Chronic Traumatic Encephalopathy (CTE): An Overview

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease linked to repeated trauma to the head. The encephalopathy symptoms can include behavioral problems, mood problems, and problems with thinking. The disease often gets worse over time and can result in dementia. It is unclear if the risk of suicide is altered. In this article, we shall discuss traumatic encephalopathy(CTE): an overview. 

Most documented cases have occurred in athletes involved in striking-based combat sports, such as boxing, kickboxing, mixed martial arts, and Muay Thai—hence its original name dementia pugilistica (Latin for “fistfighter’s dementia”)—and contact sports such as American football, Australian rules football, professional wrestling, ice hockey, rugby, and association football (soccer), and military combat arms occupations. Other risk factors include being in the military, prior domestic violence, and repeated banging of the head. The exact amount of trauma required for the condition to occur is unknown, and as of 2022 definitive diagnosis can only occur at autopsy. The disease is classified as a tauopathy.

CTE ranges in severity, and it can cause extreme brain damage, especially to particular areas of the brain, and can result in debilitating symptoms. CTE can also be a sneaky condition, taking years and sometimes even decades for severe symptoms to manifest.

Having a history of severe head trauma for several years can make anyone of any age susceptible to developing CTE. Around 17% of people who have experienced repeated concussions or mild traumatic brain injury go on to develop CTE.

Symptoms of Chronic Traumatic Encephalopathy (CTE)

CTE is a progressive disorder; symptoms can take many years to develop. When left undiagnosed and untreated, symptoms worsen over time. The most telling signs of CTE include

  • Recurring headaches
  • Short-term memory loss
  • Difficulty concentrating
  • Sudden behavioral changes
  • Impulsive behavior

In severe cases, CTE is likely to cause more troubling symptoms, such as

  • Loss of coordination
  • Difficulty speaking coherently
  • Exhibiting aggressive behavior
  • Dementia
  • Experiencing tremors and uncontrollable muscle movements
  • Having suicidal thoughts or attempting suicide

Many brain disorders share similar symptoms with CTE. Exhibiting the above symptoms isn’t a sure sign that you have the condition. In some fatal cases of CTE, people with the disorder showed no symptoms while alive.

Diagnosis of Chronic Traumatic Encephalopathy (CTE)

Diagnosing CTE is challenging. Currently, there’s no specific test to diagnose CTE conclusively when a person is alive.

If you’ve been exhibiting symptoms that suggest you have CTE, your doctor will ask if you have a history of physical head trauma. They are then likely to conduct tests like magnetic resonance imaging (MRI) scans and computed tomography (CT) scans to rule out the possibility of other brain or neurological conditions.

Unfortunately, the only way to conclusively diagnose CTE is to examine cell samples from the brain of a person who has passed away from the condition.

Causes of Chronic Traumatic Encephalopathy (CTE)

The leading cause of CTE is repeated head trauma over a prolonged period. People often assume that the head trauma must have been so severe a person collapses or loses consciousness. However, CTE is caused by the effect of repeated physical trauma to the head in varying degrees over time.

The trauma to the brain caused by recurring head injuries triggers the degeneration of brain tissue, which results in CTE. The buildup of a protein called tau has also been linked to the development of CTE. Tests for the diagnosis of CTE have identified the presence of an altered form of the tau protein in the brains of people with CTE.

Tau protein is also present in the brains of people with other neurological conditions like Alzheimer’s disease. However, In people with CTE, the protein builds up in a unique pattern that distinguishes the condition from other neurological disorders. According to some researchers, it might be possible for these proteins to spread to other parts of the brain.

The critical component for CTE to occur is time. A single blow to the head one time is unlikely to cause CTE. However, research shows that people who have experienced traumatic brain injury (TBI) are two to four times more likely to develop dementia later in life.

People who play contact sports like rugby and football or are in military service are at a higher risk of developing CTE than others. These sports and jobs expose you to a risk of experiencing recurring head injuries.

Stages of Chronic Traumatic Encephalopathy (CTE)

CTE typically develops in four stages:

  1. In the first stage, tau protein forms in some regions of the brain, typically in the lateral and frontal areas. The first stage is characterized by none or mild symptoms.
  2. In the second stage, more significant irregularities form in the brain resulting in behavioral symptoms and sometimes depression.
  3. There’s a noticeable loss of brain mass in the third stage, causing memory loss and cognitive dysfunction.
  4. The fourth stage results in psychotic symptoms, difficulty speaking coherently, and severe loss of motor skills.

Treatment for Chronic Traumatic Encephalopathy (CTE)

There is currently no cure for CTE, but some of its symptoms can be managed, especially when an early diagnosis is made. Therapy can help manage symptoms to a degree. For instance, a person experiencing difficulty with speech will benefit from speech therapy.

Behavioral therapy can help regulate mood swings. Your healthcare provider may also administer medication to manage mood and behavioral changes and aid memory loss.

Researchers and scientists are working on some promising treatment options for CTE. One such treatment is immunotherapy, a form of treatment focused on combating the buildup of tau proteins in the brain. Medication to reduce inflammation also shows much promise for treating the condition.8

Coping With Chronic Traumatic Encephalopathy (CTE)

Preventing CTE is possible by protecting yourself from repeated head injuries. With specific jobs and sports, experiencing occasional head injuries can be challenging. Taking extra measures to protect yourself in those scenarios is crucial. Some steps you can take include:

  • Wear protective gear: Wear a high-quality helmet and other protective gear while playing contact sports or engaging in any activities that are prone to causing head injuries.
  • Be safe: While playing any sports, follow safety rules that have been put in place to protect yourself and others from grievous bodily harm.
  • Don’t dismiss head injuries: A head injury may not always cause severe or debilitating injuries. Regardless, contact your healthcare provider once you experience a head injury.

Self-care is crucial after a head injury. Create a healthy daily routine that incorporates regular exercise and adequate rest. Also, maintain a healthy and balanced diet to avoid nutritional deficits.

In summary, CTE is a progressive and degenerative brain condition that can be fatal. More research needs to be done to help understand the condition and effectively treat it. The good news is that CTE is preventable.

If you work in a job or play a sport that exposes you to repeated head trauma, it’s crucial to take extra steps to protect yourself. CTE is a lifetime condition that requires ongoing management; preventing it is critical.

One of the more severe symptoms of CTE is suicidal thoughts and behavior. If you or a loved one is experiencing suicidal thoughts, contact emergency health services as soon as possible.

I hope you find this article helpful.

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