What Is CTE And How Is It Related To ‪Concussions?

February 2, 2023

Imagine hitting your head so hard you begin seeing stars, the room is spinning, and you feel like you are going to vomit, but then suddenly everything goes black. These are just a few of the symptoms individuals who suffer a concussion will often experience, including headaches, confusion, nausea and vomiting, dizziness, and even losing consciousness. What if there is a brain disease with far worse effects then concussions, that can even lead to death? Curious yet? Keep reading to find out about Chronic Traumatic Encephalopathy (CTE), its impact on the brain and how it directly relates to concussions.

What is CTE?

Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease resulting from multiple head injuries. Symptoms of CTE include behavioral and mood problems, tremors, loss of memory, depression, and suicidal rage. It also affects an individual's cognitive abilities and judgment. Many of these symptoms are not as obvious as symptoms patients experience with a concussion, and these symptoms typically do not begin until years after the initial head injuries.

These symptoms tend to worsen over time and can lead to dementia. It is unclear if CTE alters the risk of suicide, given how the brain changes due to head injuries and CTE. The majority of known cases of CTE have occurred in athletes who participate in contact sports, such as football, hockey, soccer, boxing, and wrestling, with football players showing the most signs of the disease. Other risk factors for the condition include being in the military, domestic violence, and repeated hitting of the head. The exact amount of trauma that creates the condition is unknown for now, and diagnosis of CTE occurs by examining a patient's brain tissue during an autopsy.

What Causes CTE?

As mentioned before, CTE is caused by multiple head injuries, which are often substantial blows to the head, with some hits leading to concussions. However, concussions are not what triggers this disease. The disease is distinguished by abnormal deposits of calcium and proteins throughout the brain. Researchers have observed abnormal buildup of the protein tau, which kills brain cells and is a signifier of CTE.

Other evidence of what causes CTE have led researchers to hypothesize that in the condition's early stages, leaky blood vessels are evident in the brain - as within the deep recesses of the organ's folds - these damaged and leaking blood vessels were spilling proteins into the tissues of the brain, which triggered inflammation and other symptoms. Researchers also focused on the capillaries (the smallest and most significant blood vessels in the brain) through which oxygen, nutrients, and waste removal occur, are severely impacted by brain injuries, as injuries create focal disruption to the capillaries, leading to protein leaking into the brain tissue.

Recent Research On CTE

A recent Boston University-led study published in the journal Brain conducted numerous experiments on mice and brain autopsies to determine the fundamental causes of CTE and possibly how to prevent it. In mice, head injuries causing concussions and the impacts leading to CTE had very different and distinct effects inside of the brain. Changes in behavior that becomes evident at different times are the standard symptoms patients will display, while in mice, immediate behavioral responses to a head injury ranged from nothing to disability. Researchers were also able to find what could be the earliest moments of development of CTE in the mice showing very few or immediate symptoms.

Co-author of the study, Lee Goldstein, a School of Medicine associate professor of psychiatry, and his team also inspected the brains of four teenage athletes who passed one day, two days, ten days, and four months after suffering fatal head injuries. Their brains were compared to the brains of other teenage athletes who died without a history of head injuries, and the results were staggering.

The Research's Discoveries

The researchers were able to indicate the unusual buildup of tau protein was evident in two of the athletes who experienced head trauma, giving scientists a breakthrough in the exact causes of CTE in athletes. The research's discoveries also helped to explain why twenty percent of athletes who display the early stages of CTE never had a diagnosed concussion. Goldstein suggested individuals who appeared to bounce right back after getting a head injury may have sustained internal damage that would not be evident for years. The overwhelming majority of people who receive head injuries are going back and doing the worst thing possible: getting repeatedly hit in the head, causing further brain damage.

How Are CTE And Concussions Different?

CTE and concussions are two distinctly different medical conditions, with their own symptoms and impacts on a patient. Concussions are injuries impairing a person's ability to function, such as affecting their memory or balance, whereas CTE is much more serious, as it is associated with behavioral changes, depression, aggression, and dementia. As Goldstein noticed within the research's findings, the same brain pathology observed in the teenagers after a head injury was also present within the mice, which showed no indication repeated head injuries were related to concussions, in fact, that both medical conditions were different. The research provided strong causal evidence linking head impacts to traumatic brain injuries and CTE, but that was independent of a concussion. CTE occurs in individuals who have repeated head traumas over a significant amount of time, whereas concussions are immediate brain traumas showing obvious symptoms, whereas CTE does not.

How To Prevent And Treat Patients With CTE

Currently, there is no treatment for patients who are suspected of suffering from CTE, as a diagnosis cannot take place until the person is deceased, with an autopsy. Due to the study's findings, it has become apparent that more efforts need to be done to protect athletes from developing CTE, and to shift the focus on preventing just concussions, but also prevent repeated hits to the head. Ann McKee, the director of the CTE Center and the study's co-author, believes that to reduce the risk of CTE in athletes and military personnel, that organizations, such as the U.S. Military and National Football League, need to take preventative measures and try to eliminate athletes from receiving multiple head traumas by incorporating better rules and protective gear.

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