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.

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.  

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.

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.

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/.

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.

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.

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.