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We investigated CTE neuropathological changes (CTE-NC) in an admixed, population-based clinicopathological cohort. Neuropathological evaluation was conducted on brain samples from 1151 individuals in the University of S\u00e3o Paulo Biobank for Aging Studies collected from 2004 to 2022. CTE-NC and aging-related tau astrogliopathy (ARTAG) were assessed across 14\u00a0963 histological slides using p-tau immunostaining. Clinical, cognitive, and neuropsychiatric data were obtained via informant interviews; information on sports exposure and traumatic brain injury history was limited. Seven cases (0.6%) met criteria for CTE-NC, mean age at death 73.4\u2009\u00b1\u200912.5\u2009years; 1 was female. Dementia was present in 43% of CTE-NC cases; 57% exhibited neuropsychiatric symptoms. Most common co-pathologies were Alzheimer disease-type changes, ARTAG, and argyrophilic grain disease. Comprehensive exposure histories were unavailable for most cases; 2 had documented soccer involvement. These findings indicate that CTE-NC is rare in this population-based Brazilian cohort and predominantly affects males with frequent coexisting neuropathologies. Findings align with reports from high-income countries and support prioritizing primary prevention by reducing exposure to repetitive head impacts in sport and other settings.<\/jats:p>","DOI":"10.1093\/jnen\/nlaf150","type":"journal-article","created":{"date-parts":[[2025,11,28]],"date-time":"2025-11-28T13:13:23Z","timestamp":1764335603000},"page":"425-432","source":"Crossref","is-referenced-by-count":2,"title":["Clinicopathological study of chronic traumatic encephalopathy pathology in a population-based cohort"],"prefix":"10.1093","volume":"85","author":[{"given":"Roberta Diehl","family":"Rodriguez","sequence":"first","affiliation":[{"name":"Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo Biobank for Aging Studies, LIM-22, , Sao Paulo, Sao Paulo,","place":["Brazil"]},{"name":"Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo Laboratorio de Ressonancia Magnetica em Neurorradiologia, LIM-44, , Sao Paulo, Sao Paulo,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher","family":"Nowinski","sequence":"additional","affiliation":[{"name":"Boston University School of Medicine , Boston, MA,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Claudia Kimie","family":"Suemoto","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo Biobank for Aging Studies, LIM-22, , Sao Paulo, Sao Paulo,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata Elaine P","family":"Leite","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo Biobank for Aging Studies, LIM-22, , Sao Paulo, Sao Paulo,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Renata Eloah","family":"de Lucena Ferretti-Rebustini","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo Biobank for Aging Studies, LIM-22, , Sao Paulo, Sao Paulo,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Wilson","family":"Jacob-Filho","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo Biobank for Aging Studies, LIM-22, , Sao Paulo, Sao Paulo,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Carlos Augusto","family":"Pasqualucci","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo Biobank for Aging Studies, LIM-22, , Sao Paulo, Sao Paulo,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ricardo","family":"Nitrini","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo Biobank for Aging Studies, LIM-22, , Sao Paulo, Sao Paulo,","place":["Brazil"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-6809-0618","authenticated-orcid":false,"given":"Lea T","family":"Grinberg","sequence":"additional","affiliation":[{"name":"Hospital das Clinicas, HCFMUSP, Faculdade de Medicina, Universidade de Sao Paulo Biobank for Aging Studies, LIM-22, , Sao Paulo, Sao Paulo,","place":["Brazil"]},{"name":"Departments of Laboratory Medicine and Pathology and Neurosciences, Mayo Clinic , Jacksonville, FL,","place":["United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"286","published-online":{"date-parts":[[2026,2,2]]},"reference":[{"key":"2026042915364936300_nlaf150-B1","doi-asserted-by":"crossref","first-page":"371","DOI":"10.1007\/s00401-023-02540-w","article-title":"Chronic traumatic encephalopathy (CTE): criteria for 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