Chronic Traumatic Encephalopathy (CTE)
What is chronic traumatic encephalopathy?
Chronic traumatic encephalopathy (CTE) is generally thought of as a progressive (gradually increasing) degenerative (worsening) brain condition that is linked to repeated blows to the head over a long period of time. The condition has been found in athletes who take part in contact sports, military personnel exposed to repetitive blast injuries, and even victims of domestic violence. This brain damage causes changes in a person’s thinking, personality, mood and behavior.
Who is at risk for chronic traumatic encephalopathy?
People who have repeated head trauma are at risk for CTE. This group includes:
- Boxers and wrestlers
- Athletes who take part in contact sports, such as football, hockey, and soccer
- Military personnel
CTE has also been reported in people who have epilepsy and in victims of domestic abuse.
Symptoms and Causes
What are the symptoms of chronic traumatic encephalopathy?
Symptoms of CTE may not appear until many years after a person experiences the brain trauma. Some of the symptoms are similar to those of other degenerative brain conditions, like Alzheimer’s disease and Parkinson’s disease.
Symptoms of CTE can include:
- Memory loss
- Impulsive behavior
- Changes in personality
- Problems thinking clearly
- Balance and movement difficulties
Personality changes associated with CTE, such as depression and aggression, can be difficult for some people to deal with. These feelings sometimes lead to complications, including accidents, drug and alcohol abuse, and suicide.
What causes chronic traumatic encephalopathy?
Repetitive head impacts can damage fibers that course through the brain and injure brain cells themselves. This can be associated with a buildup of a protein known as tau, which may have a role in cell death. The loss of these cells can interfere with healthy brain function, causing neurological changes that include memory loss, depression, aggressiveness, and balance and movement problems.
It is possible that several types of head injuries can lead to tau accumulation in the brain, including:
- A series of mild hits that cause no symptoms
- Mild traumatic brain injuries (concussions)
- More severe damage known as a traumatic brain injury (TBI)
It is not known how many head traumas, or exactly what kinds, it takes for CTE to develop.
Diagnosis and Tests
How is chronic traumatic encephalopathy (CTE) diagnosed?
CTE can only be definitively diagnosed in an autopsy after the person has died. The doctor will learn the personal history and analyze the brain tissue of deceased people who have shown symptoms of the condition. A specific pattern of tau protein in the brain can confirm the diagnosis.
Researchers are working to develop diagnostic tests to officially identify CTE while people are still alive.
Management and Treatment
How is chronic traumatic encephalopathy (CTE) treated?
Because CTE can only be diagnosed after the person has died, treatment can be challenging. Treatment for people who have symptoms of CTE include:
- Behavioral therapy to deal with mood swings
- Pain management therapy, including medicines, massage and acupuncture, to relieve discomfort
- Memory exercises to strengthen the ability to recall daily events
People who learn ways to deal with the symptoms of CTE often have an improved quality of life, including less pain, improved memory and fewer mood swings.
Can chronic traumatic encephalopathy (CTE) be prevented?
You can lessen your risk of CTE by reducing the number of times you take a hit to the head. Taking proper care of brain trauma when it occurs can also help prevent the condition. For athletes, this means coming out of the game after a head injury, resting, and following “return to play” guidelines.
Outlook / Prognosis
What is the outlook for people with chronic traumatic encephalopathy (CTE)?
Many people who show signs of CTE live healthy and fulfilling lives. Regular exercise and good nutrition can help manage symptoms, including pain and stress.
People can use many strategies to deal with behavioral symptoms associated with CTE. These include the following:
- Establish a daily routine. Creating a daily structure helps life feel more stable.
- Make notes. Writing things down helps combat memory problems.
- Manage feelings. Relaxation methods such as deep breathing help control emotions.
- Ask for help. Sharing challenges with friends and family can help ease the load. Sometimes professional counseling can be very helpful in managing symptoms.