Evidence map›Paper›PMID 40047953›Full record

ArticleActa neuropathologica2025

Characterizing white matter and vascular pathologies in brain donors exposed to repetitive head impacts.

Sheina Emrani, Anne Koutures, Yorghos Tripodis, Madeline Uretsky, Bobak Abdolmohammadi, Christopher Nowinski, Daniel H Daneshvar, Brigid Dwyer, Douglas I Katz, Lee E Goldstein and 12 more

Abstract read
In one paragraph

Article in Acta neuropathologica, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.

0numbers the graph read from it
0cells of the map it votes in
7citing papers in PubMed
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

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.

2 · The registry

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.

Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.

3 · Its place in the literature

Who cites it

7 citing papers in PubMed.

  1. Article
  2. Article
  3. Review
  4. CTE neuropathology alone is associated with dementia and cognitive symptoms.Alzheimer's & dementia : the journal of the Alzheimer's Association · 2026
    Article
  5. Article
  6. Cerebrovascular remodeling in aging and neurodegenerative disease progression.Frontiers in bioengineering and biotechnology · 2025
    Article
  7. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

22 authors.

Sheina EmraniDepartment of Neurology, University of Pennsylvania, Philadelphia, PA, USA.
Anne KouturesBoston University, Boston, MA, USA.
Yorghos TripodisAlzheimer's Disease Research Center and Chronic Traumatic Encephalopathy Center, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Madeline UretskyAlzheimer's Disease Research Center and Chronic Traumatic Encephalopathy Center, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Bobak AbdolmohammadiAlzheimer's Disease Research Center and Chronic Traumatic Encephalopathy Center, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Christopher NowinskiConcussion Legacy Foundation, Boston, MA, USA.
Daniel H DaneshvarDepartment of Rehabilitation Medicine, Harvard Medical School, Boston, MA, USA.
Brigid DwyerDepartment of Neurology, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Douglas I KatzDepartment of Neurology, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Lee E GoldsteinAlzheimer's Disease Research Center and Chronic Traumatic Encephalopathy Center, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Robert C CantuAlzheimer's Disease Research Center and Chronic Traumatic Encephalopathy Center, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Brett M MartinBiostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA.
Joseph N PalmisanoBiostatistics and Epidemiology Data Analytics Center, Boston University School of Public Health, Boston, MA, USA.
Kristen Dams-O'ConnorDepartment of Rehabilitation and Human Performance, Brain Injury Research Center, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
John F CraryDepartment of Neurology, Icahn School of Medicine at Mount Sinai, New York, NY, USA.
Robert A SternAlzheimer's Disease Research Center and Chronic Traumatic Encephalopathy Center, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Jesse MezAlzheimer's Disease Research Center and Chronic Traumatic Encephalopathy Center, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Victor E AlvarezAlzheimer's Disease Research Center and Chronic Traumatic Encephalopathy Center, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Bertrand R HuberAlzheimer's Disease Research Center and Chronic Traumatic Encephalopathy Center, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Ann C McKeeAlzheimer's Disease Research Center and Chronic Traumatic Encephalopathy Center, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Thor D SteinAlzheimer's Disease Research Center and Chronic Traumatic Encephalopathy Center, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA.
Michael L AloscoAlzheimer's Disease Research Center and Chronic Traumatic Encephalopathy Center, Boston University Chobanian and Avedisian School of Medicine, 72 E Concord St, Boston, MA, 02118, USA. malosco@bu.edu.

Funding

TBDU19AG068753 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Lindsay A. Farrer · 2020 to 2026
$42.4M
RL5: Research Education CoreP30AG072978 · NIA · BOSTON UNIVERSITY MEDICAL CAMPUS · PI Ann C. McKee · 2021 to 2026
$25.6M
Traumatic Brain Injury and Repetitive Head Impacts: Contributions to AD/ADRD and CTE Neuropathology and Resulting Clinical SyndromesU54NS115266 · NINDS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI STEIN, THOR · 2019 to 2023
$10.3M
Leveraging Existing Aging Research Networks to investigate TBI and AD/ADRD risk (LEARN TBI & AD)R01AG061028 · NIA · ICAHN SCHOOL OF MEDICINE AT MOUNT SINAI · PI DAMS-O'CONNOR, KRISTEN, MEZ, JESSE BENJAMIN · 2019 to 2023
$5.9M
Late Pathologies of Exposure to Repetitive Head Impacts from Contact Sports: White Matter and Vascular Contributions to Cognitive Impairment, Dementia, and Neuropsychiatric SymptomsR01NS122854 · NINDS · BOSTON UNIVERSITY MEDICAL CAMPUS · PI ALOSCO, MICHAEL, MCKEE, ANN C. · 2024 to 2025
$1.6M
NIA NIH HHS P30 AG072978NIA NIH HHS R01 AG061028NIA NIH HHS U19 AG068753NINDS NIH HHS R01 NS122854NINDS NIH HHS U54 NS115266
6 · The paper itself

Abstract

Chronic traumatic encephalopathy (CTE) is a progressive brain disease linked to repetitive head impacts (RHI), often incurred from contact sports, and can lead to dementia. Here, we investigated the association between RHI and white matter/vascular neuropathologies and their relative contribution to dementia status in deceased men 50 + years old with and without exposure to RHI from various types of contact and collision sports. Our sample included two RHI groups from the UNITE brain bank: (1) American Football players (RHI-AF, n = 79), and (2) non-AF contact and collision sport athletes (e.g., boxing, rugby; RHI-CCS, n = 49). Controls included similarly aged (± 5 years) male brain donors without RHI. A modified ischemic injury scale (mIIS) served as a global measure of white matter and vascular neuropathologies, encompassing nine subcomponents. Dementia was determined through diagnostic consensus conference based on interviews with families. Using linear regression models controlling for age at death, mIIS was different in RHI-AF versus non-RHI only (p = 0.036). Subsequent logistic regression of each mIIS subcomponent, controlling for age at death, demonstrated that worse white matter rarefaction (RHI-AF; Beta = 1.42, [95% CI 2.03-8.43]; RHI-CCS; Beta = 1.93, [95% CI 2.35-20.17]) and hippocampal sclerosis (RHI-AF; Beta = 2.01, [95% CI 2.69-20.81]; RHI-CCS; Beta = 2.19, [95% CI 2.49-32.10]) was more common in RHI groups from their controls. Further, logistic regressions found that higher global mIIS correlated with increased odds of dementia in only the RHI-AF group (p = 0.02), driven by white matter rarefaction (β = 0.94, [95% CI 1.66-4.00]) and hippocampal sclerosis (β = 1.08, [95% CI 1.35-6.42]). There were similar findings in RHI-CCS group for odds of dementia (p = 0.048), including white matter rarefaction (β = 0.68, [95% CI 1.22-3.21], p = 0.05). Overall, these results demonstrate that white matter  rarefaction and hippocampal sclerosis are linked to RHI exposure across all types of contact sports. Further, these pathologies contribute to dementia independent of p-tau pathology in American football players.

Indexed as

Athletic InjuriesBrainChronic Traumatic EncephalopathyWhite MatterAgedAged, 80 and overDementiaFootballHumansMaleMiddle AgedTissue DonorsCerebrovascular diseaseDementiaHippocampal sclerosisRepetitive head impactsWhite matter rarefaction

Identifiers

PMID40047953
PMCPMC11885321

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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.