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Chronic traumatic encephalopathy (CTE): a
progressive degeneration of neurons
Pugilistic dementia was identified in boxers in the 1920s, and chronic traumatic
encephalopathy, a more recent term, are considered the same disease. Chronic
Traumatic Encephalopathy In Athletes was extensively studied. It occurs in some
retired professional football players and other athletes who have had repetitive cranial
trauma and in some soldiers with brain injury secondary to internal head injuries due
to blast trauma.
The reason why only certain people with repetitive cranial trauma develop chronic
traumatic encephalopathy and what are the risks of developing it after several cranial
traumas (eg, how many, how much) are currently unknown. About 3% of athletes who
had multiple (even apparently minor) develop chronic traumatic encephalopathy.
Pathologically, chronic traumatic encephalopathy is characterized by deposition of
hyperphosphorylated tau protein as neurofibrillary tangles, more prominently in
perivascular spaces, depth of cortical sulcus and subpial and periventricular areas.
Diagnosis
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Clinical criteria
The criteria for clinical diagnosis of chronic traumatic encephalopathy include:
History of head injury
Signs and symptoms consistent with chronic traumatic encephalopathy
Absence of a more likely explanation of clinical outcomes
These criteria are also used in surveys.
Routine neuroimaging results such as computed tomography or magnetic resonance
imaging are usually normal. Currently, there is no objective and validated in vivo
biomarker of chronic traumatic encephalopathy
A definitive Chronic Traumatic Encephalopathy Diagnosis is based on
neuropathological examination during the autopsy.
Treatment
 Security and support measures
There is no specific Chronic Traumatic Encephalopathy Treatment. The
supportive measures are similar to those of other dementias can help. For example, the
environment should be bright, cheerful and familiar, and should be designed to
reinforce orientation (eg, placing large clocks and calendars in the environment).
Measures to ensure patient safety (eg, signal monitoring systems for patients who
roam) should be implemented.
 Advice
 Medications to relieve symptoms
 Other measures
People with chronic traumatic encephalopathy can benefit from psychological
counseling, which can help them cope with mood swings. Antidepressants and moodstabilizing medications can also help, especially in the control of suicidal thoughts.
To help reduce the risk of chronic traumatic encephalopathy, people who have
suffered a concussion are encouraged to rest and refrain from athletics and certain
activities over a period of time.
 Caregivers must take care of themselves
Caring for people with dementia is a stressful and demanding activity, and caregivers
can become depressed and exhausted and often neglect their own physical and mental
health. Caregivers will benefit from the following measures:
 Learning to effectively meet the needs of those affected by dementia and what
can be expected from them: Caregivers can obtain this information through
nurses, social workers, organizations and in material published on paper or
online.
 Seek help when needed: Caregivers can consult social workers (such as those at
your local hospital) about appropriate sources of help, such as day care
programs, nursing home visits, assistance part-time or full-time for household
chores and admission to welfare centers. Counseling and support groups can
also be beneficial.
 Take care of them: Caregivers have to remember that they have to take care of
themselves. They should not give up their friends, their hobbies and their
activities.