What is CTE?
Chronic traumatic encephalopathy (CTE) is a degenerative brain disease that can occur in people with a history of repetitive head impacts, such as contact and collision sport athletes, combat military service members, and others.
The repetitive head impacts can result in symptomatic concussions or the more common subconcussive trauma, i.e., blows to the head without symptoms of a concussion.
These repetitive head impacts result in rapid acceleration and deceleration of the brain inside the skull, and stretching, twisting, and shearing of the long connections (axons) between the brain cells (neurons).
It is thought that these repetitive injuries start a cascade of changes in the brain, including the buildup of an abnormal form of a protein called tau. This, in turn, eventually leads to the slow, progressive destruction of brain tissue and associated changes in cognitive functioning, mood, and behavior.
When these changes become severe enough, they lead to dementia.
Do I have CTE?
At this time, CTE can only be diagnosed after death through careful neuropathological examination of the brain.
Suggested signs and symptoms of CTE are not diagnostic. Research into CTE is in its early stages, so it is important to note that while the signs and symptoms described above can be caused by CTE, they can also be caused by several other diseases and illnesses.
Based on next of kin interviews and examination performed by our parent study, Diagnose I, possible clinical features of CTE can be broken down into four major areas: mood, behavior, cognition, and movement.
Possible Indicators of CTE
Non-Diagnostic
-
Mood
Problems with mood and emotion can include feelings of depression, hopelessness, or anxiety. Some people are described as having apathy, i.e., the lack of motivation, emotional connection, or drive. Others have been described as being angry and irritable
-
Behavior
Behavioral changes can include acting impulsively, having a short fuse, being out of control, or having excessive rage. Some individuals become physically and verbally explosive and can become violent. Addictive behaviors are not uncommon.
-
Cognition
Cognitive difficulties include problems with memory, learning, and recalling new information. Forgetting things that occurred prior to symptoms is rare. Other problems include difficulties with attention, planning, organization, multitasking, judgement, and decision-making. These problems can worsen and have a negative impact on routine daily functioning.
-
Movement
Movement difficulties are not seen in all cases of CTE but are more likely in individuals who participated in boxing, mixed martial arts, or other forms of hand-to-hand fighting. Movement problems can include tremors and issues with walking, balance, and speaking.
What do I do if I think I have CTE?
There are no medications available yet that can prevent, stop, or slow down the accumulation of the abnormal tau protein and associated destruction of brain tissue in CTE. However, several new medications aimed at just that are being studied in various phases of clinical trials for other tauopathies. There is hope that one or more of these medications will be approved as an effective treatment to modify the disease course.
In the meantime, there are effective treatments for many of the symptoms associated with CTE, such as:
Depression
Anxiety
Irritability
Poor emotional regulation
Attention
Memory
Behavioral regulation
There are several changes to one’s lifestyle that have been demonstrated through research studies to provide some improvement of symptoms as well as maintain overall brain health.
Physical exercise mediterranean diet, heart health, mental exercise, and community.
The most important way to help improve our understanding of CTE is by participating in research.
Several studies are seeking volunteers to join in research, and the number of CTE-related research studies will be growing over the next few years. Researchers are seeking volunteers with a history of repetitive head impacts (such as through contact or collision sports) as well as individuals with no history of blows to the head to participate as a part of comparative groups.
Studies vary in their requirements but can include anything from extensive in-person clinical examinations to online surveys. Our knowledge of CTE is still limited. As we continue to understand more about CTE, we will be able to provide better answers to your questions and identify effective methods to diagnose, treat, and even prevent CTE.