What Is Chronic Traumatic Encephalopathy – and What Should Athletes Know?

Ask the Expert: What Is Chronic Traumatic Encephalopathy and What Should Athletes Know?
Question: 

More and more studies are being conducted about contact sports and progressive brain injury. What is chronic traumatic encephalopathy, and what should we be doing to protect young athletes?

Answer: 

For years, we have known about a type of neurodegenerative disease, which may affect amateur and professional boxers, known as dementia pugilistica. Symptoms and signs of dementia pugilistica can develop progressively over a long period of time. Chronic traumatic encephalopathy, or CTE, may be similar and may be seen in more and more athletes who play contact sports like football or ice hockey. How much can the brain take, after all? It makes sense that a football player who is hit time and time again and who suffers multiple concussions would develop some sort of neurological trauma. The research that is being done on CTE is important, but it needs to be followed up with more research.

I think the increased awareness about traumatic brain injury is very helpful as is the awareness that a person doesn’t have to lose consciousness to sustain a concussion. This awareness will help everyone — from young athletes and coaches to soldiers serving in Iraq and Afghanistan. Everyone, including healthcare professionals at all levels, needs to know that TBI is not necessarily a benign event and sometimes symptoms do not go away.

Posted on BrainLine January 6, 2010.

Comments (23)

Please remember, we are not able to give medical or legal advice. If you have medical concerns, please consult your doctor. All posted comments are the views and opinions of the poster only.

I have over the years had many blows to my head due to falling, being hit, or many other ways of bashing my head. I now for many years had issues that Dr.'s can't tell me anything of why I have the issues that I have. Could this be my problem? And if so what if anything can help me?

My question is a bit different. I'm 6'6" tall and yes I played foot ball. 2 years at the big 8 level. However I also have daily impacts because of my height. I crash into the slides on my RV, every cupboard door, light fixtures, door ways, car door jams, you name it I hit it.

I went on to become a successful engineer. However by my early 50's the symptoms your are showing mark both myself and my middle brother, also 6'6" tall and did not play formal football. I retired because of diminishing capability. As kids we played everyday in the yard, no pads or helmets, but we didn't bruise each other like in organized sports

Do you think CTE occurs in very tall people. For a quick test check the top of the head of a tall bald person. While those of us with hair cover our scars they cannot. You can see the severe number of blows, and does the energy distribution of a foot ball helmet increase of decrease the events that lead to CTE?

What do you think. I cannot concentrate, even technical journals are not very hard to read and understand.

How do I tell the difference between CTE and general deterioration of my mental capabilities due to age.

I am 59 years of age, retired in my mid 50's, not by choice. I an very glad to have something that explains my distinct change not only in mental capability but the sudden rage that just comes over us. For a bit, no reason and then gone,

Sorry for so many questions but I think I may have some answers,

I was diagnosed with traumatic brain injuries and suspected CTE. It sucks. I retired in 2010 at the age of 46. Fortunately, I was in the navy 20 years and they had records of all of my brain injuries, most of which occurred playing football from teenage years until I was in my fortues.

I no longer get upset - I get furious.
I get lost driving near my home of 10 years
I have trouble spelling
Went to walmart the other day and needed to ask for help finding something. I found a worker and asked them where I can find .... I forgot. I apologized and walked around a while. I remembered what I needed and saw the same lady, but by the time I had approached her, I forgot again and just left the store.

Thank you all, and god bless your lives. I am so sorry to hear that this is happening to anyone. I recently have been doing a large research project on the subject and am so sorry to find that it truly is this severe. Also this site has good information on the subject

I will be 63 next month and I feel I might have something like CTE. 15 years ago I had a TBI in a motorcycle accident. I had multiple concussions playing football off and on from the early 1960's. A young boy, playing in the streets, high school playing football, US Navy football team, AZ DPS playing full contact football games till mid 1980's. Many times being in a Dream state lasted till I woke the next morning. I played hard, head hitting first on every tackle. I've had 4 MRI on my head since my accident in 2001. I have seen several Neurologists, Psychiatrist. I'm on Lexapro & Xanax. They help but I do hear voices. I can't smell or taste because of the head injury, quality of life is gone. Everyday I think of ending it. That's all.

