Chronic traumatic encephalopathy (CTE)

Chronic traumatic encephalopathy (CTE) is a progressive degenerative brain disease. While it has received the most media attention after being found in former athletes, anyone with a history of repetitive head trauma, such as soldiers exposed to blasts, can develop it.

Doctors can only conclusively diagnose CTE in former athletes after they die.

Signs and symptoms of CTE

The degeneration of the brain affected by CTE occurs slowly. Symptoms usually do not manifest for years after the brain trauma. In some cases, it can take a decade or longer. Symptoms generally progress as an abnormal form of the tau protein builds up and more brain tissue degenerates.

There is a mental cluster of symptoms that often starts with memory impairment. It can progress to more profound alterations in memory, insight and judgment, which Cantu called “executive function impairment.” Frank dementia can occasionally develop in later stages.

Lack of impulse control, marked by irritability and physically and verbally abusive behavior comprises the second cluster of symptoms.

Also read:
Common questions about CTE and traumatic brain injuries in sports

Doctor looking at brain MRI for evidence of CTE

The third clinical part of the triad relates to emotional problems, especially depression. Anxiety and panic attacks often develop.

What is important to note with the disease progression is that the brain degenerates slowly. Memory loss, confusion, bad judgment, impulse control struggles, depression and dementia might show up months after brain trauma.

More and more research has led most neurologic experts to conclude that CTE is associated with repetitive brain trauma. It could result from repetitive subconcussive blows. These mild blows to the head – such as offensive and defensive linemen colliding at the start of each play, for instance – are likely more of a factor than diagnosed concussions.

In my new book, That’s Gotta Hurt: The Injuries That Changed Sports Forever, I discuss concussions, CTE and the risk of playing football for young athletes. If you have kids who play football, you should read it and take steps to keep your kids healthy. Click here to get your copy!

Also read:
Chronic traumatic encephalopathy: What is CTE, and should athletes and parents be concerned?