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Severe Chronic Traumatic Encephalopathy in a US Naval Special Warfare Combatant Crewman

Priemer DS, Rhodes CH, Stewart GW, Villar J, Dalgard CL, Perl DP

JAMA network open, 2025

Abstract

IMPORTANCE: Chronic traumatic encephalopathy (CTE) is a tauopathy mostly observed following a history of repeated impact-type head injury, usually from contact sports. The overwhelming majority of published, high-stage CTE cases are in older, former high-level contact sport athletes. CTE was infrequent in a large case series of brains donated by military service members, wherein it was most often of minimal severity, while being unanimously present in former contact sport participants.

OBJECTIVE: To describe the neuropathological examination of a brain donated from a US Naval special warfare combatant crewman (SWCC) who had a 12-year career.

DESIGN, SETTING, AND PARTICIPANTS: This case study of a whole brain specimen donated after death from a 44.9-year-old military donor with multiple deployments was conducted at a US biorepository dedicated to studies of brains donated from deceased military personnel. The detailed neuropathological examination included comprehensive molecular genetic testing.

EXPOSURE: SWCC are trained to execute high-risk warfare and reconnaissance missions typically operating small, mobile, fast watercraft in numerous maritime environments, including operation in the high seas. In this context, SWCC sustain repetitive physical forces to the body from high-speed boat impacts with waves, which may number in the millions.

MAIN OUTCOMES AND MEASURES: Postmortem diagnosis for CTE using the National Institute of Neurological Disorders and Stroke-National…

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Evidence Hub reads this as a case series, done in people. Its evidence level is 5 of 5 (Very low · case / narrative / animal / in vitro / in silico). Case reports, narrative reviews, and animal, cell or computer-model studies give the weakest evidence for human health.

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