Chronic Traumatic Encephalopathy

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease induced by repeated blows to the head. Clinically, it is characterized by cognitive decline, mood disorders, and Parkinsonism. Pathologically, it is a tauopathy characterized by neurofibrillary tangles and glial tau inclusions that preferentially involve the cortical sulci, medial temporal lobe, diencephalon, and brainstem. It is a progressive degenerative disease of the brain found in athletes with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic sub concussive hits to the head.

Disease Statistics

Approximately 1% of the population of developed countries experiences traumatic brain injury (TBI) each year. The pathological consequences have received increasing attention following reports of progressive neurological dysfunction in athletes who have been exposed to repetitive concussions in high-impact sports (initially boxing and, in the past 8 years, American football) and the increasing number of war veterans presenting with CTE caused by explosive blasts. According to a study 6.2 percent of deceased pro footballers had the condition, chronic traumatic encephalopathy before dying. The brain tissue of 128 footballers in all who played semiprofessionally, in college, in high school or at country level before dying and determined that 101 athletes, or 80 percent of the entire sample, tested positive for CTE. With respect to pro athletes, the statistic is closer to nine-out-of-ten.

Typical Symptoms

Symptoms of CTE are like those of other conditions that involve progressive loss of function or structure of nerve cells (neurodegenerative diseases), including: Alzheimer's disease, Parkinson's disease, Front temporal dementia and Amyotrophic lateral sclerosis (ALS). Overall, people with CTE first have problems with thinking (cognition), mood and behavior. Later, they may also develop physical problems. Signs and symptoms of CTE usually begin eight to 10 years after repetitive mild traumatic brain injury. These include: Difficulty thinking (cognitive impairment), Impulsive behavior, Depression or apathy, Short-term memory loss, Difficulty planning and carrying out tasks (executive function), Emotional instability, Substance abuse and Suicidal thoughts or behavior.

Therapeutic Approach

Unfortunately at this time there is no cure for CTE. The best approach is to prevent head injury and stay informed about the latest recommendations for proper detection and management of mild traumatic brain injury.

Current Research

The major ongoing research studies of chronic traumatic encephalopathy are chronic traumatic encephalopathy: a potential late effect of sport-related concussive and sub concussive head trauma, TDP-43 proteinopathy and motor neuron disease in chronic traumatic encephalopathy, chronic traumatic encephalopathy in blast-exposed military veterans and a blast neuro trauma mouse model, Chronic traumatic encephalopathy, suicides and parasuicides in professional American athletes: the role of the forensic pathologist and more research works are being done to develop treatment for chronic traumatic encephalopathy.