The Disease Itself

 

According to the website of Boston University’s Alzheimer's Disease Center, chronic traumatic encephalopathy (CTE) is “a progressive degenerative disease of the brain found in people with a history of repetitive brain trauma.”

 

Dr. Ross Zafonte, the Chief of Physical Medicine and Rehabilitation at Massachusetts General Hospital and Brigham & Women’s Hospital, explained further: “At a more basic level, the brain suggests evidence or the data suggests evidence in pathological studies [of] abnormal Tau protein deposition, which is a type of protein that is important to neuronal function but develops an abnormal configuration, and where it’s deposited is a problem.”

 

CTE is not a new problem by any means. The medical community has been examining the effects of repetitive blows to the head since the 1920s. The effects of CTE were so common in boxers in the 1920s that the disease was given the moniker dementia pugilistica, or punch-drunk syndrome.

 

While the disease is commonly associated with repetitive concussions, recent developments in researching the disease suggest that concussions may not be the sole culprit. A study by Boston University, published in February 2018, indicated that subconcussive impacts, or hits to the head that may not lead to concussion symptoms, “can induce traumatic brain injury as well as early pathologies and functional sequelae associated with chronic traumatic encephalopathy.”

 

According to Dr. Zafonte, there are factors beyond repetitive head trauma that could possibly contribute to the manifestation or severity of the disease.

 

“It’s likely that these things are multifactorial,” said Zafonte, “They have to do with the density of exposure, the type of exposure, maybe one’s own genetics, maybe other medical co-factors, plus the changes that come from the pathology itself. So, a complex story."

 

Continuing insights into the causes of CTE open the door to understanding this elusive and long-standing disease and fighting its effects in those populations most affected by CTE.

 

Symptoms of CTE

 

 

According to Boston University's CTE Center, the symptoms of CTE may include the following:

• memory loss

• confusion

• impaired judgment

• impulse control problems

• aggression

• depression

• anxiety

• suicidality

• parkinsonism

• progressive dementia

 

Dr. Zafonte explained that there is still a lot to be discovered about CTE and its symptoms.

 

“I think this is an interesting and critical issue for us to understand. One, we have higher level contact sport athletes who have been noted post-mortem, after they die, in pathological specimens to have the pathology associated with CTE. Two, we cannot diagnose it yet in life. Three, we are not yet sure what the phenotype, or in other words what the direct symptoms that are directly attributable to the pathology are, although there are suspicions.”

 

Treating CTE

 

At present, there is no existing cure for CTE. However, treatments can be prescribed ad hoc for individual symptoms of CTE like anxiety and depression. As mentioned by Dr. Zafonte, the disease currently can only be diagnosed after death, making the identification and treatment of CTE extremely difficult.