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diagnosis of chronic traumatic encephalopathy

Zachary C Merz, Ryan Van Patten, John Lace
OBJECTIVE: The current study aimed to assess current broad traumatic brain injury (TBI)-related knowledge in the general public, as well as understanding regarding specific TBI-related conditions including post-concussive syndrome (PCS) and chronic traumatic encephalopathy (CTE). METHODS: Data were collected from 307 domestic and 73 international individuals via online researcher-developed survey instrumentation utilizing the Amazon Mechanical Turk marketplace, a recently developed website that allows for a streamlined process of survey-based participant recruitment and data collection...
October 20, 2016: Archives of Clinical Neuropsychology: the Official Journal of the National Academy of Neuropsychologists
D L Dickstein, M Y Pullman, C Fernandez, J A Short, L Kostakoglu, K Knesaurek, L Soleimani, B D Jordan, W A Gordon, K Dams-O'Connor, B N Delman, E Wong, C Y Tang, S T DeKosky, J R Stone, R C Cantu, M Sano, P R Hof, S Gandy
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder most commonly associated with repetitive traumatic brain injury (TBI) and characterized by the presence of neurofibrillary tangles of tau protein, known as a tauopathy. Currently, the diagnosis of CTE can only be definitively established postmortem. However, a new positron emission tomography (PET) ligand, [(18)F]T807/AV1451, may provide the antemortem detection of tau aggregates, and thus various tauopathies, including CTE. Our goal was to examine [(18)F]T807/AV1451 retention in athletes with neuropsychiatric symptoms associated with a history of multiple concussions...
2016: Translational Psychiatry
Henrik Zetterberg, Kaj Blennow
Diagnostic and prognostic biomarkers for mild traumatic brain injury (TBI), also known as concussion, remain a major unmet clinical need. Moderate to severe TBI can be diagnosed definitively by clinical assessment and standard neuroimaging techniques that detect the gross damage to the brain parenchyma. Diagnostic tools for mild TBI are lacking and, currently, the diagnosis has to be made on clinical grounds alone, because most patients show no gross pathological changes on CT. Most patients with mild TBI recover quickly, but about 15% develop an ill-defined condition called postconcussive syndrome (PCS)...
October 2016: Nature Reviews. Neurology
Shunsuke Koga, Dennis W Dickson, Kevin F Bieniek
Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disorder associated with repetitive traumatic brain injury. Multiple system atrophy (MSA) is a Parkinsonian disorder that can result in repetitive falls with associated head trauma. We hypothesized that patients with neurodegenerative disorders like MSA could develop CTE pathology. Therefore, we assessed CTE pathology in 139 MSA cases in our brain bank. Sections from convexity cerebral cortices were screened by immunohistochemistry with anti-phospho-tau antibody...
October 2016: Journal of Neuropathology and Experimental Neurology
Tad Seifert
With regard to persistent posttraumatic headache, there is legitimate concern that duration of symptoms may have an impact on the efficacy of future treatment attempts. Without neuropathologic confirmation, a clinical diagnosis of chronic traumatic encephalopathy cannot be made with a high degree of confidence. Sport-related headaches are challenging in a return-to-play context, because it is often unclear whether an athlete has an exacerbation of a primary headache disorder, has new-onset headache unrelated to trauma, or is in the recovery phase after concussion...
August 2016: Neurologic Clinics
Nicole Reams, James T Eckner, Andrea A Almeida, Andrea L Aagesen, Bruno Giordani, Hank Paulson, Matthew T Lorincz, Jeffrey S Kutcher
IMPORTANCE: Chronic traumatic encephalopathy (CTE) refers to pathologic changes that have been found in some individuals with a history of repetitive traumatic impact to the head (hereinafter referred to as head trauma). These changes cannot be assessed during the clinical evaluation of a living patient. OBSERVATIONS: The neuropathologic features, taxonomy, history, role of biomarkers in diagnosis, and existing criteria of CTE are reviewed. Previous criteria have been proposed to approach the living patient; however, a unified, specific approach is needed for the practicing clinician...
June 1, 2016: JAMA Neurology
James Pan, Ian D Connolly, Sean Dangelmajer, James Kintzing, Allen L Ho, Gerald Grant
Brain injuries are becoming increasingly common in athletes and represent an important diagnostic challenge. Early detection and management of brain injuries in sports are of utmost importance in preventing chronic neurological and psychiatric decline. These types of injuries incurred during sports are referred to as mild traumatic brain injuries, which represent a heterogeneous spectrum of disease. The most dramatic manifestation of chronic mild traumatic brain injuries is termed chronic traumatic encephalopathy, which is associated with profound neuropsychiatric deficits...
April 2016: Neurosurgical Focus
Robert A Stern, Yorghos Tripodis, Christine M Baugh, Nathan G Fritts, Brett M Martin, Christine Chaisson, Robert C Cantu, James A Joyce, Sahil Shah, Tsuneya Ikezu, Jing Zhang, Cicek Gercel-Taylor, Douglas D Taylor
BACKGROUND: Chronic traumatic encephalopathy (CTE) is a tauopathy associated with prior exposure to repetitive head impacts, such as those incurred through American football and other collision sports. Diagnosis is made through neuropathological examination. Many of the clinical features of CTE are common in the general population, with and without a history of head impact exposure, making clinical diagnosis difficult. As is now common in the diagnosis of other neurodegenerative disorders, such as Alzheimer's disease, there is a need for methods to diagnose CTE during life through objective biomarkers...
