What is: CTE
CTE or Chronic Tramatic Encephalopathy is defined by the Boston University CTE Center as a degenerative brain disease found in athletes, military veterans, and others with a history of repetitive brain trauma. In CTE, a protein called Tau forms clumps that slowly spread throughout the brain, killing brain cells. CTE has been seen in people as young as 17, but symptoms do not generally begin appearing until years after the onset of head impacts, with early symptoms usually appearing in a patient's late 20's or 30's. Some common changes include impulse control problems, aggression, depression, and paranoia. As the disease progresses, some patients may ezperience problems with thinking and memory, including memory loss, confusion, impaired judgement, and eventually progressive dementia. Cognitive symptoms tend to appear later than mood and behavioral symptoms, and generally first appear in a patient’s 40s or 50s. Patients may exhibit one or both symptom clusters. In some cases, symptoms worsen with time (even if the patient suffers no additional head impacts), in other cases, symptoms may be stable for years before worsening.
The best available evidence tells us that CTE is caused by repetitive hits to the head sustained over a period of years. This doesn’t mean a handful of concussions: most people diagnosed with CTE suffered hundreds or thousands of head impacts over the course of many years playing contact sports or serving in the military. And it’s not just concussions: the best available evidence points towards sub-concussive impacts, as the biggest factor. Subconcussive hits are those that are below that concussion threshold: the brain is shaken, but not so violently that the damage to brain cells is severe enough to see symptoms. There are also many individuals who suffer years of head impacts, but do not develop CTE. More research will help us understand these factors in the future.
Currently, CTE can only be diagnosed after death through brain tissue analysis. Doctors with a specialty in brain diseases slice brain tissue and use special chemicals to make the Tau clumps visible. They then systematically search areas of the brain for Tau clumps with a unique pattern specific to CTE. The process can take several months to complete, and the analysis is not typically performed as a part of a normal autopsy. In fact, until recently there were relatively few doctors who knew how to diagnose CTE.
Other information sources below:
https://concussionfoundation.org/CTE-resources/what-is-CTE
https://www.bu.edu/cte/about/frequently-asked-questions/
https://concussionfoundation.org/CTE-resources/subconcussive-impacts