Frequently Asked Questions about Chronic Traumatic Encephalopathy

 

What is CTE?

Chronic Traumatic Encephalopathy (CTE) is a progressive degenerative disease of the brain found in athletes, military veterans, and others with a history of repetitive brain trauma, including symptomatic concussions as well as subconcussive hits to the head that do not cause symptoms.  CTE has been known to affect boxers since the 1920’s.  However, in recent years CTE has been found in other athletes, including football and hockey players, as well as military veterans.  CTE has been found in athletes as young as 17 years old and in both professional athletes and those with a history of participation in contact sports at only the high school level.  The repeated brain trauma triggers progressive degeneration of the brain tissue, including the build-up of an abnormal protein called tau.   The brain degeneration is associated with memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, suicidality, parkinsonism, and eventually progressive dementia. These symptoms often begin years, or even decades after the last brain trauma or end of active athletic involvement.

 

How do you get CTE?  Can I get CTE from one concussion/hit to the head?

We believe CTE is caused by repetitive brain trauma.  This trauma includes concussions that cause symptoms and subconcussive hits to the head that cause no symptoms.  At this time the number or type of hits to the head needed to trigger degenerative changes of the brain are unknown.  In addition, it is likely that other factors such as genetics may play a role in the development of CTE, as not everyone with a history of repeated brain trauma develops this disease.  However, it these other factors are not yet known.  

 

What is a concussion?

Some people have the misconception that concussions only happen when you black out after a hit to the head or when the symptoms last for a while.  But, in reality, a concussion has occurred any time you have had a blow to the head that caused you to have symptoms for any amount of time.  These symptoms include blurred or double vision, seeing stars, sensitivity to light or noise, headache, dizziness or balance problems, nausea, vomiting, trouble sleeping, fatigue, confusion, difficulty remembering, difficulty concentrating, or loss of consciousness. Whenever anyone gets a “ding” or gets their “bell rung,” that, too, is a concussion.

 

What are the symptoms of CTE?

The symptoms of CTE include memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, anxiety, suicidality, parkinsonism, and, eventually, progressive dementia.  These symptoms often begin years or even decades after the last brain trauma or end of active athletic involvement.

 

I heard that CTE causes suicide, like with Dave Duerson and Junior Seau.

There have been several high profile cases of former athletes with CTE who tragically took their own lives. These tragedies attract a lot of attention, and unfortunately contributed to the idea that CTE causes suicide.  Currently, scientific evidence does not support this link.  Suicide is an extremely complex and multi-faceted behavior that is not attributable to CTE pathology. Suicide is a tragic loss that does not help the science of CTE.

 

I recently had a concussion, and I am suffering from a number of CTE symptoms listed above.  Do I have CTE?

The symptoms of CTE generally do not present until years or decades after the brain trauma occurred or after one stops actively playing contact sports.  While most concussion symptoms resolve within a few weeks, the symptoms can last for months or, in severe cases, even years.  When this occurs, it is called post-concussion syndrome.  Post-concussion syndrome is different than CTE, and the symptoms of post-concussive syndrome usually resolve years or decades before the onset of CTE symptoms.  If you believe you are suffering from either an acute concussion or post-concussion syndrome, contact your physician.  For more information on concussions, visit the Center for Disease Control (CDC) website at http://www.cdc.gov/concussion/.  For more information on physicians in your area who work with those suffering from brain trauma, please contact your local Brain Injury Association.  State and local branches of the Brain Injury Association can be found here: http://www.biausa.org/state-affiliates.htm.

 

How is CTE diagnosed?

At this time CTE can only be diagnosed after death by postmortem neuropathological analysis.  Right now there is no known way to use MRI, CT, or other brain imaging to diagnose CTE.  The CSTE is actively conducting research with the goal of learning how to diagnose CTE during life.  For more information on this research, please visit the CSTE website at http://www.bu.edu/cste/our-research/clinical-studies/.

 

I thought there was someone at UCLA with a brain scan to diagnose CTE?

There was a very exciting preliminary study that came out of UCLA using a special PET scan to identify abnormal proteins in the brain.  The particular scan they used is unfortunately unable to distinguish between CTE and Alzheimer’s disease. The media got a little carried away with it, and reported the results to be a bit more sensational then they were.  It is a great first step, and PET scans are a very promising area of CTE research right now that we and several groups around the country are working on.  We’re much closer than we were, but unfortunately we’re still not there yet.

 

Can CTE be cured?  What can I do if I think I have CTE? 

At this time there is no cure for CTE.  However, the symptoms of CTE, such as depression and anxiety, can be treated individually.  If you believe you may have CTE, please talk with your physician.  For more information on physicians in your area who work with those suffering from brain trauma, please contact your local Brain Injury Association.  State and local branches of the Brain Injury Association can be found here: http://www.biausa.org/state-affiliates.htm.

 

What’s the difference between CTE and Alzheimer’s disease (AD)?

Although there are some similarities between CTE and AD, significant differences exist.  The symptoms of CTE generally present earlier than the symptoms of AD.  The symptoms of CTE generally present in one’s 40s, while symptoms in most AD cases generally present in one’s 60s.  The first and most central symptoms in AD involve memory problems, while the first symptoms of CTE generally involve problems with judgment, reasoning, problem solving, impulse control, and aggression.  In addition, these diseases are found to be different in postmortem neuropathological findings.

 

What can I do to help/how can I become involved in research?

The CSTE is currently conducting clinical research aimed at discovering how CTE develops and progresses, risk factors for the development of the disease, and how to diagnose the disease in the future.  For more information the CSTE’s current clinical research, please visit the website at: http://www.bu.edu/cste/our-research/clinical-studies/.  The CSTE also has a brain bank that studies postmortem brain and spinal cord tissue to better understand the effects of repeated brain trauma.  Current and former athletes and military personnel of all ages and levels can pledge to donate their brain and spinal cord to the BU CSTE after death.  Being a brain donor is similar to being an organ donor, and the procedure is done in such a way that the donor may have an open casket if desired.  BU CSTE personnel understand that this is a difficult time for the family of the donor, and they work hard to make the donation process as easy as possible for the family.  For more information, visit the BU CSTE Brain Donation Registry page at: http://www.bu.edu/cste/our-research/brain-donation-registry/.

 

Do I have to be a high level amateur or professional athlete to participate in your research and/or donate my brain to the CSTE Brain Bank?

No.  The CTE Center welcomes athletes of all sports and levels to participate in our research.  Although some studies are restricted to specific sports and levels, other studies are open to anyone with a history of participation in organized sports or military service.  For more information on our clinical studies, please visit our website here: http://www.bu.edu/cste/our-research/clinical-studies/.  For more information on the Brain Donation Registry, please visit our website here: http://www.bu.edu/cste/our-research/brain-donation-registry/.

 

Where can I find more information about CTE? 

To find more information about CTE, visit the CSTE website at http://www.bu.edu/cste.  For academic research articles, visit http://www.bu.edu/cste/our-research/academic-articles/