CHRONIC TRAUMATIC ENCEPHALOPATHY (CTE)
Chronic traumatic encephalopathy is a degenerative brain disorder found in people who have had multiple head injuries.
- It is unclear, what severity or the exact amount of head injury/trauma is required to initiate chronic traumatic encephalopathy.
- Most documented cases have occurred in athletes involved in contact sports and military veterans, likely because these are some of the roles that involve purposeful, repetitive blows to the head.
- Symptoms associated with the condition typically does not begin until years after the injuries and often gets worse over time resulting in dementia.
- The rate of the condition has been found to be about 30% among those with a history of multiple head injuries.
CAUSES
The best available evidence tells that the condition is caused by any activity that involves repeated blows to the head sustained over a period of years, or recurrent episodes of concussion.
However, not all people who experience recurrent concussions go on to develop the condition.
People who are at a greater risk of developing includes:
Athletes participating in contact sports such as boxing, martial arts, American football, football/soccer, rugby, basketball, volleyball, ice hockey, wrestling, field hockey, horse riding, skiing.
Military veterans who are also prone to repetitive head trauma
People with poorly controlled epilepsy, victims of recurrent assault including domestic violence, and individuals with developmental disorders who engaged in headbanging behaviors.
SYMPTOMS
- Headaches
- Confusion
- Dizziness
- Disorientation
- Impulsive behavior
- Depression or apathy
- Memory loss
- Social instability
- Poor judgment
- Suicidal thoughts or behavior
- Irritability
- Emotional instability
- Motor impairments such as difficulty walking, weakness, loss of muscle movement, tremor.
- Progressive dementia
- Speech impediments
- Trouble swallowing (dysphagia)
- Trouble with the sense of smell
- Vision and focusing problems
- Deafness
- Aggression
DIAGNOSIS AND TREATMENT
Currently, no exact test exists to determine the condition. Definitive diagnosis can only occur at autopsy, this is because diagnosis requires evidence of degeneration of brain tissue and tau deposits in the brain that can be seen only during autopsy. Some researchers are however working to find a test that can be used while people are alive.
When CTE is suspected, the hope is to use a range of neuropsychological tests, brain imaging and biomarkers to make a diagnosis and rule out other conditions.
To check your neurological health, your doctor will test:
- Reflexes
- Muscle tone and strength
- Balance
- Coordination
- A sense of sight and hearing
- Speech, language, and cognition
- Ability to get up from a chair and walk across the room
Imaging tests such as:
Specialized MRI scan like:
Susceptibility-weighted imaging (SWI) a type of MRI that reveals hemorrhages that occurs as a result of injury to the central nervous system.
Diffusion tensor imaging (DTI) a type of MRI that shows the movement of water and the path of white matter in the brain, which can be suggestive of brain abnormalities.
Magnetic resonance spectroscopy which is similar to MRI but is capable of providing greater details about neurological damage
More researches need to be done before such techniques can be validated.
Positron emission tomography (PET). Researchers are working to develop PET markers that are able to detect tau abnormalities associated with neurodegenerative conditions. These are desired to aid diagnosis in the living.
TREATMENT
Treating condition that can’t be officially diagnosed till after death is difficult. Most treatment options include identifying the symptoms that are causing patients the most difficulty and treating them with targeted therapies.
- Cognitive behavioral therapy for mood changes such as depression, anxiety, irritability
- Medications for headaches
- Memory training exercises for memory problems
- Regular exercise
- Getting enough sleep