Chronic Traumatic Encephalopathy

Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease secondary to repetitive mild traumatic brain injury (mTBI), including concussions and sub-concussive impacts, resulting in long-term cognition, behavior and mood issues. CTE was initially recognized in boxers who developed symptoms like ataxia, memory loss and personality change, and it was coined as the “punch drunk” syndrome or “dementia pugilistica”. Over time, it became evident that CTE also affected military personnel, domestic violence victims and those participating in contact sports like football, ice hockey, professional wrestling, rugby, soccer, and boxing.

Neurodegeneration and symptoms in CTE progress even in the absence of further traumatic insults. mTBI is thought to trigger an inflammatory cascade and lead to blood-brain barrier permeability, axonal injury, and micro-hemorrhages. As a result, there is deposition of pathogenic proteins, including the pathogenic cis-isoform of p-tau, which, through the process termed cistauosis, catalyzes the conversion of normal into pathogenic tau. As such, CTE develops in pathological stages with worsening depositions of p-tau, neurofibrillary tangles and brain atrophy in similar but distinct fashions as other neurodegenerative diseases like Alzheimer’s disease.

Chronic traumatic encephalopathy

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