Looking Beyond CTE
In recent news there has been a lot of attention focused on Chronic Traumatic Encephalopathy (CTE). Every day, we learn more and more professional athletes (NFL, NHL, Professional Wrestling, Professional Soccer) that have suffered repeated concussions are now suffering disabling symptoms such as depression, sleep disorders, anxiety disorders, as well as memory and concentration problems (cognitive impairments).
Most of the well-publicized incidences involve NFL players. Increasingly, we hear of former NFL players that are suffering these symptoms in their 30’s, 40’s and 50’s. Some take their own lives in horrific acts of suicide. Others have even taken the lives of their family members before they commit suicide.
The common denominators are:
1. They were former professional athletes;
2. They suffered repeated concussions;
3. They began to suffer symptoms of cognitive decline and impairment and psychiatric issues while much younger than those who typically suffer overlapping symptoms due to Alzheimer’s.
Yet the media consistently fails to fully comprehend that:
1. Chronic Traumatic Encephalopathy (CTE) is only one possible outcome from suffering Traumatic Brain Injuries (TBI) such as concussive, or sudden acceleration/deceleration, forces to the brain. We know that professional athletes that play in the NFL or NHL are at great risks of suffering Traumatic Brain Injury (TBI).
2. The real and ultimate damage to the brain is often due to the brain suddenly moving back and forth (sudden acceleration and deceleration) within the skull, and not due to actual blows to the head, as most would have you believe or misunderstand.
3. Sudden acceleration and deceleration of the brain can cause debilitating symptoms of Traumatic Brain Injury (TBI) such as cognitive impairment and psychiatric issues without resulting in Chronic Traumatic Encephalopathy (CTE). It just happens that CTE is one of the more severe and identifiable consequences of Traumatic Brain Injury (TBI). The reason that CTE is more identifiable includes the findings of Tau protein within the brains of those suffering CTE.
4. We must stop thinking that Chronic Traumatic Encephalopathy (CTE) is the only permanent brain damage from sudden acceleration and deceleration of the brain. This violent movement can and often does cause mild Traumatic Brain Injuries (mTBI) by causing Diffuse Axonal Damage (DAI) or Traumatic Axonal Damage (TAI). Symptoms of depression, anxiety, sleep disorder, and cognitive impairments such as short term memory problems, concentration impairments and decision making impairments are often related to Diffuse Axonal Damage (DAI) or Traumatic Axonal Damage (TAI). A person can suffer Diffuse Axonal Damage (DAI) or Traumatic Axonal Damage (TAI), and all of the resulting debilitating effects, without ever suffering from CTE.
5. Trying to understand why some former professional athletes suffer Traumatic Brain Injury (TBI) and wind up with Chronic Traumatic Encephalopathy (CTE), while others that play the same sport do not, is like trying to understand why everyone that smokes does not develop cancer. It is a pointless exercise and basically impossible due to a myriad of factors, including genetics, the exact types of concussions, the proximity of repeated concussions to each other, the nature and location of the resulting lesions, etc.
Many articles about CTE question whether psychiatric and/or cognitive impairment is due to CTE or other possibilities such as Alzheimer’s Disease. In order to determine whether cognitive impairments and/or psychiatric issues are causally related to TBI or Alzheimer’s, we need only consider the age of the athlete. Approximately 95% of people who suffer from Alzheimer’s are 65 and older. The fact that these athletes are significantly younger when they start to suffer symptoms should rule out Alzheimer’s. But given that athletes have often been playing Junior High, H.S., college, and professional football (15-20 years on average) and have suffered multiple concussions along the way should conclusively rule out Alzheimer’s.
It’s silly to consider Alzheimer’s as a possible explanation for those suffering TBI and its sequelae, even in those cases that do not result in CTE.