User:Carriefish2021/sandbox

Although a definite cause for Chronic Traumatic Encephalopathy is unknown the research has started to point towards the development of many separate mild traumatic brain injuries. One of the only ways to diagnose an individual with chronic traumatic encephalopathy is to perform an autopsy of the brain following death so the amount of cases among the general population is unknown. According to an article authored by Gardner and Yaffe entitled “Epidemiology of mild traumatic brain injury and neurodegenerative disease”, there has only been one reported case of chronic traumatic encephalopathy in an adolescent athlete when he died suddenly and for no apparent reason so the coroner completed a full autopsy. Chronic traumatic encephalopathy is not only seen in athletes that have suffered many mild traumatic brain injuries. It is also seen in people who served tours in the military or people who have been in multiple car accidents (Gardner & Yaffe, 2015). Some issues that are seen in the ability to conduct an epidemiological study on chronic traumatic encephalopathy is the lack of agreement on the criteria for CTE, differing definitions of the disease, measurements of exposure to mild traumatic brain injuries are hard to achieve, and recall bias (Gardner & Yaffe, 2015). According to the largest modern autopsy series that included a total of 85 patients composed of athletes and military veterans and there was identifiable evidence that 80% had CTE (Gardner & Yaffe, 2015).

Gardner RC, Yaffe K. Epidemiology of mild traumatic brain injury and neurodegenerative disease. Mol Cell Neurosci. 2015 Mar 5;66(0):75-80

As stated above CTE is usually only diagnosed after death. Therefore, “descriptions of the clinical features of CTE are based almost entirely on interviews with family members of deceased individuals who were diagnosed with CTE after death” (CDC, 2019). Many people do notice changes of their loved ones when they are getting close to the end. They notice changes in their thinking, feeling, movement and behavior. The CDC has found links in people who have CTE are usually diagnosed with depression or anxiety first (CDC, 2019). The CDC does state they are not certain which symptoms are directly related to CTE because many of these symptoms can also be found in people with CTE.

Center for Disease Control. Answering questions about chronic traumatic encephalopathy (CTE), information for healthcare providers. Center for Disease Control Heads Up. 2019 Jan. 1-4

Concussion or mild traumatic brain injury (mTBI) is one of the most common neurologic disorders accounting for approximately 90% of all brain injuries sustained (Saulle M, Greenwald BD, 2012). CTE is common among the athletic population because of the high prevalence of concussions;  “estimated 1.6–3.8 million sport-related concussion annually in the USA” (Saulle M, Greenwald BD, 2012). This number could be higher because many people do not report their symptoms or may not even know they could have a concussion. This could be due to athletes not wanting to be taken out of the game or pressure by the coach/ family members to continue with playing. Also, athletes who have had concussions before may underreport their symptoms to the athletic trainer because they know it takes about six weeks to return back to play from a concussion. “In a 2009 review of CTE, McKee et al. found that 51 neuropathologically diagnosed cases of CTE 46 (90%) occurred in athletes. Specifically, athletes participating in American football, boxing, soccer, and hockey comprise the majority of cases” (Saulle M, Greenwald BD, 2012). It is unclear the incidence of CTE as well as at what age it can start. Many researchers do think CTE is based on sport, position, length of career, number of head injuries, age of first head injury and genetics.

Saulle M, Greenwald BD. Chronic Traumatic Encephalopathy: A Review. Rehabilitation Research and Practice. 2012 April 10;2012:1-9.

Family members of people that suffered from CTE may notice a change in their loved ones personality. Behavioral changes, memory deficits, cognitive impairments and executive dysfunction are associated with CTE (Daniel H, Daneshvar, 2015). These effects slowly progress over decades. The long term effects of Traumatic Brain Injuries are becoming more understood due to research. As for CTE, there are large gaps of knowledge when it comes to the incidence and prevalence (Daniel H, Daneshvar, 2015). To close these knowledge gaps more research needs to be done on generic risk factors, prior history of head, age of exposure and much more (Daniel H, Daneshvar, 2015).

Daniel H, Daneshvar. Post-Traumatic Neurodegeneration and Chronic Traumatic Encephalopathy. 2015 March 7.