chronic traumatic encephalopathy (CTE)
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Etiology
- repetitive head injury, concussion
- hits to the head more important than concussions as cause of CTE[10]
Epidemiology
Pathology
- tauopathy
- tau protein found outside the microtubules of axons[3]
- neurofibrillary tangles throughout the brain
- relative absence of amyloid deposits
- ref[8] mentions amyloid-beta
- TDP43 positive inculsions & TDP43 positive neurites
- affects frontal cortex, temporal cortex, medial temporal lobe, basal ganglia, diencephalon, brainstem
Clinical manifestations
- mood, behavioral, or cognitive symptoms common
- headache & loss of attention span in early phases
- cognitive slowing, disorganized thoughts[5]
- memory impairment & visualspatial disorder less prominent early
- dementia & aggression in later phases[3]
- parkinsonism, psychomotor slowing
- progressive motor neuron disease in severe cases[8]
- bradykinesia
- profound weakness
- atrophy
- spacsticity
- fasciculations
- gait ataxia (shuffling, wide base), balance disorder
- dysarthria
- slow processing speed
- executive function impairment
- onset of symptoms several years before death
Laboratory
- CCL11 in CSF may be increased[9]
Differential diagnosis
- amyotrophic lateral sclerosis
- dementia pugilistica (probably the same disorder)
More general terms
Additional terms
References
- ↑ McKee AC et al TDP-43 proteinopathy and motor neuron disease in chronic traumatic encephalopathy. J Neuropathol Ex Neurol 2010 69(9):918 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/20720505 <Internet> http://journals.lww.com/jneuropath/Documents/tdp-43%20proteinopathy%20and%20motor%20neuron%20disease%20in%20chronic%20traumatic%20encephalopathy.pdf
- ↑ Jump up to: 2.0 2.1 Fox Sports, Nov 29, 2011
- ↑ Jump up to: 3.0 3.1 3.2 McKee AC et al The spectrum of disease in chronic traumatic encephalopathy Brain. December 2, 2012 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/23208308 <Internet> http://brain.oxfordjournals.org/content/early/2012/12/02/brain.aws307.full?sid=1920e46f-1812-4a44-ab87-bb3b93b48ea8
- ↑ Jump up to: 4.0 4.1 Mathews BR Mild Cognitive Impairment Linked to Concussion in Retired NFL Players. NEJM Journal Watch. June 17, 2015 Massachusetts Medical Society (subscription needed) http://www.jwatch.org
- ↑ Jump up to: 5.0 5.1 Medical Knowledge Self Assessment Program (MKSAP) 17, 18. American College of Physicians, Philadelphia 2015, 2018.
- ↑ Jump up to: 6.0 6.1 6.2 Stewart WF, Kim N, Ifrah CS et al Symptoms from repeated intentional and unintentional head impact in soccer players. Neurology Feb 1, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28148633 <Internet> http://www.neurology.org/content/early/2017/02/01/WNL.0000000000003657
Lingsma H, Maas A Heading in soccer. More than a subconcussive event? Neurology Feb 1, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28148628 <Internet> http://www.neurology.org/content/early/2017/02/01/WNL.0000000000003679 - ↑ Jump up to: 7.0 7.1 Ling H, Morris HR, Neal JW et al Mixed pathologies including chronic traumatic encephalopathy account for dementia in retired association football (soccer) players. Acta Neuropathologica. Feb 15, 2017 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28205009 <Internet> http://link.springer.com/article/10.1007%2Fs00401-017-1680-3
- ↑ Jump up to: 8.0 8.1 8.2 8.3 Mez J, Daneshvar DH, Kiernan PT et al Clinicopathological Evaluation of Chronic Traumatic Encephalopathy in Players of American Football. JAMA. 2017;318(4):360-370 <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28742910 <Internet> http://jamanetwork.com/journals/jama/fullarticle/2645104
Rabinovici GD Advances and Gaps in Understanding Chronic Traumatic Encephalopathy. From Pugilists to American Football Players. JAMA. 2017;318(4):338-340. <PubMed> PMID: https://www.ncbi.nlm.nih.gov/pubmed/28742889 <Internet> http://jamanetwork.com/journals/jama/article-abstract/2645082 - ↑ Jump up to: 9.0 9.1 Cherry JD, Stein TD, Tripodis Y, et al. CCL11 is increased in the CNS in chronic traumatic encephalopathy but not in Alzheimer's disease. PLoS One. 2017 Sep 26;12(9):e0185541 PMID: https://www.ncbi.nlm.nih.gov/pubmed/28950005 Free PMC Article
- ↑ Jump up to: 10.0 10.1 Boren C A new study shows that hits to the head, not concussions, cause CTE. Washington Post. Jan 18, 2018 https://www.washingtonpost.com/news/early-lead/wp/2018/01/18/a-new-study-shows-that-hits-to-the-head-not-concussions-cause-cte/?utm_term=.a820fd964c9b