Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease consistently associated with repetitive traumatic brain injuries (TBIs), which makes multiple professions, such as contact sports athletes and the military, especially susceptible to its onset. There are currently no approved biomarkers to diagnose CTE, thus it can only be confirmed through a post-mortem brain autopsy. Several imaging and cerebrospinal fluid biomarkers have shown promise in the diagnosis. However, blood-based biomarkers can be more easily obtained and quantified, increasing their clinical feasibility and potential for prophylactic use. This article aimed to comprehensively review the studies into potential blood-based biomarkers of CTE, discussing common themes and limitations, as well as suggesting future research directions. While the interest in blood-based biomarkers of CTE has recently increased, the research is still in its early stages. The main issue for many proposed biomarkers is their lack of selectivity for CTE. However, several molecules, such as different phosphorylated tau isoforms, were able to discern CTE from different neurodegenerative diseases. Further, the results from studies on exosomal biomarkers suggest that exosomes are a promising source of biomarkers, reflective of the internal environment of the brain. Nonetheless, more longitudinal studies combining imaging, neurobehavioral, and biochemical approaches are warranted to establish robust biomarkers for CTE.

This study employs a Developmental Origins of Health and Disease (DOHaD) approach to assess the effect of vitamin D deficiency (VDD) in childhood on the risk of osteoporosis in adulthood in an archaeological sample of skeletons dating from the 18th to 19th centuries. Femora and lumbar vertebrae of 65 adults aged 18+ years (26 diagnosed with residual rickets and 39 without) from an 18th-19th century Quaker burial ground at Coach Lane, North Shields, England. Bone mineral density (BMD) was measured for the femoral neck and first four lumbar vertebrae of each individual using a dual energy X-ray absorptiometry (DXA) scanner as a proxy for assessing osteoporotic fracture risk. 3-way ANOVA revealed no statistically significant differences in BMD between individuals with and without residual rickets across age and sex. A combination of lifestyle and environmental factors likely influenced the BMD of people buried at Coach Lane across the life course. The impact of childhood VDD on BMD later in life can be mitigated through other factors such as physical activity and diet. This is one of the first bioarchaeological studies to take a DOHaD approach to understand osteoporosis risk in 18th-19th century England. It highlights the complexity of aetiological factors for osteoporosis and that VDD in early life does not necessarily predispose a person to osteoporosis in adulthood. BMD is not the only indicator of osteoporosis. Microscopic methods for the assessment of childhood vitamin D deficiency, such as inter-globular dentine analysis, were not applied.

Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease consistently associated with repetitive traumatic brain injuries (TBIs), which makes multiple professions, such as contact sports athletes, especially susceptible to its onset. There are currently no approved biomarkers to diagnose CTE, thus it can only be confirmed through a post-mortem brain autopsy. Several imaging and cerebrospinal fluid biomarkers have shown promise in the diagnosis. However, blood-based biomarkers can be more easily obtained and quantified, increasing their clinical feasibility and potential for prophylactic use. This article aimed to comprehensively review the studies into potential blood-based biomarkers of CTE, discussing common themes and limitations as well as suggesting future research directions. While the interest in blood-based biomarkers of CTE has recently increased, the research is still in its early stages. The main issue for many proposed biomarkers is their lack of selectivity for CTE. However, several molecules, such as tau phosphorylated on different epitopes, were able to discern CTE from different neurodegenerative diseases. Further, results from studies of exosomal biomarkers suggest that exosomes are a promising source of biomarkers reflective of the internal environment of the brain. Nonetheless, more longitudinal studies combining imaging, neurobehavioral and biochemical approaches are warranted to establish robust biomarkers of CTE.

Effective assessment of bone health requires evaluation of both bone mass and bone microarchitecture. Osteoporosis is characterised not only by reduced bone mineral density (BMD) but also by deterioration of trabecular microstructure, both of which contribute independently to fracture risk. Despite this, clinical evaluation often focuses solely on BMD, which fails to capture many individuals at risk. Indeed, the majority of fragility fractures occur in patients with BMD values above the osteoporotic threshold, underscoring the importance of incorporating additional measures of bone quality. Trabecular bone score (TBS) is a validated, non-invasive index of bone microarchitecture derived from lumbar spine DXA images. By providing complementary and additive information, TBS improves the detection of individuals at elevated fracture risk who may be missed by BMD alone. For more than a decade, TBS has been extensively validated as an independent predictor of fracture risk, for both the assessment and management of osteoporosis. This article reviews the clinical evidence supporting TBS and its integration into routine practice. We also introduce a broader vision for future connected bone health ecosystem, in which next-generation TBS solutions, including TBS Reveal™ for opportunistic screening from X-rays and TBS Ortho™ for pre-operative fragility assessment, expand the clinical reach of bone quality assessment. Together, these technologies provide scalable, AI-enabled tools to support precision bone fragility evaluation across diverse clinical settings and patient populations.

Long-term effects of concussions, particularly in contact sport athletes, have been linked to changes in neuronal health. Lipid dysregulation has emerged as a potential contributor to neuronal injury and may serve as a measurable biomarker of brain pathology. This study investigated cognitive scores and serum lipid biomarkers in retired rugby players with a history of concussion to assess their association with concussion exposure. Serum levels of 24-hydroxycholesterol (24-HC), 25-HC, 27-HC, total triglycerides, and ceramide were compared between retired rugby players with a history of repeated concussions (n = 26) and non-contact sport controls (n = 19). ELISA-based quantification and statistical analyses identified significant group differences. Concussed athletes exhibited significantly lower serum 24-HC and significantly higher levels of 27-HC, triglycerides, and ceramide compared to controls, while no significant difference was observed for 25-HC. These findings indicate that repeated concussion is associated with reductions in cognitive performance and persistent alterations in serum lipid profiles. The observed lipid changes, particularly in 24-HC, 27-HC, ceramide, and triglycerides, may serve as measurable biomarkers of concussion-related biochemical alterations, providing a foundation for future studies aimed at monitoring neurological health in at-risk populations.

Neurodegenerative diseases such as Alzheimer’s disease (AD) and amyotrophic lateral sclerosis (ALS) have been associated with long-term effects of concussions, particularly in contact sport athletes. Lipid dysregulation has emerged as a potential contributor to neuronal damage and could serve as an early biomarker of brain pathology. This study aimed to investigate serum lipid biomarkers in retired rugby players with a history of concussion to explore their diagnostic relevance and potential link to neurodegenerative disease risk. A comparative analysis was conducted comparing serum levels of ApoE4, 24-hydroxycholesterol (24-HC), 25-HC, 27-HC, total triglycerides, and ceramide between concussed retired rugby players and non-contact healthy controls. ELISA-based quantification and statistical comparisons were used to identify significant group differences. Retired rugby players exhibited significantly lower serum 24-HC and significantly higher levels of ApoE4, 27-HC, triglycerides, and ceramide compared to controls. No significant difference was found in 25-HC, though some concussed individuals showed elevated levels. These findings align with previous reports in AD, PD, and ALS populations, supporting lipid dysregulation as a hallmark of neurodegenerative progression. Alterations in lipid profiles among concussed athletes suggest potential roles for ApoE4, 24-HC, 27-HC, ceramide, and triglycerides as early biomarkers for concussion-induced neurodegeneration. These findings may guide future diagnostics and post-care strategies for at-risk populations.