Why CTE Can Only Be Diagnosed Definitively Post Mortem

So, in my mind, the diagnosis of CTE is very well established and I think the preponderance of scientists and individuals would agree with that. We have a very definitive diagnosis for it pathologically. We have well-accepted criteria. They were defined by a panel of expert neuropathologists, and they even went to far as to say there was a pathognomonic lesion of CTE. This is a major advance for science in that a pathognomonic lesion means that if you see this specific lesion you can be sure that this is the diagnosis. This lesion is not seen in anything else. And so that was back in 2016 that we did that. So the definitive diagnosis of CTE made pathologically is clear. What we still don’t have is a way to be certain about the diagnosis during life. And that’s partially because the clinical symptoms are broad. They overlap with many other disorders. And also because we don’t have a diagnostic test. We don’t have a biomarker for CTE. So we can do blood tests. We can do spinal fluid tests. We can do imagine studies. But none of them is specific. They can be suggestive of CTE, but not specific for it. So that’s the holy grail. We’re still trying to get that diagnostic test.

The diagnosis of chronic traumatic encephalopathy is well established with clear criteria -- but only after death. Dr. Ann McKee explains why scientists are still struggling to diagnose CTE in the living.

Ann McKee

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.

Posted on BrainLine January 11, 2019.

Comments (2)

The specific leison can't be seen by any type of scan?

Not at this time. Diagnostics can be suggestive of CTE, but definitive diagnosis can only be made post-mortem.