11/05/2025
Young and middle-aged athletes exposed to repeated head impacts may experience profound changes in their brains years before chronic traumatic encephalopathy, or CTE, can be diagnosed. New research shows that even without the classic protein clumps linked to CTE, the brains of these athletes reveal early signs of inflammation, neuron loss, and altered blood vessel cells. Microglia, the brain’s resident immune cells, shift from their normal “homeostatic” state to an inflammatory state, with the proportion of these cells increasing the longer an athlete played contact sports. These inflammatory microglia express genes related to metabolism, oxygen stress, and immune signaling, hinting at ongoing cellular stress.
The study also uncovered damage to endothelial cells, which line blood vessels. These cells show signs of inflammation and activate genes involved in forming new vessels, suggesting the brain attempts repair but may compromise the blood-brain barrier over time. Most strikingly, a specific population of neurons in the upper cortex, critical for cognitive function, was reduced by more than half in athletes exposed to repeated head impacts. This loss was proportional to the years spent playing contact sports and could explain early cognitive and mood symptoms reported by athletes.
Research Paper 📄
DOI: 10.1038/s41586-025-09534-6