Chronic Traumatic Encephalopathy as a Consequence of Repetitive Sports Head Injury: A Review

Michael Galgano,Lawrence S Chin,Robert Cantu

doi:10.7759/cureus.234

Abstract

Abstract: Chronic traumatic encephalopathy is a disabling condition seen most frequently in athletes involved in high-impact sports. Physical and emotional abnormalities begin to display themselves later on in an athlete's life. Routine neuro-radiographic imaging generally does not show any significant findings, however newer MRI-based techniques such as DTI, fMRI, and MRS have shown promise for earlier detection. Three stages of the clinical presentation of CTE have been described. CTE likely results from progressive neuronal loss. Once the cascades are started, the symptoms of CTE become progressive. Sport-specific preventive strategies and early detection in our athletes is of vital importance in the management of CTE.

Highlights

BackgroundEvery year, 1.5 million Americans suffer traumatic brain injuries without loss of consciousness or hospitalization [1]
Chronic traumatic encephalopathy (CTE) is a disabling condition seen most frequently in athletes involved in high-impact sports
A study of high school athletes found that all sports were at risk for concussions with boys' football being the highest at 63% of the total followed by wrestling (10%), soccer (6%), with the remainder in basketball, softball, baseball, field hockey, and volleyball [3,4]

Summary

Introduction

1.5 million Americans suffer traumatic brain injuries without loss of consciousness or hospitalization [1]. Sports-related chronic traumatic encephalopathy (CTE) manifests as a progressive worsening of cerebral neurological symptoms, initiated by and perhaps worsened by repetitive concussions and subconcussive injuries. Zhang et al compared MRI with DTI in 49 professional boxers and found only nonspecific white matter changes on MRI, but diffusion anisotropy analysis revealed a decrease in the average diffusion constant and whole brain diffusion [28] These changes may indicate an early response to concussion in athletes and could become a useful tool both for detecting early damage and monitoring longterm neurological deficits. Further findings suggest that complete metabolic recovery may be delayed if a second concussion occurs within a short time-interval from the first and that further abnormal metabolic changes may take place This suggests that there are chronological differences in clinical recovery and metabolic recovery following a mild traumatic brain injury [33]. Further refinement of this new model will inevitably take place in the future, allowing researchers and clinicians to bridge the gap between the lab and clinical arena

Conclusions

Disclosures

Cantu RC