Chronic Traumatic Encephalopathy (CTE)
Author: Disabled World
Synopsis and Key Points:
Information regarding Chronic Traumatic Encephalopathy a disease that affects the brain and is found in athletes and others with a history of repetitive brain trauma.
Main DigestChronic Traumatic Encephalopathy or, 'CTE,' is a disease that is both progressive and degenerative and affects a person's brain. The disease is found in athletes and others who have a history of repetitive brain trauma. The trauma, which includes multiple concussions, triggers progressive degeneration of the person's brain tissue, to include the build-up of a protein referred to as, 'tau.' The changes in a person's brain may start in months, years, or even decades after they experience their last concussion, or end active involvement in athletics.
CTE is a neurological degenerative disease found in individuals who have been subjected to repetitive traumatic brain injuries by way of the acceleration of the head on impact and the subsequent damage to axons. CTE was first noticed as a peculiar condition casually referred to as a punch-drunk syndrome in boxers and prizefighters before the 1930s. It was recognized as affecting individuals who took considerable blows to the head, but was believed to be confined to boxers and not other athletes. Recent reports have been published of neuro-pathologically confirmed CTE in retired professional football players and other athletes who have a history of repetitive brain trauma. CTE can only be diagnosed posthumously. Research studies are looking into possible genetic, exposure level, and other risk factors.
CTE may only be definitively diagnosed through postmortem examination of a person's brain unfortunately, although efforts are being pursued to learn how to diagnose CTE in people who are still living. The step is key to developing a treatment for the disease. CTE was first referred to as, 'punch drunk,' syndrome and, 'dementia pugilistica.' It was first described by New Jersey pathologist Harrison Martland in, 'Martland HS: Punch Drunk.' Harrison Martland noted symptoms such as tremors, slowed movement, speech issues and confusion - issues typical of the condition. In the year 1973, a group led by J.A. Corsellis described the typical neuro-pathological findings of CTE after postmortem examinations of 15 former boxers.
The term, 'Chronic Traumatic Encephalopathy,' appears in medical literature as early as the year 1966 and has become the preferred term for the disease. Through the year 2009 there were only 49 cases described in medical literature, 39 of the people who experienced CTE were boxers. A number of people believed CTE was a disease involving only boxers, although cases have been identified in a person with epilepsy, a woman who was battered, two people who exhibited head-banging behaviors, and a circus performer from Australia who has involved in what medical reports referred to as, 'dwarf-throwing.'
Chart showing symptoms of CTE
Symptoms of Chronic Traumatic Encephalopathy (CTE)
Chronic Traumatic Encephalopathy (CTE) was not well known in sports other than boxing until a Pittsburgh medical examiner named Bennet Omalu identified CTE in two former Pittsburgh Steelers players who died in his jurisdiction in the years 2002 and 2005. The brain degeneration from CTE is associated with a number of symptoms which include the following:
- Memory loss
- Speaking issues
- Impaired judgment
- Progressive dementia
- Cognitive impairment
- Impulse control issues
- Disorientation or feeling lost
- Loss of hearing, sight or other senses
- Struggling with concentration or attention
The outward symptoms of CTE may sound familiar to those who have experience with Alzheimer's disease or other forms of dementia - disorientation, memory issues and difficulty with concentrating are the earliest signs. As CTE progresses, those affected start to show erratic behavior, poor judgment, significant memory loss, as well as some degree of Parkinson's disease such as difficulty with motor skills, impaired speech, loss of balance and slow movement. In more advanced stages of CTE, people experience tremors, Parkinsonism, deafness, a staggering gait, and dementia. CTE is also associated with psychological issues such as agitation, depression, loss of inhibitions, aggression and violence, euphoria, sexual compulsiveness, alcohol and drug abuse, and suicide.
CTE is a progressive disease that stands apart from the manifestations of traumatic brain injury (TBI). At the first research conference dedicated exclusively to CTE on September 30th and October 1st of 2012, scientists presented the idea of the estimated 1.7 million people who experience mild TBI's in America each year, an unknown number do not recover or live with the chronic, stable impairment that is at times referred to as, 'post-concussion syndrome.' Instead, they develop secondary, 'tauopathy,' which worsens as the person ages, eventually leading to dementia or parkinsonism if the person lives long enough. Research hints that CTE might self-propagate from cell to cell as other tauopathies do.
The symptoms of CTE usually present themselves a few years after a person has stopped playing a sport. Some researchers believe the severity of the disease might correlate with the length of time a person spend participating in the sport. Unfortunately, a 2009 analysis of 51 people who experience CTE found the average lifespan of those with the disease is just 51 years.
CTE is distinct from Parkinson's, Alzheimer's, Amyothrophic Lateral Sclerosis (ALS), or Frontotemporal Dementia (FTD), although individuals may experience an overlap of these. The U.S. Surgeon General stated, "CTE is a debilitating disease found in people with a history of repeated brain trauma. CTE can start months or years after brain trauma has occurred, either in contact sports, military service, veterans, or perhaps even partner violence, shaken baby syndrome, motor vehicle accidents, and other circumstances of life in the U.S."
How might researchers and doctors in the community distinguish TBI from CTEIn regards to this, progression is the main difference; so much so that the name may eventually change or become, 'Chronic Progressive Encephalopathy.' There are many people who have a stable encephalopathy after experiencing a trauma, people who most likely do not have a progressive tau disorder.
The incidence and prevalence of CTE remain unknown at this time, even though the military is concerned it may be rather high. Captain Paul Hammer, Director of the Defense Centers of Excellence for Psychological Health and Traumatic Brain Injury said, "I believe we have a very large population of people who may be at the beginning of what we are talking about here." The Department of Defense estimate of TBI's has risen sharply since the year 2005.
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