2-Minute Neuroscience: Chronic Traumatic Encephalopathy (CTE)

Chronic traumatic encephalopathy, or CTE, is a neurological condition linked primarily to repetitive head trauma. In this video, I discuss what happens in the brain during CTE.

TRANSCRIPT:

Chronic traumatic encephalopathy, or CTE, is a neurological condition linked primarily to repetitive head trauma. Most cases of CTE occur in those who play sports where head injuries are common, but anyone who has experienced repeated head trauma is at risk. CTE symptoms generally begin to appear years after head trauma and may include: memory deficits and other cognitive impairment, abnormal behavior such as paranoia, aggression and impulsivity, mood disturbances such as depression, and movement problems such as tremor and other symptoms similar to those seen in Parkinson’s disease. In most cases, CTE is a progressive condition that gets worse over time.

Although the pathology of CTE in the brain is not fully understood, a common feature of CTE involves a protein called tau that’s normally involved in maintaining the structure of the cell. In CTE, tau proteins accumulate in neurons and other cells like astrocytes to form abnormal clusters or aggregates. The tau aggregates are called neurofibrillary tangles when they form in neurons and astrocytic or glial tangles when they form in astrocytes. The role of tau aggregates in disease progression is still not fully understood, but it’s thought they can disrupt cellular communication, and their presence is associated with the degeneration and death of neurons. They also seem to be able to spread throughout the brain, so a neuron that develops neurofibrillary tangles may cause surrounding neurons to develop them as well.

Initially, tau aggregates primarily form close to the surface of the cerebral cortex, but as the disease progresses they spread throughout the cortex and to other areas of the brain like the hippocampus, amygdala, and various other regions. The spread of the tau pathology is correlated with other degenerative signs, such as general atrophy of the brain, severe neuronal loss in areas such as the hippocampus and amygdala, and less substantial neuronal loss in a number of other brain regions.

REFERENCES:

Asken BM, Sullan MJ, DeKosky ST, Jaffee MS, Bauer RM. Research Gaps and Controversies in Chronic Traumatic Encephalopathy: A Review. JAMA Neurol. 2017 Oct 1;74(10):1255-1262. doi: 10.1001/jamaneurol.2017.2396. PMID: 28975240.

Baugh CM, Stamm JM, Riley DO, Gavett BE, Shenton ME, Lin A, Nowinski CJ, Cantu RC, McKee AC, Stern RA. Chronic traumatic encephalopathy: neurodegeneration following repetitive concussive and subconcussive brain trauma. Brain Imaging Behav. 2012 Jun;6(2):244-54. doi: 10.1007/s11682-012-9164-5. PMID: 22552850.

McKee AC, Stern RA, Nowinski CJ, Stein TD, Alvarez VE, Daneshvar DH, Lee HS, Wojtowicz SM, Hall G, Baugh CM, Riley DO, Kubilus CA, Cormier KA, Jacobs MA, Martin BR, Abraham CR, Ikezu T, Reichard RR, Wolozin BL, Budson AE, Goldstein LE, Kowall NW, Cantu RC. The spectrum of disease in chronic traumatic encephalopathy. Brain. 2013 Jan;136(Pt 1):43-64. doi: 10.1093/brain/aws307. Epub 2012 Dec 2. Erratum in: Brain. 2013 Oct;136(Pt 10):e255. PMID: 23208308; PMCID: PMC3624697.

Montenigro PH, Corp DT, Stein TD, Cantu RC, Stern RA. Chronic traumatic encephalopathy: historical origins and current perspective. Annu Rev Clin Psychol. 2015;11:309-30. doi: 10.1146/annurev-clinpsy-032814-112814. Epub 2015 Jan 12. PMID: 25581233.

[Defeshh]

Man, I worry so much about this.
I'm a working mechanical engineer and a fighter. I've been fighting as an amateur for 9 years, and god knows how many times I've sparred. I got rocked probably 5 times, never knocked out.
My main worry is that probably I'm dumber than I would be if I didn't do this sport. And the likelyhood of that being the case only grows with the time I practice it. I love sparring, fighting and the camaraderie; I wouldn't imagine a life without this sport.
At the same time I feel like my contributions as an engineer or thinker are probably hindered. I don't want to be even slightly dumber than I should be.

I hate that this is a consequence of the sport that I love so much and has given me so much. I simply also don't want to lose cognitive functions, I hope to contribute to society in some meaninfull way as well, and for that I need all the brainpower I can muster and no less.
At the same time, there is no real and good improvement without sparring, its a tacit knowledge. I don't sparr hard anymore, but still, sometimes you get hit a bit harder.

I hate this dilemma

[PaulyT]

I played high school football for two years. During those 2 years I suffered 6 concussions. Back then we had no regulations for concussions and no on field tests. If we said we were good they would put us back in even if we weren't.