I was involved in all types of sports from an early age and incurred many injuries as a result.  Among them were a couple of skull fractures and numerous concussions.  I recently turned 60 and have noticed changes that might signal CTE - mainly short-term memory loss, inability to sleep through the night and mood swings/depression.  I'm almost afraid to be examined for this as I'm not sure that I want to know the truth.  Has anyone else experienced what I've described and is there any effective treatment available?

i wonder what the materiel is in the brain cells of those who have CTE?  I have heard that the injury that leads to concussion is disruption of the gray matter and white matter in the brain: because the gray matter has a higher density than the white (has more fat because of myelin), when a rotational impulse hits the brain, a shear force is imposed between the white and gray matter, causing breaks between neurons and their axons.

is it possible that the materiel that accumulates in the cell comes from the cells attempt to reconnect to its axon?  could there be a sort of extrusion of axonal materiel from the cell body into the axon as a routine process throughout the life of the cell, and when the connection between axon and cell body is broken, that materiel simply accumulates in the cell body?

I have been ready to fire an employee for about two weeks now, for some outrageous behavior in the office and in the field. I found myself thinking, "how did she get so far in life, if she's always been this disorganized, angry, rude and flustered? How could any one make it to 60 years old and be so obnoxious?" As a retired nurse, I knew something wasn't quite right. My employee, who has some very valuable skills, neglected to tell me about a serious head injury some years back. Now, on Monday, I'm going to talk with her, and see if this situation can't be salvaged. Thanks for a great site and message board. And thanks for reminding me of how difficult it is for some with CTE. Another sad scenario averted!

What isn't being addressed in CTE are the drugs being taken and the condition of the kidney. If one develops headaches, what is being done?  Drugs? Opioids, pain medications, NSAIDS, are all known to cause kidney damage.  Kidney damage is progressive and irreversible.  Guess what, so is CTE and Alzheimers.  It is my opinion that with increasing kidney damage, their is a corresponding decrease in the ability of the kidneys to filter out toxins and plaque.  This accumulates then on vessels, heart and fine brain cells, causing their death.  As the pain and subsequent symptoms develop such as changes in behavior, depression, then there is a corresponding reliance on drugs, causing more kidney damage.

I'm a 27 year old male who recently had to drop out of a flight school due to a concussion in which I lost consciousness.  Less than 6 months before that I was elbowed directly in the temple playing basketball.  Before these recent occurrences I played basketball aggressively for years and also suffered shots to the head from older siblings in early life quite frequently.  I am having a hard time remembering things with my new studies.  I also have a hard time with my energy levels probably from depression.  I just watched the documentary   on CTE on PBS and now I am quite scared.  Since there is no way of truly knowing if someone has this until postmortem, how can I get help with this?

I played football from youth through college. It is frustrating to deteriorate mentally at such a rapid rate. I can't function in my current professional field. I appreciate the comment about creating connections through taxing the brain. I have lost my job and have lost my wife and two young kids. I'm afraid to be around them because I am so unstable. My behavior doesn't make sense to me after an emotional outburst. I can't sleep for more than a few hours at a time. My physical health is weakened because i am unable to care for myself because of depression. Can anyone help me?

I was a victim of domestic abuse and my ex husband was a golden gloves boxer when he was younger, it didn\'t take him long to figure out that if he hit me in the head no one could see the damage. This went on for years even after I divorced him until the stalking laws were passed here in Iowa. I always had migraines but they are becoming more often and intense and I am noticing short term and long term memory loss where I used to be very good like, spelling, putting things places, telling people things, and I am also dealing with anger issues with others which I thought I had come to terms with along time ago. All of this is very scary to me and very different from who I used to be. Could this be CTE? I am going to see my primary doctor on Friday and am going to ask her about it. Right now she knows nothing of this part of my past. I tried to keep it a secret from everyone but now I need to let it out to help myself.
I have a history of head injuries,now i have severe ringing in the ears,constant headache,severe neck pain,depression and anexioty disorder for many years, and can't find a Dr that even knows what it is.I found out what i had reading an article on ice hockey players and their sucide rates.
I\'ve had multiple concussions from early in life. In my late teens I started getting the head aches then later the mood swings. In my thirties I started getting horrible nightmares. The type that start right back up the moment you fall back asleep.If you can call it sleep. I found that if I smoked or ate cannabis the nightmares wouldn\'t occur. I also don\'t get migraines nearly as much anymore. The cannabis won\'t get rid of your migraine if you already have one, almost makes it worse. Since I already have serious short term memory loss, why not

I have been watching a lot of documentaries on the new research being done on cannabis, and how the progress of isolating certain strains for certain issues is coming. I also have a bachelor's degree in psychology - emphasis on drug and alcohol psychology. Colorado seems to be ahead of other legalized states in fine tuning and regulating the potency of strains produced. There are 66 chemical compounds in cannabis; only one of which makes you high (THC). CBD may help with your headaches. It's legal in all states and comes in many forms.

