Chronic Traumatic Encephalopathy

CTE LINKED TO PLAYING FOOTBALL

Causes

It is believed to be caused by repeated blows to the head. These repeated blows damage brain tissue. This leaves a buildup of tau, an abnormal protein (Rettner, 2015). Concussions are thought to be a cause. After a concussion there may be damage to the white matter in the brain (Rettner, 2015). White matter is the connective tissue that allows communication between each part of the brain. Football, boxing, hockey and other sports where there is repeated mild head trauma, military combat fighting, physical abuse, epileptic seizures and head banging are all possible culprits for causing CTE (Gavett, Stern, & McKee, 2011). The gene APOE may be linked to a hereditary cause (Rettner, 2015)

Neuro-degenerative changes

The brain will go through neurodegenerative changes. These changes are often seen as changes in mood, aggression and impulse control.The changes in the brain may include:


  • cerebral atrophy (wasting away)
  • cavum septum pellucidum with fenestrations
  • shrinkage of the mammillary bodies
  • protein deposits of tau
  • neurofibrillary tangles
  • glial tangles
  • neuropil neurites
  • axons lose ability to communicate
  • build up of the protein TDP-43
  • scarring of the brain

Signs and symptoms

There are many signs and symptoms that may occur. Changes in white matter have been linked to depression (Rettner, 2015). These include:

  • memory loss
  • poor memory recall
  • depression
  • apathy
  • irritability
  • impulsivity
  • suicidal thoughts or actions
  • difficulty moving
  • motor neuron disease
  • trouble speaking
  • vision problems
  • disorientation

Treatment

This is usually not accurately diagnosed until after death. However, if symptoms are noticed a doctor should further explore medical history and make recommendations based on the possibility that it could be CTE. According to the Mayo Clinic Staff it might be advised that one

  • Take medication such as antidepressants, mood stabilizers or antipsychotics
  • eat a healthy diet
  • avoid alcohol
  • avoid drugs
  • work with a therapist
  • join a support group (Mayo Clinic Staff, n.d.)

Progression

Presently there is no cure. The disease will progress and will progress through these stages. The first stage will present with headaches, poor focus and loss of attention (Mayo Clinic Staff, n.d.) The second stage will bring depression, explosive mood swings and short-term memory loss(Mayo Clinic Staff, n.d.). The third stage will affect execution of decisions and cognitive impairments(Mayo Clinic Staff, n.d.). The Final stage, stage four, brings dementia, speech problems, inability to form words and aggression(Mayo Clinic Staff, n.d.).

Questions from the patient/caretaker

Are there any trials or experimental treatments that might be beneficial?

Yes. We can help you look for them but you may also want to do your own research.


Are there any limitations on current activities?

Avoid anything that will cause further head injuries. Do what you feel comfortable doing.


Do I need more tests?

Not at this time but you may in the future, depending on progression.

References

Gavett, B. E., Stern, R. A., & McKee, A. C. (2011). Chronic Traumatic Encephalopathy: A Potential Late Effect of Sport-Related Concussive and Subconcussive Head Trauma. Clinics in Sports Medicine, 30(1), 179–xi. http://doi.org/10.1016/j.csm.2010.09.007


Mayo Clinic Staff. (n.d.)Chronic traumatic encephalopathy. Retrieved November 11, 2015, from http://www.mayoclinic.org/diseases-conditions/chronic-traumatic-encephalopathy/basics/risk-factors/con-20113581


Rettner, R. (2015, March 17). Chris Borland Leaves NFL: The Science of Football and Brain Injury. Retrieved November 11, 2015, from http://www.livescience.com/50163-football-cte-brain-disease-risk.html