Concussion Crisis: A Guide to CTE

If you’ve been involved in a sport or military organization within the last few years, you’ve probably heard a little bit about CTE. CTE is a degenerative brain disease that’s become a major issue in the media. For example, the 2015 movie Concussion, which starred Will Smith and Alec Baldwin, told the true story of the NFL trying to suppress a scientist’s damning CTE research.

If you’ve ever played contact sports for a long period of time or have a job or lifestyle where you often experience head trauma, it’s probably concerning for you to learn about this disease. However, it’s important to spread knowledge of CTE around as much as possible, so we can focus on treating people before it begins to negatively impact their life.

What is CTE?

Chronic traumatic encephalopathy (CTE) is a brain disease that’s caused by repeated impacts to the head. Many people associate it with concussions, but that’s not actually true. It’s not really about the severity of the impact to the head, it’s about how many times it happens and over how long. It’s often found in soldiers, professional athletes, or people who have been the victim of ongoing domestic violence.

In essence, what happens when you get hit in the head repeatedly is that a protein in the brain called tau starts to form clumps. These clumps eventually spread throughout the brain, killing the formerly healthy brain cells.

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History of CTE

CTE was first recognized among boxers. Doctors started noticing a similar pattern of behavior among older boxers who had been competing in the sport for a long time. They referred to their odd behavior as “punch drunk syndrome.” The first doctor to use the phrase “punch drunk syndrome” was Macdonald Critchley in 1949, but it took another few decades to confirm similar cases in boxers, and gather enough evidence to publish a formal analysis.

Another well-known doctor who made a name for himself in the field of CTE research was Dr. Bennet Omalu, whose story is told in the movie Concussion. Dr. Omalu’s research inspired the creation of a brain bank, the function of which was to collect brains that were specifically donated post-mortem for scientific research purposes.

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Is CTE caused by concussions?

It’s not known at this time how many hits to the head are required before the brain starts to produce the tau protein that eventually starts killing healthy brain cells. What is known is that the hits don’t have to be that impactful. You may not exhibit any concussion symptoms for the hit to be considered traumatic and contribute to the build-up of tau.

These less-severe hits are known as subconcussive hits, and you may not exhibit any of the classic concussion symptoms, like dizziness, balance problems, headaches, blurred vision, or light sensitivity. If you were hit subconcussively, you’ll most likely be able to walk away feeling fine.

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What are the symptoms of CTE?

Some common symptoms of CTE to watch out for in yourself or your loved one if either of you has a history of head trauma are simple things like memory loss, confusion, and impaired judgement. Some more insidious symptoms that are equally important to watch out for are ongoing mental health issues like depression and anxiety, as well as aggressive behavior and impulse control problems.

One critical symptom is suicidal tendencies. If you’re worried that a loved one is thinking about ending their own life, it’s integral to seek professional help right away.

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When do symptoms usually develop?

If you’re experiencing your first head trauma, don’t panic. One concussion will not lead to a CTE diagnosis. Generally, the patient who is diagnosed with CTE will have years of blunt head trauma.

Often, people with CTE don’t experience any symptoms until years or even decades after their last head trauma or concussion. It takes a long time for the tau proteins to form clumps that are large enough to damage brain cells. If you feel like you have some of these symptoms within a few days or weeks of a head injury, you could be suffering from something called post-concussion syndrome, which will generally resolve itself over time.

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How is CTE diagnosed?

Currently, CTE can only be diagnosed with 100 percent accuracy by doing an examination of the brain tissue post-mortem. There is no way to definitively diagnose a person with CTE while they are still alive, but doctors have developed a special kind of imaging that can be done on a living person that is able to reveal information about the tau protein in their brain, which is directly connected to the development of CTE. There is currently research being done on an even more specific form of imaging, which will hopefully allow doctors to diagnose CTE while the patient is still alive.

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Who is most affected by CTE?

As we’ve said before, CTE impacts people who have a history of blunt force trauma, including military personnel, victims of domestic violence, but most frequently athletes.

There has been a lot of coverage in the media regarding CTE and the National Football League from their initial attempts to silence CTE researchers to decades of the NFL shirking the blame for all of the horrific cases of CTE that were diagnosed following the suicide or premature death of a former player. In 2012, over four thousand former NFL players sued the league, and were successful in forcing them to pay out a settlement of over $765 million dollars. They were even able to force the NFL to build a $675 million fund to compensate players who are diagnosed with CTE in the future.

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What are my treatment options?

While there is no cure for CTE, there are ways to treat the symptoms of it before they negatively impact your life. One of the most troubling symptoms of CTE is the mental health issues that people face when they develop the disease — most frequently, depression and anxiety.

If you find yourself dealing with symptoms of CTE, the best thing that you can do other than going to your doctor is talking to a therapist. They can help you deal with your depression or anxiety, as well as make sure that your other symptoms like aggression and poor impulse control are being managed in the safest way possible.

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What are the newest medical advances?

One of the biggest names in CTE research is the brain bank that’s a joint effort between Boston University, the Department of Veteran’s Affairs, and the Concussion Legacy Foundation. It currently has over 400 brains that have been donated so that they can be studied and hopefully contribute to finding a way to diagnose CTE earlier, or potentially limit its impact. The brains in the bank are mostly former athletes, and the researchers using the brain tissue for study have already found a potential link between amyotrophic lateral sclerosis (ALS) and CTE.

In 2013, President Obama used federal funds to create the Chronic Effects of Neurotrauma Consortium, a research project that exists to study and treat traumatic brain injuries within the military community. Hopefully, this public funding boost will encourage other researchers to add their knowledge to this relatively new field of study.

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Is there a way to prevent CTE?

Recently, researchers have found that immobilizing the head during impact can prevent the memory losses that usually accompany blunt force trauma. Whether or not immobilizing the head will prevent CTE is unknown at this time, but researchers were encouraged when they saw that it did have an impact on at least one symptom that is associated with CTE.

Since not every athlete or active military personnel develops CTE, geneticists are hard at work trying to figure out what makes a person prone to CTE, and why others are immune.

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How do I live with CTE if I think I have it?

Unfortunately, the only thing we can do at this time is treat the symptoms of CTE. A therapist can use cognitive behavioral therapy to help you examine your feelings and treat the depression and anxiety that often comes along with CTE. It’s also important to focus on keeping your body as healthy as you possibly can. Exercise, sleep, and nutrition are key factors in maintaining your health for as long as possible. Connect with family and friends, and keep them informed of your situation so they can do their best to support you.

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