What is Repetitive Head Injury Syndrome?
Chronic Traumatic Encephalopathy (CTE), originally known as “punch drunk” syndrome, was first identified in boxers in the 1920s. Since then, it has become a well-acknowledged issue in the field of sports medicine. CTE, also known as repetitive head injury syndrome, is a unique type of progressive brain disease often found in people involved in contact sports or those who work in the military. These environments can expose people to a higher risk of repeated head injuries.
What Causes Repetitive Head Injury Syndrome?
Having multiple head injuries is a key factor in developing certain health conditions. There’s a specific gene (the APOE epsilon-4 allele) that can make a person more likely to have a slowed mental function after experiencing repeated head injuries. This gene is just one element that can add to the risk.
The severity of future neurological symptoms – issues related to the brain and nervous system – also heavily relates to other factors. These include cognitive reserve (or the brain’s ability to solve problems), the age when the first head injury occurred (those that happened when less than 12), and the total number of head injuries a person has had.
Risk Factors and Frequency for Repetitive Head Injury Syndrome
Sports-related concussions are a significant issue, with around 4 million cases reported every year in the US alone. It’s particularly noticeable among boxers, with 17% of them experiencing neurological problems due to their sport. Research carried out at the Mayo Clinic Brain Bank found evidence of chronic traumatic encephalopathy (CTE), a type of brain damage, in 32% of athletes who took part in contact sports.
- 4 million sports-related concussions happen each year in the US.
- Boxers have a 17% chance of experiencing neurological issues from their sport.
- In one study, 32% of contact sports athletes were found to have CTE.
- In another study involving 177 former professional football players, up to 87% of them were diagnosed with CTE.
- There is high evidence of CTE among football players who donated their brains for research.
Signs and Symptoms of Repetitive Head Injury Syndrome
Repetitive head trauma is common in individuals who engage in contact sports or are in the military. According to Browne’s description of the disease process, this trauma can lead to a disease that progresses in three stages:
- First stage: Affective disturbances or emotional changes
- Second stage: Social instability and behavioural changes, which may show early signs of Parkinson’s disease
- Third stage: Cognitive dysfunction, dementia, and full-blown Parkinson’s disease
These changes are believed to mainly affect a part of the brain known as the Papez circuit.
Testing for Repetitive Head Injury Syndrome
To better understand what’s going on with your brain function, your doctor will conduct a thorough neurological evaluation, paying close attention to your mental status.
However, confirmation of Chronic Traumatic Encephalopathy, a brain condition often associated with repeated head trauma, can only be definitively diagnosed after death, through an autopsy and certain staining tests that can highlight abnormal proteins in the brain.
Even so, recent advances in medical imaging and the development of new biomarkers are promising. Techniques like FDDNP PET, a form of brain imaging, and markers such as CCL11 and CSF sTREM2, which are substances in the body that can indicate certain medical conditions, are now providing valuable information that can support the diagnosis.
Moreover, recent scientific findings have uncovered new features in the protein structures related to Chronic Traumatic Encephalopathy. This discovery may provide further insights and aid in the early detection and diagnosis of the condition.
Treatment Options for Repetitive Head Injury Syndrome
Unfortunately, there is no specific cure for chronic traumatic encephalopathy, a type of brain condition caused by repeated head injuries. However, researchers are exploring potential treatments, such as a new drug called salsalate. This medication is believed to help slow down the disease by controlling certain processes in the brain related to inflammation.
Even though there’s no definitive cure, there are ways to help manage the symptoms, similar to how other forms of dementia are treated. These management methods are known as supportive treatments, which are designed to help the patients live more comfortably despite the condition.
What else can Repetitive Head Injury Syndrome be?
Chronic traumatic encephalopathy, or CTE, is different from other similar conditions like Alzheimer’s and Lewy body dementia. One key difference is found in a particular pattern involving certain cells in the brain. In CTE, there is a buildup of a protein called tau within star-shaped brain cells (astrocytes) in certain parts of the brain’s surface.
Another characteristic that sets CTE apart is that a certain type of abnormal structure, known as neurofibrillary tangles (NFTs), tends to be bigger in people with CTE. Additionally, these larger NFTs tend to be found alongside clusters of a substance known as TDP-43.
What to expect with Repetitive Head Injury Syndrome
Most people experience a good prognosis, which means they generally have a positive outlook for recovery or treatment. However, studies have shown that former players have a higher probability of dying due to neurodegenerative diseases – they are 3 times more likely to die from such conditions compared to those who are healthy. Neurodegenerative diseases include conditions like Alzheimer’s that affect the brain and nerves, leading to a loss of mental and physical functions over time.
Another significant observation is the link between Chronic Traumatic Encephalopathy (CTE) and the development of early Parkinson’s dementia. CTE is a brain condition often found in athletes, military veterans, and others with a history of repetitive brain trauma. In this case, it’s related to the development of a specific type of dementia (Parkinson’s) at an earlier age than typically expected.
Possible Complications When Diagnosed with Repetitive Head Injury Syndrome
Chronic traumatic encephalopathy (CTE) is a condition that gets worse over time in about 68% of people who have it. Particularly, the patients with major symptoms like changes in behavior or mood can experience years without any progress in their condition. However, after a silence of about 11 to 14 years, their condition may start to worsen.
CTE is a neurodegenerative disorder, which means it gradually destroys the brain. The disease typically starts with social instability, then leads to changes in a person’s behavior and finally turns into dementia.
It’s important to note that people with CTE are at a higher risk of committing suicide.
List of Points:
- About 68% of patients experience a worsening of Chronic Traumatic Encephalopathy over time
- Patients primarily exhibiting mood or behavioral symptoms might see their condition remain static for several years
- After 11 to 14 years, the condition can start deteriorating
- CTE usually starts with social instability, progresses to behavioral changes, and ends with dementia
- People with CTE are at an increased risk for suicide
Preventing Repetitive Head Injury Syndrome
The most important step in dealing with chronic traumatic encephalopathy (a disease of the brain often found in people with a history of repetitive brain trauma) is to take preventive actions, especially among people who are at high risk. This includes creating a safe environment and sticking to guidelines for early detection of the disease. It’s also crucial to protect those at high risk from additional head impacts to reduce the chances of getting this disease. Unfortunately, there is no perfect solution for treating this condition right now, so management of the symptoms is the only option.
