Chronic Traumatic Encephalopathy

The term chronic traumatic encephalopathy (CTE) refers to brain deterioration that is probably brought on by frequent head trauma. CTE is a diagnosis made only after an autopsy by analyzing portions of the brain.

CTE is an uncommon condition that is still poorly understood. The initial effects of a late-life event of head trauma are unrelated to CTE. Head injuries that cause second impact syndrome and chronic post-concussive symptoms earlier in life have a complicated association with CTE.

Researchers are still attempting to figure out how repeated head traumas, other variables, such as the number and severity of head injuries, and other factors may affect the changes in the brain that lead to CTE.

CTE has been detected in the brains of persons who played football and other contact sports, including boxing. Military soldiers who were exposed to explosive explosions may also experience it. Cognitive and emotional challenges, physical issues, and other behaviors are considered to be some indicators and symptoms of CTE. They are believed to appear years or even decades after a brain injury.

CTE cannot be diagnosed during life, except for a small number of people who have experienced high-risk exposures. Researchers do not yet understand the etiology of CTE or the prevalence of CTE in the general population. CTE has no known treatment. There are presently no proven diagnostic biomarkers for CTE being developed by researchers.

Chronic Traumatic Encephalopathy: Causes

CTE is probably brought on by repeated brain trauma. The majority of CTE research has been on football and ice hockey players, as well as military people serving in combat zones, however repetitive brain traumas can also result from other sports and variables like physical abuse.

Military men and athletes who sustain multiple concussions are not universally at risk for developing CTE. Several studies have found no increased incidence of CTE in patients exposed to recurrent head traumas.

Researchers have discovered a buildup of a protein called "tau" around the blood vessels in CTE brains. Tau buildup in CTE is distinct from accumulations of tau reported in Alzheimer's disease and other kinds of dementia.

It's believed that CTE makes some parts of the brain deteriorate (atrophy). Communication between cells is impacted by damage to the nerve cells' electrical impulse-conducting regions. CTE patients may also manifest symptoms of other neurodegenerative conditions, such as Alzheimer's, Parkinson's, or frontotemporal lobar degeneration. These conditions include amyotrophic lateral sclerosis (ALS), popularly known as Lou Gehrig's disease, and frontotemporal lobar degeneration (frontotemporal dementia).

Chronic Traumatic Encephalopathy: Symptoms

No particular symptoms have been definitively linked to CTE. Several different disorders might share some of the CTE symptoms and indications. Cognitive, behavioral, emotional, and motor abnormalities have been observed in the few individuals with proven CTE.

  • Cognitive dysfunction

  • Having trouble thinking (cognitive impairment)

  • No memory

  • Planning, organizing, and task-performance issues (executive function)

  • Behavioral alterations

  • Impulsive actions

  • Aggression

  • Mood issues

  • Moodiness or passivity

  • Unstable emotional state

  • Abuse of substances

  • Suicidal ideas or actions

  • Driving Symptoms

  • Parkinsonism

  • Motor neuron disease

CTE symptoms don't appear soon after a brain injury, but doctors believe that they can develop over years or decades following repeated head trauma. Now, experts think there are two ways that CTE symptoms might manifest.

The first kind of CTE may result in mental health and behavioral problems in early childhood, such as depression, anxiety, impulsivity, and violence. It is believed that signs of the second type of CTE appear later in life, around age 60. These warning signs and symptoms include memory and cognitive issues that might lead to dementia.

It is still uncertain what all symptoms to look for in CTE patients when autopsied. What symptoms, if any, CTE could produce throughout life is unknown. Nothing is known right now about how CTE evolves.

Chronic Traumatic Encephalopathy: Risk Factors

Although researchers are still learning about the risk variables, repeated exposure to traumatic brain injury is likely to raise the chance of CTE.

Chronic Traumatic Encephalopathy: Diagnosis

CTE cannot yet be diagnosed. Only those at high risk who have sustained recurrent head trauma over many years while participating in sports or serving in the military might be suspected of having it. The presence of deposits of tau and other proteins in the brain that can only be observed after death, as well as signs of brain tissue deterioration, are necessary for a diagnosis (autopsy).

Several scientists are working hard to develop a CTE test that can be used on living subjects. Others are still researching the brains of people who have passed away and may have had CTE, including football players.

In the future, it is hoped to diagnose CTE using a variety of neuropsychological tests, brain imaging techniques such as specialized MRI exams, and biomarkers.

PET Imaging

An intravenous injection of a low-level radioactive tracer is used in positron emission tomography (PET) scans. The passage of the tracer through the brain is then monitored using a scanner. To identify tau anomalies linked to neurodegenerative illness in vivo, researchers are actively developing PET indicators.

Moreover, scientists are striving to create tracers that may be used to identify and bind proteins such as tau accumulation on PET scans. These kinds of scans and tracers are being used in studies to check for tau accumulation in the brains of retired sportsmen who had head injuries. These PET scans are not yet approved for clinical use because they are still in the research stage.

Further Tests

Little study has been done on plasma or cerebral spinal fluid to identify CTE's long-term disease processes. Due to the similarities between CTE and Alzheimer's disease, certain biomarkers utilized in studies on Alzheimer's disease may also be helpful for CTE. These indicators would have to distinguish between CTE-caused brain degeneration and initial brain damage.

Chronic Traumatic Encephalopathy: Treatment

There is no cure for CTE, a severe, degenerative brain condition. Further study on therapies is needed, although the present approach is to avoid brain damage. Also, it's critical to keep up with the most recent guidelines for identifying and treating traumatic brain injury.

Chronic Traumatic Encephalopathy: Prevention

There is no therapy for CTE. Yet given that CTE is linked to repeated concussions, it might be avoided. Concussion survivors are more susceptible to suffering another head injury. The current advice for preventing CTE is to lessen minor traumatic brain injuries and stop more harm from occurring after a concussion.


CTE is a neurodegenerative condition that develops later in life in certain people who have had recurrent head trauma. The precise connection between repeated mild traumatic brain injury, with or without symptomatic concussion, and CTE is unclear, but repeated axonal injury may set off a chain of metabolic, ionic, and cytoskeletal abnormalities that, in susceptible people, set off a pathological cascade leading to CTE.

CTE has been linked to activities such as playing American football, professional wrestling, soccer, and hockey as well as physical abuse, epilepsy, and head pounding, indicating that mild TBI from a variety of sources may cause CTE.

Dr. Durgesh Kumar Sinha
Dr. Durgesh Kumar Sinha


Updated on: 30-Mar-2023


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