Research Details Of The Chronic Traumatic Encephalopathy (CTE) Study At The Canadian Concussion Centre (CCC)



Chronic traumatic encephalopathy (CTE) is a brain condition associated with repeated blows to the head. "Our study, for the first time, shows military personnel that have experienced blast exposure exhibit CTE that's basically indistinguishable from the CTE in the athletes we've looked at," said study researcher Patric Stanton, a cell biology professor at New York Medical College in Valhalla, New York.

Traditional structural neuroimaging techniques such as computed tomography (CT) and MRI that are often used in clinical assessments to evaluate gross anatomical changes are unable to effectively detect many of the pathological features of the disease that can only be observed at the cellular level, such as the aforementioned TDP-43 and hyperphosphorylated tau protein.

Investigators are developing PET radioligands to image pathology associated with CTE, 116 including aggregations of tau 117 and Aβ. 118 PET is also being used to assess changes in metabolic activity in the brain associated with exposure to head trauma.

CTE is a progressive neurodegenerative disease associated with a history of repetitive head impacts (RHI) 1 Over the last decade, CTE has become an increasingly recognized as a potential consequence for athletes participating in contact sports such as American football, soccer, boxing, and ice hockey, and military veterans exposed to blasts 2 , 3 A recent analysis of the brains from 111 National Football League (NFL) players observed 110 (99%) had evidence of CTE, further suggesting how prevalent the disease might be 4 Currently, CTE can only be diagnosed by post mortem examination of brain tissue.

In a recent retrospective analysis a higher incidence of mortality from neurodegenerative disease including AD- and ALS was reported among former National Football League players, compared to the general population ( Lehman et al., 2012 ). Notably, however, players (vs.

A potential confounder to the study of CTE resulting from multiple subconcussive or mild concussive impacts is the observation NFL of single moderate to severe TBI events also leading to chronic progressive neurodegeneration. The criteria for submitting a brain was based on exposure to repetitive head trauma, regardless of whether that individual exhibited symptoms during their lifetime.

Moreover, there is a rather large research literature on effective treatments for behavioral problems in people with head injuries, such as TBI, which may be helpful in informing treatment interventions for those at high risk for developing CTE. Iverson GL, et al. A critical review of chronic traumatic encephalopathy.

These abnormalities are often found in the brains of individuals with other neurological conditions including those who did not play contact sports. CTE is a progressive degenerative brain disease that develops in an estimated 17 percent of people with a history of head and brain trauma.

Our Research Results: In May 2013, the Canadian Concussion Centre research team published the findings on the first six autopsied brains of former CFL professional football players in Frontiers in Human Neuroscience a medical journal. Chronic traumatic encephalopathy (CTE) is a degenerative brain disease that kills brain cells.

Investigators are working to develop neuroimaging and biospecimen-based biomarkers, targeting the pathophysiological mechanisms associated with CTE (e.g., tau aggregates) and the biological processes after head injury exposure. In addition to studies on CTE, multiple studies have demonstrated brain changes on neuroimaging following concussion 11-16, but the long-term implication of these changes is currently unknown.

Each of these players had a history of concussions and, with the support and consent of each of the players' families, had donated their brains to the research project. The scan that stood out was of a retired National Football League player who had suffered 22 concussions over the course of his 11-year career.

It's this rapid motion of the brain inside the skull that creates the traumatic brain injury known as a concussion. Five football players, including our Case 1, had neuropathologically verified CTE at autopsy. For example, in football players with pathology consistent with the current understanding of CTE, some have a history of at least one concussion and some do not.

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