Clinical presentation of chronic traumatic encephalopathy

Abstract

Objective: The goal of this study was to examine the clinical presentation of chronic traumatic encephalopathy (CTE) in neuropathologically confirmed cases.Methods: Thirty-six adult male subjects were selected from all cases of neuropathologically confirmed CTE at the Boston University Center for the Study of Traumatic Encephalopathy brain bank. Subjects were all athletes, had no comorbid neurodegenerative or motor neuron disease, and had next-of-kin informants to provide retrospective reports of the subjects' histories and clinical presentations. These interviews were conducted blind to the subjects' neuropathologic findings.Results: A triad of cognitive, behavioral, and mood impairments was common overall, with cognitive deficits reported for almost all subjects. Three subjects were asymptomatic at the time of death. Consistent with earlier case reports of boxers, 2 relatively distinct clinical presentations emerged, with one group whose initial features developed at a younger age and involved behavioral and/or mood disturbance (n 5 22), and another group whose initial presentation developed at an older age and involved cognitive impairment (n 5 11). Conclusions:

The Influence of Head Impact Threshold for Reporting Data in Contact and Collision Sports: Systematic Review and Original Data Analysis

“…100 The effects of concussive events and multiple subconcussive impacts have been associated with long term progressive neuropathologies and cognitive deficits. 2,68,84,101 To be able to identify what may be occurring then longitudinal impact monitoring at the level where these subconcussive events are beginning to occur is important, but the identified threshold still needs to be established.…”

Mind the gaps—advancing research into short-term and long-term neuropsychological outcomes of youth sports-related concussions

“…78,79 Subjective memory complaints such as anterograde amnesia are common, as are mood disorders including anxiety or depression, 79 and reduced executive function, which can result in disinhibition and impaired decision-making skills. 80 These clinical symptoms define disease severity.…”

Age at First Exposure to Football Is Associated with Altered Corpus Callosum White Matter Microstructure in Former Professional Football Players

“…1 In addition to concussive injuries, recent evidence indicates that sustaining repetitive subconcussive head impacts through sports participation may result in long-term consequences, including behavioral symptoms, 2,3 cognitive impairment, 4 brain structure alterations, 5 and neurodegenerative diseases, such as chronic traumatic encephalopathy (CTE). [6][7][8][9][10] Neuroimaging and electrophysiological studies have identified structural and functional abnormalities in former contact sport athletes many years after they stopped playing. [11][12][13][14][15] Tackle football players ages 7-12 may experience hundreds of repetitive head impacts (RHI), concussive and/or subconcussive, over the course of one season, several of which may exceed forces of 80 g. 16,17 Our previous research suggests that incurring RHI during critical periods of neurodevelopment in childhood may lead to later-life mood, behavioral, and cognitive impairment.…”