To follow our 2016 study of chronic traumatic encephalopathy neuropathologic change (CTE-NC) in our forensic autopsy service, we prospectively screened all cases with clinical histories of multiple concussions, persistent post-head injury symptoms, or ≥3 hospital investigations for head injuries from 2016 to 2022 inclusive using hyperphosphorylated tau (p-tau) immunostaining. The cases had routine brain sampling plus 4-6 additional lateral hemisphere samples. When “pathognomonic” CTE-NC lesions were identified, additional p-tau immunostaining was done for CTE-NC staging. Of ∼1100 adult brains aged 18–65 years examined, 85 were screened, and 16 were positive for CTE-NC (2 women, 14 men, ages 35–61 years, median 47 years). Alcohol abuse was documented in 14 of 16 (8 in combination with other substances); 5 had developmental brain anomalies (2 presumed genetic, 3 from acquired perinatal insults). Widespread p-tau deposits (high CTE-NC) were found in 7 of 16. Old brain contusions were present in 9 of 16, but CTE-NC did not colocalize. Of particular interest were (1) a man with FGFR3 mutation/hypochondroplasia and life-long head banging, (2) a woman with cerebral palsy and life-long head banging, and (3) a man with bilateral peri-Sylvian polymicrogyria, alcohol abuse, and multiple head injuries. Thus, CTE-NC occurs in association with repeated head trauma outside contact sports. Substance abuse is a common determinant of risk behavior. The utility of diagnosing mild-/low-stage CTE-NC in this population remains to be determined.

中文翻译：

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常规神经病理学服务中的慢性创伤性脑病-神经病理学变化：7 年随访

为了追踪我们 2016 年法医尸检服务中慢性创伤性脑病神经病理学改变 (CTE-NC) 的研究，我们前瞻性地筛选了所有具有多发性脑震荡、持续性头部受伤后症状或 ≥ 3 次医院调查的头部受伤临床病史的病例。 2016 年至 2022 年（含），使用过度磷酸化 tau (p-tau) 免疫染色。这些病例接受了常规脑部取样以及 4-6 个额外的外侧半球样本。当识别出“特征性”CTE-NC 病变时，需要进行额外的 p-tau 免疫染色以进行 CTE-NC 分期。在约 1100 名 18-65 岁成人大脑中，85 名接受了筛查，其中 16 名 CTE-NC 呈阳性（2 名女性，14 名男性，年龄 35-61 岁，中位年龄 47 岁）。16 例中有 14 例记录了酒精滥用（其中 8 例与其他物质混合使用）；5 名患有大脑发育异常（2 名推测为遗传性，3 名来自获得性围产期损伤）。16 人中有 7 人发现了广泛的 p-tau 沉积物（高 CTE-NC）。16 人中有 9 人存在陈旧性脑挫伤，但 CTE-NC 并未共定位。特别感兴趣的是（1）一名患有 FGFR3 突变/软骨发育不全并终生摇头的男性，（2）一名患有脑瘫并终生摇头的女性，以及（3）一名患有双侧侧裂周围多小脑回、酗酒的男性虐待和多处头部受伤。因此，CTE-NC 的发生与接触运动之外的反复头部创伤有关。药物滥用是危险行为的常见决定因素。在这一人群中诊断轻度/低期 CTE-NC 的效用仍有待确定。