What is CTE?
Chronic traumatic encephalopathy (CTE) is a progressive 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 more commonly, sub-clinical brain injury, i.e., blows to the head without symptoms.
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, might eventually lead to the slow, progressive destruction of brain tissue and associated changes in thinking, memory, behavior, and function.
When these changes become severe enough, they lead to dementia.
Importantly, not everyone who experiences these repetitive head impacts will develop CTE. Our research continues to focus on why some individuals do and do not develop CTE.
Do I have CTE?
At this time, CTE can only be diagnosed after death through careful neuropathological examination of the brain.
Research diagnostic criteria for the clinical syndrome of CTE exist and are known as traumatic encephalopathy (TES). However, the validity of the TES criteria are unknown and the specific signs and symptoms of CTE are still being clarified. At this time, CTE cannot be accurately diagnosed during life. It is important to note that while the signs and symptoms described below can be associated with CTE, they can also be caused by several other diseases and illnesses and might be able to be treated and managed. None of the below is currently diagnostic of CTE.
Based on next of kin interviews and research from DxCTE-I, possible clinical features of CTE include:
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Cognitive Difficulties
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.
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Neurobehavioral Dysregulation
These 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. Importantly, while these symptoms have been described in people who have autopsy-confirmed CTE, their specificity to CTE is uncertain at this time. Addictive behaviors are not uncommon.
Cognitive difficulties and neurobehavioral dysregulation have been most described in people who had autopsy-confirmed CTE. These are the proposed “core features.” People often hear about other symptoms in this setting, too, such as depression or parkinsonism. These other symptoms may or may not be related to CTE and are currently being investigated.
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 symptoms, 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.
If you are interested in participating in DIAGNOSE CTE-II, click here to learn if you are eligible: Am I eligible?
To contact us directly, click here: Contact Us
Additionally, we have several other ongoing studies that are seeking volunteers to join in research. 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.