Send to

Choose Destination
Neuropsychol Rev. 2016 Dec;26(4):340-363. Epub 2016 Aug 25.

Factors Influencing Clinical Correlates of Chronic Traumatic Encephalopathy (CTE): a Review.

Author information

Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
Department of Clinical and Health Psychology, University of Florida, Gainesville, FL, USA.
Department of Neurology, University of Florida, Gainesville, FL, USA.


Chronic traumatic encephalopathy (CTE) is a neuropathologically defined disease reportedly linked to a history of repetitive brain trauma. As such, retired collision sport athletes are likely at heightened risk for developing CTE. Researchers have described distinct pathological features of CTE as well a wide range of clinical symptom presentations, recently termed traumatic encephalopathy syndrome (TES). These clinical symptoms are highly variable, non-specific to individuals described as having CTE pathology in case reports, and are often associated with many other factors. This review describes the cognitive, emotional, and behavioral changes associated with 1) developmental and demographic factors, 2) neurodevelopmental disorders, 3) normal aging, 4) adjusting to retirement, 5) drug and alcohol abuse, 6) surgeries and anesthesia, and 7) sleep difficulties, as well as the relationship between these factors and risk for developing dementia-related neurodegenerative disease. We discuss why some professional athletes may be particularly susceptible to many of these effects and the importance of choosing appropriate controls groups when designing research protocols. We conclude that these factors should be considered as modifiers predominantly of the clinical outcomes associated with repetitive brain trauma within a broader biopsychosocial framework when interpreting and attributing symptom development, though also note potential effects on neuropathological outcomes. Importantly, this could have significant treatment implications for improving quality of life.


Biopsychosocial; Brain injury; CTE; Chronic traumatic encephalopathy; Concussion; Repetitive brain trauma

[Indexed for MEDLINE]
Free PMC Article

Supplemental Content

Full text links

Icon for Springer Icon for PubMed Central
Loading ...
Support Center