November 4, 2026

@michaelokun

What resonates most with me about this important new study by Gallini and colleagues in JAMA Network Open is that even when we account for scientific bias, the burden of chronic traumatic encephalopathy (CTE) among former NFL players remains alarmingly high. Previous brain donation studies suggested that more than 90% of former NFL players had CTE, but critics correctly pointed out that individuals with neurological symptoms were more likely to donate their brains. In this study of 2,362 deceased former NFL players, researchers addressed this selection bias and estimated that 74.5% had CTE pathology at death, with a conservative analysis still suggesting nearly 64%. They also estimated that 27.2% had experienced dementia during life, although this does not establish that CTE caused their dementia. These findings do not mean that three out of four living NFL players have CTE, nor that everyone with CTE pathology develops dementia. However, they raise serious questions about the long-term consequences of repetitive head impacts. As a neurologist, I believe we must move beyond debating whether the problem exists and focus more urgently on prevention, safer sports participation, better biomarkers, and protecting young developing brains. My biggest takeaway is that we should not have to wait until someone dies to understand what years of repetitive head impacts have done to their brain. The future of CTE research must be about protecting the living, not simply counting the damage in the dead. https://cutt.ly/JyUWjDur