Fig. 6.

CTE Stage II with motor neuron disease in a 29-year-old soccer player who developed fatigue and weakness of his lower extremities and hands at age 27 and 3 months later was diagnosed with ALS. 21 months after the onset of his symptoms, he died of respiratory insufficiency at age 29. He had played soccer since the age of 3, and started heading the ball at age 5. He played soccer for 12 years in public school, 4 years in college, and 2.5 years as a semi-professional. a Whole mount sections showing clusters of perivascular PHF-tau immunoreactivity preferentially at the sulcal depths of the frontal, temporal, and parietal cortices; CP-13 immunostain. b Sections of lower medulla, cervical thoracic, and lumbar spinal cord show extreme loss of lateral (asterisks) and ventral corticospinal tracts; luxol fast blue, and hematoxylin and eosin stain. c Extreme loss of axons, myelin with macrophage infiltration in lateral corticospinal tracts; luxol fast blue, and hematoxylin and eosin stain. d Severe loss of anterior horn cells in the ventral horn of spinal cord; luxol fast blue, and hematoxylin and eosin stain. e–g Perivascular clusters of PHF-tau immunoreactive NFTs and neurites in cortex; CP-13 immunostain, 50 mm free-floating sections. h Axonal swellings and distorted axons and hemosiderin-laden macrophages around small blood vessel in cortical white matter; SMI-34 immunostain, 10 m paraffin section. i FUS immunoreactive intracytoplasmic inclusions, both rounded and fibrillar; FUS immunostain, 10 m paraffin section. j Ubiquilin immunoreactive nucleus; ubiquilin immunostain, 10 m-paraffin section. k PTDP-43 neurites in frontal cortex; phospho-rylated-TDP-43 immunostain, 50-mm free-floating section. l PTDP-43 neurites in Rolandic cortex; phosphorylated-TDP-43 immunostain, 50-mm free-floating section. m PTDP43 intraneuronal fibrillar inclusions and neurites in lumbar spinal cord; phosphorylated-TDP-43 immunostain, 50 mm free-floating section. n PTDP-43 immuno-reactivity in axon in lumbar spinal cord; phosphorylated-TDP-43 immunostain, 50-mm free-floating section. o PTDP immunoreactive intracytoplasmic inclusions and neurites; phosphorylated-TDP-43 immunostain, 10 m-paraffin section. p PHF-tau immunoreactive intra-cytoplasmic granular inclusions; AT8 immunostain, 10 m-paraffin section