Research are looking for answers about chronic traumatic encephalopathy — including the question “Is there any chronic traumatic encephalopathy treatment?”
Chronic traumatic encephalopathy (CTE) is a progressive, degenerative brain disease found in athletes, military veterans, and others with a history of brain trauma. How many people have the condition is unknown — in large part because there is no way to positively diagnose the condition at present, except during an autopsy.
The condition was brought to the attention of the public, doctors, and researchers over the past two decades as several high-profile athletes developed signs of CTE. After several former professional football players (including Mike Webster, Frank Gifford, and Ken Stabler) were found to have CTE after their deaths, the National Football League (NFL) became a lightning rod for concern that head trauma from impact sports could cause the condition. In fact, Boston University researchers discovered the brains of 87 out of 91 former NFL players were found to have CTE on autopsy, CBS news reported.
Symptoms of CTE typically include memory problems, mood and behavioral disturbances (including depression, impulsivity, aggressiveness, anger and irritability, suicidal behavior and, eventually, dementia, according to the Centers for Disease Control and Prevention (CDC). However, more research is needed to understand the condition, establish what specific types and amounts of head trauma carry the greatest risk for CTE and, importantly, find an effective chronic traumatic encephalopathy treatment.
What causes chronic traumatic encephalopathy?
CTE isn’t a new condition. In 1928, pathologist Harrison Stanford Martland described similar symptoms as a disorder known as “punch-drunk syndrome,” which affected boxers who had suffered multiple blows to the head. Eventually, the condition was called “dementia pugilistica.”
Almost a century after Martland’s first observation, researchers know sustaining brain injuries raises the risk of what’s now called CTE, according to the National Institute of Neurological Disorders and Stroke — but much remains to be understood about what causes the condition and why.
“The current studies would suggest that repeated injuries are likely needed to form the CTE pathology,” neurologist Chad Hales MD, PhD, an assistant professor in the Emory University School of Medicine explains.
“However, until we are able to track the pathological changes in living people with biomarkers of CTE, it will be difficult to determine what the threshold is for the number of injuries. We also do not understand individual genetic and environmental variation between individuals (i.e., some individuals may be more at risk than others for a given number of head injuries),” adds Hales, who is an expert in behavioral neurology and neuropsychiatry.
Is there any chronic traumatic encephalopathy treatment available?
There’s no doubt that CTE is a frightening condition. It has no known cure, and people who have suffered blows to the head and experience symptoms ranging from memory glitches to depression may be concerned they have the condition. However, it’s a good idea to talk to your doctor about any troubling symptoms — which may well have another, less serious explanation.
“Unfortunately, I don’t think the field has a clear understanding of the symptoms that correlate with the CTE pathologic changes in the brain,” Hales says. “Retrospective studies suggest several possible variants, including younger patients with primary neuropsychiatric symptoms at onset (anxiety, severe depression, violence, psychotic symptoms) and older patients with more memory symptoms similar to what you may see in Alzheimer’s disease.”
“Oftentimes, patients with a history of repetitive head injury or families will read about symptoms online and may assume that the symptoms must be due to underlying CTE pathology,” Hales says. “Although in some cases, there may be an association with changes in the brain and the symptoms, I think it is important to understand that we still do not have the studies that correlate the underlying pathology with the types of symptoms being experienced.”
The answer to the obvious question — Is there any chronic traumatic encephalopathy treatment? — is, at present, “no.” However, seeking treatment for symptoms like depression, anxiety, sleep disruption, and headache, is important, whatever the cause.
“Although we do not yet have therapies that target the pathology of traumatic encephalopathy syndrome (i.e., underlying CTE pathology), there are treatments for many of the symptoms that may be caused by the underlying pathology,” Hales emphasizes, “Addressing these symptoms can significantly improve quality of life.”
Bottom line: Research for chronic traumatic encephalopathy treatment
Scientists need far more information about who gets CTE, and why, before they can pinpoint possible treatments. A seven-year study, the Diagnose CTE Research Project, funded by the National Institutes of Health, is looking for risk factors for the condition. The researchers will be using neuroimaging and fluid biomarkers for the detection of CTE in study volunteers.
“There are CTE research studies underway including basic mechanisms of diseases, understanding the natural history and progression of disease, and developing biomarkers to assist with diagnosis,” Hales says. “A main component of CTE pathology is the abnormal accumulation of the protein tau, which also accumulates in other neurodegenerative disorders, like Alzheimer’s disease and variants of frontotemporal dementia. As a result, current Alzheimer’s studies and clinical trials that target tau may end up providing insights and possible therapies that can also be applied to CTE.”
“It’s important to recognize that if the main hypothesis on CTE continues to hold true — and repetitive head injuries are the main cause for most cases of traumatic encephalopathy syndrome/CTE pathology — then many of the cases may be preventable by avoiding activities that cause repetitive head injuries,” Hale adds.
So, while there’s no chronic traumatic encephalopathy treatment yet, you can take action to lower the risks of CTE. The best proactive strategy to help protect yourself and your children from CTE is to avoid head injuries. Wear protective sports equipment, for example, when participating in contact sports and always wear seatbelts.
What’s more, by avoiding head trauma you may be lowering the risk for another dreaded brain disease — Alzheimer’s. “There is some literature suggesting that a single traumatic brain injury (TBI) can increase your risk of Alzheimer’s disease later in life, so there may be risks to head injury beyond just CTE,” Hales explains.
April 26, 2019
Janet O’Dell, RN