Mateus Gonçalves de Sena Barbosa
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Ghaspar Gomes de Oliveira Alves Francisco
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Rafaela Luiza Vilela de Souza
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João Marcos Alcântara de Souza
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Nicollas Nunes Rabelo
Background: Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease linked to tau protein associated with recurrent brain trauma, clinically marked by mood, personality, cognitive and behavioral changes. Objectives: The objective of the study was to demonstrate whether athletes and military personnel can really be victims of CTE and to elucidate this same pathology. Design and setting: This is a systematic review, based on the PRISMA guidelines and a literature review with a summary of the evidence found. Methods: Articles were selected, published from 1934 to 2020, in PubMed and Scielo using the descriptors: “chronic traumatic encephalopathy”, “cerebral concussion”, “players”, “boxers”, “athletes” and “military”. Inclusion criteria were: studies available in English, Spanish and Portuguese published, with randomized clinical trial, cohort study or meta-analysis. Results: In 52 articles, 14 were selected for qualitative synthesis in the results table that addresses chronic traumatic encephalopathy in football, soccer and rugby players, boxers and the military. Neuropathologically, CTE is characterized by cerebral atrophy, a pelvic septum cavity with fenestrations, dense diffuse immunoreactive inclusions and a TDP-43 proteinopathy. Microscopically, there are extensive neurofibrillary tangles and spindle-shaped and filiform neurites throughout the brain. Conclusions: American football players, boxers and military men are more likely to trigger CTE, due to the constant mechanical shocks from their heads. The most frequent clinical manifestations were: headache, aggression, dementia, executive dysfunction and suicide. CTE is definitely diagnosed only at autopsy.