Repeated blows to the head in contact sports may trigger significant brain changes years before chronic traumatic encephalopathy (CTE) becomes visible, according to new research supported by the National Institutes of Health.

The findings suggest that damage to neurons, immune system activation, and blood vessel changes in the brain can occur in athletes as young as their 20s and 30s — far earlier than scientists have previously been able to detect signs of CTE.

CTE, a progressive brain disease tied to repeated head trauma, is currently only diagnosable after death. By identifying early cellular damage, researchers say doctors may one day be able to detect and treat CTE before symptoms develop.

"This study underscores that many changes in the brain can occur after repetitive head impact

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