Dr. Ann McKee: Are Some People More Susceptible to CTE?

Genes, sleep, an active mind, and when a person starts playing football may all play a factor in the development of chronic traumatic encephalopathy (CTE). Dr. Ann McKee explains what researchers have learned, and what's on the horizon. 

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Susceptibility markers and genetic resistance markers. We’ve got some information. We’re working on that. The genetics of it are likely to be complicated. It’s not going to be a single gene that says oh you shouldn’t play football, but it’s probably many genes. There’s some early evidence that it’s some of the genes that regulate inflammation. We’re learning that inflammation is a key component to this disease. So some individuals have a difference in the way they react to the injury and they have more inflammation, and that may make them potentially more susceptible. We’re also looking at genes that regulate sensitivity or susceptibility to Alzheimer’s, and we’re seeing some minor overlaps. It’s not as strong as it is in Alzheimer’s. We’re also looking at the clearance system. The brain actually at night clears abnormal proteins. Part of a clearance system called the glymphatics. It sort of drains all the bad stuff out of your brain. It’s most active when you’re sleeping, which is a reason to get a lot of sleep at night. And we think it’s altered in people with CTE. So, these are clues to not only why people get it, but how we can maybe attack it therapeutically. So we’re looking at that. And that’s, again, for another day. We’re not quite there yet. But things we’re also looking at are like things like when the person starts to play football. And we have done some early work on looking at professional football players who start before the age of 12 playing tackle and comparing them to individuals who start after the age of 12. And what we’re finding is the pathology is not different between those two groups, surprisingly because we thought the pathology might be different. But we are seeing that the ones who start earlier, develop symptoms earlier. So it seems to lower their resistance to the pathology. They become symptomatic a decade earlier or 13 years earlier than their counterparts. They don’t have as much resilience. For whatever reason their what we call “cognitive reserve” is lower. And we also know that people that have high occupational attainment, meaning they use their brain, they stay involved in mental activities. If you compare those with people who have high occupational attainment, educational attainment, to those who play tackle football and don’t have that same level of education and occupation. The low level of occupational attainment is associated with earlier onset of clinical symptoms. So another thing that lowers your resistance to disease. This video was produced by BrainLine thanks to generous support from the Infinite Hero Foundation.
Posted on BrainLine January 4, 2019.

This video was produced by BrainLine thanks to generous support from the Infinite Hero Foundation.

© 2019 BrainLine

About the author: Ann McKee, MD

Ann McKee, MD is the chief neuropathologist for the Framingham Heart Study and the Boston University-based Centenarian Study. She is also the chief neuropathologist for the Boston-based Veterans Administration Medical Centers and for the Sports Legacy Institute.

Ann McKee