Diagnosing chronic traumatic encephalopathy (CTE) during life is crucial for the development of therapies and determining how common the disease is among people exposed to recurrent head injuries due to contact sports, military service, and physical violence.
Although the ability to diagnose CTE before death has remained elusive, researchers at Boston University School of Medicine (BUSM) have shown for the first time that progressive memory loss and executive function problems, the ability to focus, follow instructions, and solve problems are more useful in predicting CTE pathology than mood and behavior symptoms.
CTE is a progressive brain disease. Clinically, impulsivity, explosiveness, depression, memory impairment, and executive dysfunction have been reported in the disease.
This study significantly improves our understanding of how to diagnose CTE in life, suggesting that progressive symptoms of memory and executive functions are particularly valuable for predicting CTE pathology. “
Jesse Mez, Ph.D. Med., MS, Corresponding Author, Director, Clinical Core Center for Alzheimer’s Disease at Boston University (BU) and BU CTE Center Researcher
In 2014, criteria for traumatic encephalopathy syndrome (TES) were proposed for use in clinical trials for the diagnosis of CTE in life. In an attempt to assess the reliability and diagnostic validity of the TES criteria, a team of clinicians interviewed family members of 336 brain donors exposed to repeated head blows to contact sports, military service, and / or physical violence who were at risk for CTE. Neuropathologists then assessed the brain for CTE pathology. An expert panel of clinicians then determined whether the criteria (TES) were met (i.e., the proposed criteria for the diagnosis of CTE in life). They found that when individual components of the TES criteria were assessed, cognitive symptoms, but not mood / behavior or motor symptoms, were significantly associated with CTE pathology.
According to Mezu, this research brings this area of the possibility of diagnosing CTE in life, and not exclusively after death, as is currently the case. “Our study provides physicians with information on which symptoms most predict CTE pathology,” he adds.
Although having reliable and valid criteria for diagnosing CTE in life will improve patient care and accelerate the development of effective therapies, Mez points out that the criteria did not have good enough results to move to the clinic immediately. However, these findings have been used by an international team of experts to develop improved TES criteria.
Boston University School of Medicine