{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,20]],"date-time":"2026-10-20T06:33:11Z","timestamp":1792477991239,"version":"4.5.0"},"reference-count":49,"publisher":"SAGE Publications","issue":"7-8","license":[{"start":{"date-parts":[[2026,1,29]],"date-time":"2026-01-29T00:00:00Z","timestamp":1769644800000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Journal of Neurotrauma"],"published-print":{"date-parts":[[2026,4,1]]},"abstract":"<jats:p>\n                    Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with exposure to repetitive head impacts (RHIs), characterized by tau tangles around small blood vessels at the depths of the sulci. Currently, CTE can be diagnosed only\n                    <jats:italic toggle=\"yes\">postmortem<\/jats:italic>\n                    , but can present with an array of cognitive, behavioral, mood, and motor symptoms. However, traumatic brain injury is also associated with increased risk of Alzheimer\u2019s disease (AD) and may lead to comorbid neuropathology. Characterization of the\n                    <jats:italic toggle=\"yes\">in\u00a0vivo<\/jats:italic>\n                    biomarkers of CTE is a necessary next step to facilitate accurate diagnoses. We examined the profile of cerebrospinal fluid (CSF) biomarkers of amyloid-\u03b2, total tau (tTau), and phospho-tau (pTau) in a cohort of former professional (PRO,\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 100) and college (COL,\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 40) football players at high risk of CTE compared to asymptomatic unexposed controls (UE,\n                    <jats:italic toggle=\"yes\">n<\/jats:italic>\n                    = 43). CSF was collected under controlled conditions using collection, processing, and cryostorage kits provided by the DIAGNOSE CTE Research Project Biomarker Core, and concentrations of A\u03b2\n                    <jats:sub>40<\/jats:sub>\n                    , A\u03b2\n                    <jats:sub>42<\/jats:sub>\n                    , tTau, and pTau (pTau\n                    <jats:sub>181<\/jats:sub>\n                    , pTau\n                    <jats:sub>217<\/jats:sub>\n                    , pTau\n                    <jats:sub>231<\/jats:sub>\n                    ) were measured at the University of Gothenburg, Sweden, using immunoassays. Associations between CSF biomarker levels with football history, and diagnosis of traumatic encephalopathy syndrome (TES) were examined using linear regression, and corrected for age, education,\n                    <jats:italic toggle=\"yes\">APOE<\/jats:italic>\n                    -\u03b54 allele status, race, and body mass index. Our analysis revealed that football exposure affected both CSF A\u03b2\n                    <jats:sub>40<\/jats:sub>\n                    (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.039) and A\u03b2\n                    <jats:sub>42<\/jats:sub>\n                    (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.038), particularly among those under 60 years of age in the PRO compared to the UE exposure group. Among former football players, estimates of RHI exposure were not generally associated with CSF A\u03b2, tTau, and pTau biomarker levels. CSF A\u03b2\n                    <jats:sub>40<\/jats:sub>\n                    (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.0041) and A\u03b2\n                    <jats:sub>42<\/jats:sub>\n                    (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.011) were lower in former football players with TES diagnosis compared to unexposed participants, although CSF A\u03b2, tTau, and pTau biomarker levels did not differ between former players with and without a TES diagnosis. Among former football players, reduced CSF A\u03b2\n                    <jats:sub>40<\/jats:sub>\n                    (\n                    <jats:italic toggle=\"yes\">p<\/jats:italic>\n                    = 0.011) and A\u03b2\n                    <jats:sub>42<\/jats:sub>\n                    (p = 6e-04) were observed in those with cognitive impairment compared to those with neurobehavioral dysregulation. The findings of significant associations of reduced CSF A\u03b2 levels with RHI in elite football players are in line with recent\n                    <jats:italic toggle=\"yes\">postmortem<\/jats:italic>\n                    studies; however, the lack of relationship with CSF tTau and pTau species observed to be altered in the setting of AD suggests that the pathological features of CTE reflected in fluid biomarkers are complex and require further study. The overlapping comorbid age-dependent features of neurodegeneration that occur in those at risk for CTE suggest that tau pathology in CTE is not reliably reflected by currently available fluid biomarkers and that the use of multiple biomarkers related to the compound characteristics of CTE may be required for early detection.\n                  <\/jats:p>","DOI":"10.1177\/08977151251390520","type":"journal-article","created":{"date-parts":[[2026,1,30]],"date-time":"2026-01-30T05:04:08Z","timestamp":1769749448000},"page":"559-574","update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":3,"title":["Alterations in CSF Amyloid-\u03b2 and Tau Biomarkers in Former College and Professional American Football Players: Findings from the DIAGNOSE CTE Research Project"],"prefix":"10.1177","volume":"43","author":[{"given":"Deidre","family":"Jansson","sequence":"first","affiliation":[{"name":"VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, Washington, USA."},{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jane","family":"Shofer","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elizabeth","family":"Colasurdo","sequence":"additional","affiliation":[{"name":"VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Abigail","family":"Schindler","sequence":"additional","affiliation":[{"name":"VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, Washington, USA."},{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA."},{"name":"Geriatric Research, Education, and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ge","family":"Li","sequence":"additional","affiliation":[{"name":"VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, Washington, USA."},{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA."},{"name":"Geriatric Research, Education, and Clinical Center (GRECC), VA Puget Sound Health Care System, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles H.","family":"Adler","sequence":"additional","affiliation":[{"name":"Department of Neurology, Mayo Clinic College of Medicine, Mayo Clinic Arizona, Scottsdale, Arizona, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura","family":"Balcer","sequence":"additional","affiliation":[{"name":"Departments of Neurology, Population Health and Ophthalmology, NYU Grossman School of Medicine, New York, New York, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles","family":"Bernick","sequence":"additional","affiliation":[{"name":"Cleveland Clinic Lou Ruvo Center for Brain Health, Las Vegas, Nevada, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Daniel","family":"Daneshvar","sequence":"additional","affiliation":[{"name":"Department of Physical Medicine and Rehabilitation Medicine, Harvard Medical School, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Douglas","family":"Katz","sequence":"additional","affiliation":[{"name":"Boston University CTE Center, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."