware that such a request had been made by someone who had committed suicide that was potentially linked to cte 116 stern and his colleagues found high levels of the protein tau in duerson s brain these elevated levels which were abnormally clumped and pooled along the brain sulci 31 are indicative of cte 117 in july 2010 nhl enforcer bob probert died of heart failure before his death he asked his wife to donate his brain to cte research because it was noticed that probert experienced a mental decline in his 40s in march 2011 researchers at boston university concluded that probert had cte upon analysis of the brain tissue he donated he was the second nhl player from the program at the bu cte center to be diagnosed with cte postmortem 118 the bu cte center has also found indications of links between amyotrophic lateral sclerosis als and cte in athletes who have participated in contact sports tissue for the study was donated by twelve athletes and their families to the va bu clf brain bank at the bedford massachusetts va medical center 119 in 2013 president barack obama announced the creation of the chronic effects of neurotrauma consortium or cenc a federally funded research project devised to address the long term effects of mild traumatic brain injury in military service personnel sms and veterans 120 121 122 the cenc is a multi center collaboration linking premiere basic science translational and clinical neuroscience researchers from the dod va academic universities and private research institutes to effectively address the scientific diagnostic and therapeutic ramifications of mild tbi and its long term effects 123 124 125 126 127 nearly 20 of the more than 2 5 million u s service members sms deployed since 2003 to operation enduring freedom oef and operation iraqi freedom oif have sustained at least one traumatic brain injury tbi predominantly concussions mtbi 128 129 and almost 8 of all oef oif veterans demonstrate persistent post tbi symptoms more than six months post injury 130 131 unlike those head injuries incurred in most sporting events recent military head injuries are most often the result of blast wave exposure 132 after a competitive application process a consortium led by virginia commonwealth university was awarded funding to study brain injuries in military veterans 123 124 125 unreliable source 126 133 134 the project principal investigator for the cenc is david cifu chairman and herman j flax professor 135 of the department of physical medicine and rehabilitation pm r at virginia commonwealth university vcu in richmond virginia with co principal investigators ramon diaz arrastia professor of neurology uniformed services university of the health sciences 126 and rick l williams statistician at rti international citation needed in 2017 aaron hernandez a former professional football player and convicted murderer committed suicide at the age of 27 while in prison his family donated his brain to the bu cte center ann mckee the head of center concluded that hernandez had stage 3 cte which researchers had never seen in a brain younger than 46 years old 136 in 2022 former nrl player and coach paul green died by suicide at the age of 49 green s brain was donated to the australian sports brain bank with his family posting on the website in memory of our beloved paul we ask that you support the pioneering work of the australian sports brain bank to raise money for further understanding of cte 137 a post mortem examination revealed that green was suffering from one of the most severe forms of cte professor michael buckland said green had an organic brain disease which robbed him of his decision making and impulse control he added green would likely have been symptomatic for some time 138 research into the genetic component of cte is evolving and well summarized in a recent review 139 the minor allele of tmem106b is associated with a protective phenotype 139 in 2023 australian rules football player heather anderson became the first female athlete diagnosed with cte after her death by suicide on 13 november 2022 at the age of 28 her brain which was donated to the australian sports brain bank was found to contain multiple cte lesions and abnormalities were found nearly everywhere in the cortex 140 also in 2023 a study was published on 28 august in jama neurology regarding brain autopsies of athletes one of whom was the first american female athlete diagnosed with cte her name is unknown but she died at age 28 and was a collegiate soccer player 141 in march 2024 former rugby union player billy guyton became the first new zealand based athlete diagnosed with cte following his forced retirement in 2018 due to the complications of multiple concussions and his death by suspected suicide in 2023 142 143 his brain had been donated by his family to the neurological foundation human brain bank at the university of auckland 142 with post mortem analyses conducted in new zealand and australia eventually finding background changes consistent with global hypoxic ischaemic encephalopathy 142 as well as trauma induced cavum septi pellucidi and age related tau deposits 143 in august 2026 researchers examined data from 2016 to 2021 and came to the conclusion that 1 in 4 though likely more nfl players will be diagnosed with cte 144 over the full study period 93 2 of the donated brains of nfl players showed cte pathology 145 the study analyzed several stages of cte causes of death and death age finding a mean death age of 66 5 a figure significantly associated with stage 4 it also found that dementia was common among the deceased at a rate of 59 8 146 see also edit wikiversity is calling for essays on concussions in sports acquired brain injury brain damage chronic traumatic encephalopathy in sports concussions in american football concussions in rugby 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