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CTE: The New Face of Dementia?
Carrie Steckl, Ph.D.: Fri, Feb 1st 2013
When I was first studying psychology and aging, it was called dementia pugilistica - or dementia caused by repeated blows to the head. The term was mainly used to refer to boxers who had become what was casually known as "punch-drunk."
Over the years, attention gravitated toward other athletes, particularly professional football players, regarding the long-term ramifications of sports-related concussions. When increasing numbers of retired NFL players began exhibiting symptoms of dementia, the media and general public took notice. And when tragedies such as the suicides of ex-NFL players Junior Seau and Dave Duerson occurred, lawyers took notice too.
Now we have a new name for what common sense told us has been happening all along: chronic traumatic encephalopathy, or CTE. Although it's a long name, CTE is pretty self-explanatory. It describes a dementia-like condition that results from damage to the brain by chronic trauma (such as multiple concussions). CTE's symptoms include memory loss, confusion, personality changes, depression, suicidal thoughts and behavior, and tremors. The hallmark of CTE seems to be a protein called tau that builds up over time in the brains of those affected. Tau is also one of the proteins found in Alzheimer's disease along with another protein called beta-amyloid.
Up until recently, the only way to diagnose CTE was through autopsy. Now that may have changed. In a study conducted by UCLA, five former NFL players who had experienced at least one concussion were compared to five non-players who were approximately the same age. Using an innovative brain scan procedure, the participants were injected with a chemical marker that made tau deposits light up during the scan. The former football players' scans showed significantly more tau than the non-players' scans.
Not surprisingly, substantial tau deposits were also found during the autopsies of Seau and Duerson. The researchers admitted that more research was needed due to the small study size. Yet they feel optimistic that they are moving toward an effective way to detect CTE while people are still alive, which could offer opportunities to provide support, preventive measures (to keep CTE from getting worse through additional head injuries), and hopefully, new treatment modalities.
Acceptance of CTE as a legitimate diagnosis has taken time. Some scientists remain skeptical regarding whether repeated head injuries such as sports concussions actually lead to dementia or whether an accumulation of tau is the real cause. But organizations that previously did not recognize CTE are now doing so. For instance, the Alzheimer's Association recently added this statement to its website:
Emerging evidence suggests that repeated mild traumatic brain injuries, such as those that can occur in sports like American football, hockey and soccer, may be linked to a greater risk of a type of dementia called chronic traumatic encephalopathy. Research has shown that boxers have an increased risk of chronic traumatic encephalopathy.
And so we come full circle, from boxers with dementia pugilistica to boxers with CTE. The problem has been here all along. Now it's finally time to do something about it.