What is Chronic Traumatic Encephalopathy
CTE results from repetitive mild traumatic brain injuries that cause accumulation of abnormal tau protein in the brain. Each head impact causes microlesions and neuroinflammation. Over time, damaged tissues form neurofibrillary tangles and tau deposits, leading to brain cell death. This produces cumulative effects, with symptoms worsening as damage progresses.
Some common early symptoms include headaches, loss of attention and concentration, memory loss, and mood or behaviour changes like impulsivity, depression and aggression. As CTE advances, more severe cognitive dysfunction, motor impairment, speech issues and dementia emerge. Symptoms reflect worsening brain pathology that begins focally and spreads across regions.
Diagnosis
Currently, CTE can only be diagnosed conclusively through examination of brain tissue after death. Many clinicians rely on patient history of repetitive head injuries and evaluation of symptoms to estimate likelihood while living. Diagnostic methods like PET scans and biomarkers in cerebrospinal fluid are being researched.
Prevention and treatments
As yet, there is no definitive treatment to halt or reverse CTE progression. Symptomatic management focuses on cognitive rehabilitation, physical therapy, speech therapy, and medications to manage specific symptoms. Lifestyle changes like a healthy diet, exercise, and building cognitive reserves through engagement in stimulating activities are also recommended.
Prevention is key, as head trauma is the sole known risk factor for developing CTE. Contact sports have implemented protocols like immediate removal from play after a potential concussion, limits to full-contact practices, and teaching proper tackling form. The military has updated helmet designs and protocols to better protect from blasts. However, total avoidance of head impacts in sports and military settings may be impossible.
Long-term outcomes of CTE
The potential for long-term devastating neurological outcomes makes studying CTE diagnostics and treatment a major medical priority. Though still not fully understood, the clear links between repetitive head trauma and CTE development are driving critical conversations regarding safety across different fields. While many questions remain unanswered, the progress made in understanding CTE will hopefully translate into better protection and outcomes.