Chronic traumatic encephalopathy

Chronic traumatic encephalopathy
Other namesTraumatic encephalopathy syndrome, dementia pugilistica,[1] punch drunk syndrome
A normal brain (left) and one with advanced CTE (right)
SpecialtyNeurology, psychiatry, sports medicine
SymptomsBehavioral problems, mood problems, problems with thinking[1]
ComplicationsBrain damage, dementia,[2] aggression, depression, suicide[3]
Usual onsetYears after initial injuries[2]
CausesRepeated head injuries[1]
Risk factorsContact sports, military service, domestic abuse, repeated banging of the head[1]
Diagnostic methodAutopsy[1]
Differential diagnosisAlzheimer's disease, Parkinson's disease[3]
TreatmentSupportive care[3]
PrognosisWorsens over time[2]
FrequencyUncertain[2]

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.[1][4] The disease often gets worse over time and can result in dementia.[2]

Most documented cases have occurred in athletes involved in striking-based combat sports, such as boxing, kickboxing, mixed martial arts, and Muay Thai and contact sports such as American football, rugby league, rugby union, Australian rules football, professional wrestling, and ice hockey. It is also an issue in association football (soccer), but largely as a result of heading the ball rather than player contact.[1][5] Other risk factors include being in the military (combat arms), prior domestic violence, and repeated banging of the head.[1] The exact amount of trauma required for the condition to occur is unknown, and as of 2022 definitive diagnosis can only occur at autopsy.[1] The disease is classified as a tauopathy.[1]

There is no specific treatment for the disease.[3] Rates of CTE have been found to be about 30% among those with a history of multiple head injuries;[1] however, population rates are unclear.[2] Research in brain damage as a result of repeated head injuries began in the 1920s, at which time the condition was known as dementia pugilistica or "boxer's dementia", "boxer's madness", or "punch drunk syndrome".[1][3] It has been proposed that the rules of some sports be changed as a means of prevention.[1]

  1. ^ a b c d e f g h i j k l m Asken BM, Sullan MJ, DeKosky ST, et al. (1 October 2017). "Research Gaps and Controversies in Chronic Traumatic Encephalopathy: A Review". JAMA Neurology. 74 (10): 1255–62. doi:10.1001/jamaneurol.2017.2396. PMID 28975240. S2CID 24317634.
  2. ^ a b c d e f Stein TD, Alvarez VE, McKee AC (2014). "Chronic traumatic encephalopathy: a spectrum of neuropathological changes following repetitive brain trauma in athletes and military personnel". Alzheimer's Research & Therapy. 6 (1): 4. doi:10.1186/alzrt234. PMC 3979082. PMID 24423082.
  3. ^ a b c d e "Alzheimer's & Dementia". Alzheimer's Association. Retrieved 21 September 2017.
  4. ^ McKee AC, Stein TD, Huber BR, et al. (April 2023). "Chronic traumatic encephalopathy (CTE): criteria for neuropathological diagnosis and relationship to repetitive head impacts". Acta Neuropathologica. 145 (4): 371–394. doi:10.1007/s00401-023-02540-w. PMC 10020327. PMID 36759368.
  5. ^ Maroon JC, Winkelman R, Bost J, et al. (2015). "Chronic Traumatic Encephalopathy in Contact Sports: A Systematic Review of All Reported Pathological Cases". PLOS One. 10 (2): e0117338. Bibcode:2015PLoSO..1017338M. doi:10.1371/journal.pone.0117338. PMC 4324991. PMID 25671598. (Erratum: doi:10.1371/journal.pone.0130507, PMID 26039052,  Retraction Watch. If the erratum has been checked and does not affect the cited material, please replace {{erratum|...}} with {{erratum|...|checked=yes}}.)