Traumatic Brain Injury in Sports: Long-Term Neurological Effects, Pathophysiology, and Prevention

Abstract

Traumatic brain injury (TBI) in sports has become a growing public health concern due to its long-term impact on cognitive, emotional, and neurological functioning. Although often viewed as short-term injuries, concussions and subconcussive impacts can lead to serious and sometimes irreversible consequences. Athletes in high-contact sports such as football, boxing, and hockey are especially vulnerable to repeated head trauma, which can lead to chronic symptoms like memory loss, depression, impaired decision-making, and neurodegenerative diseases such as chronic traumatic encephalopathy. The brain damage associated with TBI often includes diffuse axonal injury, persistent inflammation, and pathological tau protein accumulation. Many of these effects may not manifest until years after the initial injuries, making early detection and treatment difficult. While protective equipment, education, and concussion protocols have improved, significant gaps remain in prevention and long-term care. This review explores the current understanding of sports-related TBI and its persistent effects on brain health. Despite progress, the long-term consequences of sports-related TBI remain a serious and insufficiently addressed health concern, demanding further research, improved diagnostic tools, and stronger preventative strategies to protect athletes at all levels of play.