},{"name":"Boston University Alzheimer\u2019s Disease Research Center, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."},{"name":"Brain Injury Program, Encompass Health Braintree Rehabilitation Hospital, Braintree, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael","family":"McClean","sequence":"additional","affiliation":[{"name":"Encompass Health Braintree Rehabilitation Hospital, Braintree, Massachusetts, USA."},{"name":"Department of Environmental Health, Boston University School of Public Health, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jesse","family":"Mez","sequence":"additional","affiliation":[{"name":"Boston University Alzheimer\u2019s Disease Research Center, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."},{"name":"Framingham Heart Study, Framingham, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Joseph","family":"Palmisano","sequence":"additional","affiliation":[{"name":"Biostatistics and Epidemiology Data Analytics Center (BEDAC), Boston University School of Public Health, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicholas","family":"Ashton","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, M\u00f6lndal, Sweden."},{"name":"Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, M\u00f6lndal, Sweden."},{"name":"Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaj","family":"Blennow","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, M\u00f6lndal, Sweden."},{"name":"Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, M\u00f6lndal, Sweden."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Henrik","family":"Zetterberg","sequence":"additional","affiliation":[{"name":"Department of Psychiatry and Neurochemistry, Institute of Neuroscience and Physiology, The Sahlgrenska Academy at the University of Gothenburg, M\u00f6lndal, Sweden."},{"name":"Clinical Neurochemistry Laboratory, Sahlgrenska University Hospital, M\u00f6lndal, Sweden."},{"name":"Institute of Psychiatry, Psychology and Neuroscience, King\u2019s College London, Maurice Wohl Institute Clinical Neuroscience Institute, London, UK."},{"name":"Department of Neurodegenerative Disease, UCL Institute of Neurology, Queen Square, London, UK."},{"name":"UK Dementia Research Institute at UCL, London, UK."},{"name":"Hong Kong Center for Neurodegenerative Diseases, Clear Water Bay, Hong Kong, China."},{"name":"Wisconsin Alzheimer\u2019s Disease Research Center, University of Wisconsin School of Medicine and Public Health, University of Wisconsin-Madison, Madison, Wisconsin, USA."},{"name":"Department of Neurodegenerative Disease, University of Washington, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yorghos","family":"Tripodis","sequence":"additional","affiliation":[{"name":"Boston University CTE Center, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."},{"name":"Boston University Alzheimer\u2019s Disease Research Center, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."},{"name":"Department of Biostatistics, Boston University School of Public Health, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael L.","family":"Alosco","sequence":"additional","affiliation":[{"name":"Boston University CTE Center, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."},{"name":"Boston University Alzheimer\u2019s Disease Research Center, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."},{"name":"Department of Neurology, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey L.","family":"Cummings","sequence":"additional","affiliation":[{"name":"Chambers-Grundy Center for Transformative Neuroscience; Department of Brain Health, Kirk Kerkorian School of Medicine, University of Nevada Las Vegas, Las Vegas, Nevada, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eric M.","family":"Reiman","sequence":"additional","affiliation":[{"name":"Banner Alzheimer\u2019s Institute, University of Arizona, Arizona State University, Translational Genomics Research Institute, and Arizona Alzheimer\u2019s Consortium, Phoenix, Arizona, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Martha","family":"Shenton","sequence":"additional","affiliation":[{"name":"Psychiatry Neuroimaging Laboratory, Harvard Medical School, Departments of Psychiatry and Radiology, Brigham and Women\u2019s Hospital, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert A.","family":"Stern","sequence":"additional","affiliation":[{"name":"Boston University CTE Center, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."},{"name":"Boston University Alzheimer\u2019s Disease Research Center, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."},{"name":"Department of Neurology, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."},{"name":"Departments of Neurosurgery, and Anatomy and Neurobiology, Boston University Chobanian &amp; Avedisian School of Medicine, Boston, Massachusetts, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jeffrey","family":"Iliff","sequence":"additional","affiliation":[{"name":"VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, Washington, USA."},{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA."},{"name":"Department of Neurology, University of Washington School of Medicine, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Elaine R.","family":"Peskind","sequence":"additional","affiliation":[{"name":"VISN 20 Northwest Mental Illness Research, Education and Clinical Center (MIRECC), VA Puget Sound Health Care System, Seattle, Washington, USA."},{"name":"Department of Psychiatry and Behavioral Sciences, University of Washington School of Medicine, Seattle, Washington, USA."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"For the DIAGNOSE CTE Research Project","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,29]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1186\/s13024-023-00697-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1017\/S0033291700049588"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.1093\/brain\/aws307"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.1007\/s00401-023-02540-w"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40478-019-0772-9"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.1097\/JSM.0000000000001174"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.1186\/s40478-023-01572-3"},{"key":"e_1_3_3_9_2","doi-asserted-by":"publisher","DOI":"10.1001\/jamanetworkopen.2024.49106"},{"key":"e_1_3_3_10_2","article-title":"Preliminary results of the NINDS\/NIBIB Consensus Meeting to evaluate pathological criteria for the diagnosis of CTE (P2. 178)","author":"McKee A","year":"2015","unstructured":"McKee A, , Alvarez V, , Bieniek K, et al. Preliminary results of the NINDS\/NIBIB Consensus Meeting to evaluate pathological criteria for the diagnosis of CTE (P2. 178). 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