Dr. Harrison Martland first described Chronic Traumatic Encephalopathy (CTE) in 1928. Back then, he referred to it as being punch drunk. Today, we know that CTE affects more than just boxers. Everyone, from high school athletes who suffer a concussion in football to military veterans, is at risk for CTE. What is CTE?
What Is CTE?
CTE refers to a degenerative brain disease that can come from repeated blows to the head, hence the initial reference to punch drunk boxers. The New York Times reports that more than 315 former NFL players in the U.S. have this condition.
The list includes players who suffer a concussion in football, such as Junior Seau and Dave Duerson, who died by suicide. CTE was also found in the brain of Aaron Hernandez, a tight end who killed his girlfriend and then committed suicide in prison.
Often, CTE isn’t discovered until after death, when the brain can be examined appropriately. For living patients, doctors must assume CTE exists at some level for those at risk and symptomatic because no test can confirm it.
What Causes CTE?
CTE has often been linked to repetitive concussions, so people associate it with contact sports. Concussions are not the only cause of CTE, though.
Experts at the CTE Center at Boston University indicate that about 20 per cent of people diagnosed with CTE never had a recognized concussion. That would suggest that the blows to the head, even the small ones, cause CTE, not the concussions themselves.
What Happens to the Brain With CTE?
Autopsies of people with known CTE, such as Hernandez, showed a build-up of a naturally occurring protein called tau. This protein is connected to several degenerative brain conditions, including Alzheimer’s disease. The autopsy done on Aaron Hernandez showed he suffered from severe CTE, indicated by dark spots of tau in his brain.
When clumps of tau build up around brain cells, the protein strangles them. The strangulation reduces their functioning, leading to cognitive decline such as memory loss. Eventually, the protein kills the cells leaving the brain withered in critical areas.
In cases of CTE, the tau protein clumps in a similar pattern around the brain. It is focused heavily on the dorsolateral frontal cortex. Hernandez’s brain showed significant damage in this area.
The Stages of CTE
CTE is a progressive disease, meaning the damage occurs over time. Dr. Ann McKee, director of the CTE Center at Boston University, developed a staging system similar to what you see with Alzheimer’s disease. Stage one is the mild form, and stage four is the most severe.
Today, the NFL has significant protocols in place to try to protect its players from this degenerative condition. They maintain a spotter in the press box whose sole job is to look for injuries that might otherwise go unreported.
The teams also keep doctors and neurotrauma specialists on hand for each game to do cognitive testing designed to spot a concussion in football players. The NFL is investing in the future of its players by putting millions of dollars into research for improved helmets and better treatment for CTE.
In the meantime, there is no cure for CTE and no reliable way to diagnose it in the living. Scientists continue to work to solve the mystery of CTE and head injuries.