ReviewFrontiers in neurology2022
Applying the Bradford Hill Criteria for Causation to Repetitive Head Impacts and Chronic Traumatic Encephalopathy.
Review in Frontiers in neurology, 2022. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 78 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
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Who cites it
78 citing papers in PubMed, 2 syntheses or guidelines pooled it, 166 citations in OpenAlex.
- The Incidence of Sports-Related Concussion in Children and Adolescents: A Systematic Review and Meta-Analysis.Sports medicine - open · 2025Pooled it
- Neuropathology in chronic traumatic encephalopathy: a systematic review of comparative post-mortem histology literature.Acta neuropathologica communications · 2022Pooled it
- The acute influence of amateur boxing on dynamic cerebral autoregulation and cerebrovascular reactivity to carbon dioxide.European journal of applied physiology · 2024Trial
- Review
- Readability of Online Chronic Traumatic Encephalopathy (CTE) Information: Health Literacy Implications for Parents Navigating Youth Tackle Football Decisions.Journal of community health · 2026Article
- Associations Between Cumulative Head Trauma and Self-Reported Parkinsonism and Parkinson's Disease in Former Soccer Players.Movement disorders : official journal of the Movement Disorder Society · 2026Article
- Regional ventricular enlargement as an in vivo biomarker of cumulative biomechanical neurodegeneration in former American football players.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Plasma Phosphorylated Tau 217 in Participants at Risk for Chronic Traumatic Encephalopathy.JAMA network open · 2026Article
- Non-concussive impacts, cognition, and the menstrual cycle: a proof-of-concept study of elite female footballers.Experimental brain research · 2026Article
- Disproportionality and Case-Based Evidence for a Possible Association Between Fluoroquinolones and Kounis Syndrome.Pharmaceuticals (Basel, Switzerland) · 2026Article
- Clinicopathological study of chronic traumatic encephalopathy pathology in a population-based cohort.Journal of neuropathology and experimental neurology · 2026Article
- Imaging the later-life white matter pathologies of repetitive head impacts: A novel pattern revealed through T2 FLAIR MRI.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026Article
- Article
- Direct Evidence for the Feedforward Neurovascular Coupling Mechanism in Humans During Task Onset: An EEG-fNIRS-TCD Multimodal Imaging Study.Sensors (Basel, Switzerland) · 2026Article
- Motivation and methods for a first population-based case-control study of traumatic brain injury (TBI) and chronic traumatic encephalopathy (CTE).British journal of sports medicine · 2026Article
- Persistent dysmorphology and dysfunction of the brain microvasculature following repeated trauma.Journal of cerebral blood flow and metabolism : official journal of the International Society of Cerebral Blood Flow and Metabolism · 2026Article
- Is polycystic ovary syndrome associated with uterine malformations? A systematic review using Bradford Hill's causality framework.Human reproduction open · 2026Review
- Neurorehabilitation needs a qualitative perspective: a case exemplar from stroke recovery and rehabilitation.Frontiers in human neuroscience · 2026Article
- Brain health in association football: perspectives of professional players.Frontiers in sports and active living · 2026Article
- Genetic variation in TMEM106B alters microglial activation and cytokine responses in chronic traumatic encephalopathy.Acta neuropathologica · 2025Article
18 more citing papers are in PubMed but not listed here.
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
14 authors at 10 institutions in 5 countries.
Funding
Abstract
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease associated with a history of repetitive head impacts (RHI). CTE was described in boxers as early as the 1920s and by the 1950s it was widely accepted that hits to the head caused some boxers to become "punch drunk." However, the recent discovery of CTE in American and Australian-rules football, soccer, rugby, ice hockey, and other sports has resulted in renewed debate on whether the relationship between RHI and CTE is causal. Identifying the strength of the evidential relationship between CTE and RHI has implications for public health and medico-legal issues. From a public health perspective, environmentally caused diseases can be mitigated or prevented. Medico-legally, millions of children are exposed to RHI through sports participation; this demographic is too young to legally consent to any potential long-term risks associated with this exposure. To better understand the strength of evidence underlying the possible causal relationship between RHI and CTE, we examined the medical literature through the Bradford Hill criteria for causation. The Bradford Hill criteria, first proposed in 1965 by Sir Austin Bradford Hill, provide a framework to determine if one can justifiably move from an observed association to a verdict of causation. The Bradford Hill criteria include nine viewpoints by which to evaluate human epidemiologic evidence to determine if causation can be deduced: strength, consistency, specificity, temporality, biological gradient, plausibility, coherence, experiment, and analogy. We explored the question of causation by evaluating studies on CTE as it relates to RHI exposure. Through this lens, we found convincing evidence of a causal relationship between RHI and CTE, as well as an absence of evidence-based alternative explanations. By organizing the CTE literature through this framework, we hope to advance the global conversation on CTE mitigation efforts.
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Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.