From Dementia Pugilistica to Chronic Traumatic Encephalopathy

Ann McKee, MD
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Punk drunk, dementia pugilistica, post-traumatic encephalopathy, or chronic traumatic encephalopathy — same criteria of diagnosis, the same patterns of change seen in the brain.

So the term that was used in boxers really began in the 20s, 1928, is “punch drunk”, but then very quickly was called the dementia pugilistica of boxers. It had other names. Over the years people called it “post-traumatic encephalopathy” and then even in the 40s and 50s —1950s. People were talking about it as “chronic traumatic encephalopathy.” The idea was that the disease was just not restricted to boxers. It could be from brain trauma of many causes and so they felt that the chronic traumatic encephalopathy more broad and could represent that. And when you looked at the literature, after I had seen Paul Pender’s brain, yes, some people call it “dementia pugilistica” and some people called it “chronic traumatic encephalopathy”. They’re in mind indistinguishable. They have the same criteria of diagnosis, the same patterns of change. The original studies were done using silver stains, which is a stain that’s been around for over 100 years. It was, you know, how we originally diagnosed Alzheimer’s disease like in the 1900s. But as science has advanced, our techniques have advanced, and it was really in the 1980s that immunocytochemistry, or the ability to use an antibody to tag a protein and then color it became widely used. And so the original studies on dementia pugilistica were only silver stain studies. And that does not show the changes nearly as well as tau immunocyte chemistry. SO that was the thing that changed in the 90s really. People started looking at boxers and individuals with this CTE with tau and they discovered a pattern of abnormalities that had never been described before.
Posted on BrainLine January 11, 2019.