PunchDrunk
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to repeated trauma to the head. The encephalopathy symptoms can include behavioral problems, mood problems, and problems with thinking. The disease often gets worse over time and can result in dementia.
Most documented cases have occurred in athletes involved in striking-based combat sports, such as boxing, kickboxing, and mixed martial arts, and contact sports, such as rugby union, rugby league, gridiron football, Australian rules football, professional wrestling, and ice hockey. It is also an issue in association football, but largely as a result of heading the ball rather than player contact. Other risk factors include being in the military (combat arms), prior domestic violence, and repeated injuries to the head. The exact amount of trauma required for the condition to occur is unknown, and as of 2026 definitive diagnosis can only occur at autopsy. The disease is classified as a tauopathy.
CTE is considered uncommon but significant in the general population, with an estimated rate of ~0.6%-6%, but is highly common among individuals with histories of repetitive head impacts, such as contact sports athletes. Studies have identified CTE in 99% of studied NFL players' brains, 96% of studied NHL players' brains, and over 40% of younger, non-professional contact sport athletes, with rates increasing proportionally with duration of play. The risk of CTE is regardless of diagnosed concussions, as it is driven by the cumulative, total number of repetitive head impacts (RHI), also known as subconcussive impacts, rather than diagnosed concussions. Exact population rates are unclear. The largest study has found CTE in up to 6% of the general population. Research in brain damage as a result of repeated head injuries began in the 1920s, at which time the condition was known as dementia pugilistica or "boxer's dementia", "boxer's madness", or "punch drunk syndrome". It has been proposed that the rules of some sports be changed as a means of prevention. There is currently no specific treatment for the disease, with research advancing in this area.
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