Chronic Traumatic Encephalopathy (CTE)

Chronic Traumatic Encephalopathy (CTE) is a type of brain disease that is caused by repeated blows to the head, resulting in brain damage and long-term neurological problems. It is also known as dementia pugilistica or punch-drunk syndrome.

Causes and Risk Factors

CTE is primarily associated with contact sports, such as football, hockey, rugby, and boxing, where athletes are at risk of repeated head trauma. Other factors that may increase the risk of developing CTE include:

• Repetitive head injuries, including concussions and subconcussive blows
• Length of time playing contact sports
• Number of years playing contact sports
• Position played (e.g., linemen in football are at higher risk)
• History of previous head injuries or concussions

Symptoms

The symptoms of CTE can vary, but common signs and symptoms include:

• Memory loss and difficulty learning new information
• Mood changes, such as depression, anxiety, and irritability
• Personality changes, including impulsivity and aggression
• Difficulty with speech and language
• Difficulty with balance and coordination
• Sleep disturbances
• Headaches and fatigue

Stages of CTE

CTE has been classified into four stages, each with distinct symptoms and characteristics:

• Stage I: Symptoms include headaches, difficulty concentrating, and mood changes
• Stage II: Symptoms include memory loss, difficulty with speech and language, and personality changes
• Stage III: Symptoms include significant cognitive decline, difficulty with balance and coordination, and increased risk of dementia
• Stage IV: Symptoms include severe cognitive decline, difficulty with daily activities, and increased risk of death

Diagnosis

CTE can only be diagnosed after death, through an autopsy examination of the brain. However, a diagnosis of possible or probable CTE can be made during life based on a combination of:

• Medical history and physical examination
• Neurological tests, such as cognitive and memory assessments
• Imaging studies, such as MRI or CT scans

Treatment and Management

There is currently no cure for CTE, but treatment and management strategies can help alleviate symptoms and improve quality of life. These may include:

• Cognitive therapy and rehabilitation
• Medications to manage symptoms such as depression, anxiety, and sleep disturbances
• Lifestyle modifications, such as regular exercise, healthy diet, and stress management

Prevention

Preventing CTE requires reducing the risk of head injuries and concussions. Strategies for prevention include:

• Proper helmet fitting and use in contact sports
• Rule changes to reduce the number of high-impact hits
• Education and awareness about concussion symptoms and management
• Removal from play after a suspected concussion