[bucsbrah]

I played hardcore real deal football age 7 to 18 every year and played linebacker (MLB). Legit was a Luke Kuechley type player in high school. Didn’t play JV cause I was too good. I’ve had so many concussions it’s impossible to tell how many but definitely north of 15-20 mild concussions from as best as I can possibly remember (not great), and 5-10 serious concussions. Was ambulanced off the field by paramedics my sophomore year with a major closed head injury on the field and they shut down the game half way through the 4th quarter after it happened. Led to the discovery of brain lesions all over my frontal lobe. Literally says in my medical records that 1-2 of the many “neoplasms” or lesions couldn’t be verified as any one type of lesion or tumor as it presented on the brain images atypical to most astrocytomas, angiomas, etc. My dad threw a fit as to no biopsy because he wanted me back on the field. He pressured and pressed my neurologist to certify me to play again even though I didn’t want to. My neurologist wasn’t a sports fan and CTE wasn’t really being talked about in 2007 so I guess she was like screw it I don’t want to take away his potential career in the NFL as that was what my dad was on about. He forced me to play football and I quit many times because I told him I’m always seeing stars and was having abnormal headaches. He joked it off and teased me relentlessly to play because it made him look good as he really and truly lived vicariously through me and I HATED that. It was also definitely creepy at times because his mentality was so immature and egotistical. I was definitely psychologically abused by him and also by other members in my family too unfortunately. Only my grandmothers and mom took to my defense. After my TBI I came back and balled out without even trying or putting in my best effort. My grades suffered from football and the demands of it being in a top national district for recruiting and performance (Tampa FL). I went to a D3 school cause of my grades in high school and before I left for training camp I broke my ankle pretty gruesomely in a basketball game in the summer before college started. I decided not to play football after that gruesome injury and my dad went bat shit crazy cause that meant he couldn’t talk about football and me 24/7. He didn’t even care that I couldn’t walk for 6-8 months after my injury. He tried to talk me out of having ankle surgery to play football even though I couldn’t support my weight on my ankle. He was an absolute nightmare and still is sometimes.

My worst brain symptoms are: headaches (1-2 per week on average since 2007), impulsivity, ADD (mild-bad if not treated), spaced out, day dreaming on a loop, zoning out during conversation, slowed motor activity, weird obsessions, transitory mood problems, PTSD (from an unrelated witnessing of my uncles suicide), major depression, abnormal thoughts about life, morning confusion and horrible mental fog, risky and sometimes poor judgment on impulse, horrible forgetfulness, definitely short term memory issues, but my long term memory performs way better for some reason. There are some other symptoms too I didn’t mention.

[andrewburgemeister]

Really interesting.

I had first heard of CTE or at least of the phenomenon as I didn’t know of it back then back in 2009 when I was 12 as my Dad was telling me about how a lot of NFL players were getting what could be described as being similar to early-onset dementia as they used to thump their helmets together and take hard blows to their helmets.

I became more interested in the topic last year after an Australian Rules Football player and coach Danny Frawley had died in a suicide car crash which was initially linked to his battles with depression until the autopsy confirmed he had CTE from repeated concussions in the sport.

I’ve then been reading about the two most extreme examples of CTE in professional athletes Aaron Hernandez (NFL) and Chris Benoit (WWE) who committed extremely violent acts of murder and then eventually suicide and were both discovered to have the condition sustained from repeated head blows and which also seems to have caused paranoia, memory loss and behavioural problems with them.

[johnmike]

What's sad is I feel like (for myself) there is no treatment. I stay in my apartment and any lights makes me uncomfortable, I'm so depressed

[hwernie]

What a great explanation, thank you ❤️

[leesonstream]

Can you do a video on antihistamines and their mechanism of action on H1 and H2 receptors and how it causes drowsiness (and at high doses hallucinations)? You sir, have earned yourself a subscriber. Keep up the good stuff 👍

[baymillz]

I was diagnosed with cluster headaches. But maybe it could be CTE. I dont really know. Im depressive and have a lot of anxiety as well as mood swings. A lot of the times depression comes after my headaches. I dont know what to do because I no longer have health insurance or a job atm. Im 29 and it feels like my life is already over.

[prashanth-pyjc]

I like this you tube channel to learn about nervous system

[sssweetnesss]

Why did I even play football. Kinda regret it now.

[michaeltiller]

What about confusion and memories loss or wandering not know-how you got or did something or maybe doing thong you dontvm belive on or would nevrr do without remembering after a certain date or time you were inn

[injusticeanywherethreatens]

thanks for this! you're doing the world a favor! Maybe they'll learn a thing or two from it this time?

[samuelabela]

I'm worried... A year ago i attempted _ through paracetamol+alc overdose... I progressively developed symptoms similar to confusion and catatonia... But certainly not the main issue, i've noticed an increase of mood swings and high affectability and explosive rage... And i found i have very similar symptoms to Bipolar disorder. I am in fact currently undergoing a professional test for it.

But this condition seems way more serious...

[habibg]

Interesting it remind me of Alzheimer pathophysiology.

[gabe]

I hit my head 3 times really bad and I swear I wasn’t the same after the 3rd

[UltraViolent]

Damnit I’m sure I have this after thousands of blows to the head. I can’t remember names anymore .

[applepie]

There is absolutely no evidence of the "spread" that is referenced here.

[MaherKaderDrums]

Any ideas on how repeated trauma might lead to clustering of Tau proteins in neurons?

[zzkcdly]

WHO & WPA may you please help india. 🚑
Indians have to face with Covid-19 & its complications includes : trauma, PTSD, grief, melancholic depression etc.
Pray for indians ❤️❤️❤️

[YC_]

Sir please make a video on hand nerves and its defect.