The aftermath of boxing revisited: identifying chronic traumatic encephalopathy pathology in the original Corsellis boxer series

Excerpt

In 1973, Corsellis and colleagues presented their findings of neuropathological changes in retired boxers in their seminal paper entitled ‘The Aftermath of Boxing’ [2]. The neuropathological changes associated with boxing, such as ventricular dilatation, cavum septum pellucidum and neurofibrillary tangle pathology highlighted by the authors would go on to set the groundwork for our understanding of chronic traumatic encephalopathy (CTE) [2‐4, 9, 10]. In 2016, under the guidance of NINDS/NIBIB, a consensus was reached amongst neuropathologists with expertise in neurodegenerative brain pathologies on the preliminary neuropathological diagnostic criteria for CTE, with a pathognomonic lesion of hyperphosphorylated tau in both neurons and astrocytes around small blood vessels at the base of cortical sulci [8]. Here, we sought to audit the neuropathological diagnosis of the boxers in the Corsellis series using the proposed preliminary criteria for CTE. Employing modern immunohistochemical techniques to tissue sections available from 14 of the original 15 cases, we screened for the deposition of hyperphosphorylated tau. The archival brain tissue from the Corsellis collection has been in fixative since the early 70s and sampled by many researchers over the past 45 years. This has limited the scope of our study and may affect our results in that we did not have access to all recommended regions outlined in the consensus criteria [8]. We therefore sampled multiple sites within the frontal and temporal cortices and systematically examined serial sections from these regions. The available brain regions and immunohistochemical staining applied are summarised in the supplementary tables. Antigen retrieval was performed to optimise staining in tissue fixed for prolonged periods. …