I have had increasing short term memory loss, and I'm only 34. I find that cannabis oil has made a small, but positive impact on the cloudiness I experience. It can be frustrating when I cant remember a word or lose track of what I was talking about mid-sentence. I dont have access to it all the time, as I live in a state that hasn't accepted the fact that cannabis is in fact a miracle plant.

Humans and many other mammals (including dogs and cats) have an endocannabinoid system...its a neurological system in our bodies that binds with properties in cannabis just like serotonin or dopamine. Why would we have this system, and kept it through evolution, if our bodies weren't meant to utilize it? Food for thought, I hope this gives you some hope.

I had 5 head injuries before my 17th birth day. 2 where I was hit by a car, 2 were bmx/freestyle accidents (no helmet) 1 was slip and fall on the kitchen floor. All resulted in loss of consciousness except the kitchen. The 2 BMX accidents resulted in me waking up in the ambulance with no recollection of what just happened. I fear these early injuries may have caused damage that has progressed to my forty\'s now. Some people think Im bipolar because I go from happy to emotional in the snap of the fingers. I also drink alot. Any thoughts? Should I contact a University who does these studies? Who?
Please Help! I'm a disabled combat veteran in need of answers. I am living with an 18 day, never ending migraine. I wake with it, I attempt to go to bed with it. The pain, cranial pressure, and fatigue will not fade. From a Run of Steroids, to Oxycontin, nothing brings relief. I am a survivor of a dozen serious concussions and two T.B.I's. (Med-Evac, Life Flighted With Loss Of Conciousness Twice. No Brain Bleeds.) My last serious T.B.I was 7 months ago. I seemed to recover at first. About six months after the car accident I began to have mild headaches at night. They now last around the clock and are medication & treatment resistant. I always feel sick to my stomach, irritable and feel like I have lost a third of my I.Q. I sleep but wake feeling even more fatigued! It's like waking up after having drank all night and remembering that I fell on my head drunk. I don't drink though. I take 2-3 long hot baths a day. I spend hours laying around on an ice pack. I feel like I am 90 years old. My recent CT was negative. I am waiting for an MRI. I guess it's been to long for post concussive syndrome. What could this be? Just all the added up traumas? How do I find relief? The pressure in my head is driving me crazy! Thanks. Sincerely, Desperate Veteran From California
I have had 2 major head injuries and a near drowning from 2 horrific auto crashes. The 1st I was a sleeping passenger and the driver fell asleep at the wheel and went through a commercial wharf. I was knock unconscious from hitting the dash board, ( no seat Belts in those days), I went from sleeping to unconscious and work up briefly and had to kick the back glass to escape from under water. The second happened 7 years later my father and I were run over by a drunk drive while jump starting my dads truck ..My father was killed instantly and I was in ICU for 4 days in a coma with another major head injury. The Trauma doctor who was an X MASH Army doctor from the Korean War..told me after the second head injury that he had a theory..he said I should tax my brain as much as possible to create new connections to stave off dementia and alzheimer's in my later years.. His Hypothesis proved to be correct...I began teaching myself how to play different musical instruments and I taught my self how to compose write and arrange music..how to record multiple tracks edit and mix in a digital format..very complicated when you are playing all of the tracks..I recorded some 30 songs 17 are ready for mastering. My next endeavor will be to write a novel..Taxing ones brain has worked for me.. I was loosing ground a few years after the accident but as the years went by and I used the Doctor's Hypothesis I began to see my mental abilities return..It doesn't work however for social interaction..just processing logic..which now I am very good at.
Thanks for helping bring awareness to these important brain injuries! I recently did some BRAINWAVE OPTIMIZATION (www.brainstatetech.com) and my anxiety went way down as did my anger outbursts etc.. Pat in Canada
I am getting concerned. I have had 83 fights as a boxer and now 10+ years later...migrains, anger, depression, thoughts to hurt others when they cross me, got into heavy gambling and drinking, short term memory lacking... I am in communication for case studies at Boston College
i am a 61 year old male who had a CVA infarction of the right occipital lobe. I suffered loss of peripheral vision, night vision & other nuerological problems. please advise if CVA can be reversed by drugs or therapy.
I'm a 34 year old female and firmly believe that I have CTE. Also a victim of domestic violence and two time car accident survivor. All injuries focused on the head still my MRIs show normal. In the last car accident I couldn't remember how to get home and walked around wetting my pants this lasted six months I was in my late twenties at this time. I sank into a deep depression and began acting out of character became out of touch with reality with day to day memory loss. Now I'm on medication Abilify and Paxil. This has helped greatly however still not who I used to be. Not sure if any other advice also hope this helps others. Audrey
Great information on Chronic Traumatic Encephalopathy!