2016: Journal of Alzheimer's Disease: JAD
S Sivak, V Nosal, M Bittsansky, J Dluha, D Dobrota, E Kurca
Traumatic brain injury (TBI) remains a major public health and socio-economic problem, and 70-90% of all TBIs are classified as mild. Mild TBIs and concussions are mostly considered to be non-serious conditions with symptoms subsiding within a few days or weeks. However in 10-15% of patients, the symptoms persist one year after concussion and mostly include headache, fatigue, irritability, and cognitive problems (e.g. memory, concentration). These persisting symptoms negatively influence patient daily activities as postconcussion syndrome (PCS)...
2016: Bratislavské Lekárske Listy
Teena Shetty, Avtar Raince, Erin Manning, Apostolos John Tsiouris
CONTEXT: The diagnosis of chronic traumatic encephalopathy (CTE) can only be made pathologically, and there is no concordance of defined clinical criteria for premorbid diagnosis. The absence of established criteria and the insufficient imaging findings to detect this disease in a living athlete are of growing concern. EVIDENCE ACQUISITION: The article is a review of the current literature on CTE. Databases searched include Medline, PubMed, JAMA evidence, and evidence-based medicine guidelines Cochrane Library, Hospital for Special Surgery, and Cornell Library databases...
January 2016: Sports Health
Laura B Eisenmenger, Eugene J Huo, John M Hoffman, Satoshi Minoshima, Manuela C Matesan, David H Lewis, Brian J Lopresti, Chester A Mathis, David O Okonkwo, James M Mountz
In this review we present the most recent advances in nuclear medicine imaging as a diagnostic and management tool for dementia. The clinical diagnosis of dementia syndromes can be challenging for physicians, particularly in the early stages of disease. Given the growing number of individuals affected by dementia, early and accurate diagnosis can lead to improved clinical management of patients. Although tests are available for exclusion of certain causes of cognitive impairment, the results rarely allow the clinician to make a definitive diagnosis...
January 2016: Seminars in Nuclear Medicine
Ann C McKee, Nigel J Cairns, Dennis W Dickson, Rebecca D Folkerth, C Dirk Keene, Irene Litvan, Daniel P Perl, Thor D Stein, Jean-Paul Vonsattel, William Stewart, Yorghos Tripodis, John F Crary, Kevin F Bieniek, Kristen Dams-O'Connor, Victor E Alvarez, Wayne A Gordon
Chronic traumatic encephalopathy (CTE) is a neurodegeneration characterized by the abnormal accumulation of hyperphosphorylated tau protein within the brain. Like many other neurodegenerative conditions, at present, CTE can only be definitively diagnosed by post-mortem examination of brain tissue. As the first part of a series of consensus panels funded by the NINDS/NIBIB to define the neuropathological criteria for CTE, preliminary neuropathological criteria were used by 7 neuropathologists to blindly evaluate 25 cases of various tauopathies, including CTE, Alzheimer's disease, progressive supranuclear palsy, argyrophilic grain disease, corticobasal degeneration, primary age-related tauopathy, and parkinsonism dementia complex of Guam...
January 2016: Acta Neuropathologica
Ryan C Turner, Brandon P Lucke-Wold, Aric F Logsdon, Matthew J Robson, John M Lee, Julian E Bailes, Matthew L Dashnaw, Jason D Huber, Anthony L Petraglia, Charles L Rosen
Despite the extensive media coverage associated with the diagnosis of chronic traumatic encephalopathy (CTE), our fundamental understanding of the disease pathophysiology remains in its infancy. Only recently have scientific laboratories and personnel begun to explore CTE pathophysiology through the use of preclinical models of neurotrauma. Some studies have shown the ability to recapitulate some aspects of CTE in rodent models, through the use of various neuropathological, biochemical, and/or behavioral assays...
2015: Frontiers in Neurology
M Dani, D J Brooks, P Edison
Aggregated tau protein is a major neuropathological substrate central to the pathophysiology of neurodegenerative diseases such as Alzheimer's disease (AD), frontotemporal dementia, progressive supranuclear palsy, corticobasal degeneration and chronic traumatic encephalopathy. In AD, it has been shown that the density of hyperphosphorylated tau tangles correlates closely with neuronal dysfunction and cell death, unlike β-amyloid. Until now, diagnostic and pathologic information about tau deposition has only been available from invasive techniques such as brain biopsy or autopsy...
June 2016: European Journal of Nuclear Medicine and Molecular Imaging
Tej D Azad, Amy Li, Arjun V Pendharkar, Anand Veeravagu, Gerald A Grant
BACKGROUND: Few neurologic diseases have captured the nation's attention more completely than chronic traumatic encephalopathy (CTE), which has been discovered in the autopsies of professional athletes, most notably professional football players. The tragic case of Junior Seau, a Hall of Fame, National Football League linebacker, has been the most high-profile confirmed case of CTE. Here we describe Seau's case, which concludes an autopsy conducted at the National Institutes of Health that confirmed the diagnosis...
February 2016: World Neurosurgery
Jesse Mez, Todd M Solomon, Daniel H Daneshvar, Lauren Murphy, Patrick T Kiernan, Philip H Montenigro, Joshua Kriegel, Bobak Abdolmohammadi, Brian Fry, Katharine J Babcock, Jason W Adams, Alexandra P Bourlas, Zachary Papadopoulos, Lisa McHale, Brent M Ardaugh, Brett R Martin, Diane Dixon, Christopher J Nowinski, Christine Chaisson, Victor E Alvarez, Yorghos Tripodis, Thor D Stein, Lee E Goldstein, Douglas I Katz, Neil W Kowall, Robert C Cantu, Robert A Stern, Ann C McKee
INTRODUCTION: Chronic traumatic encephalopathy (CTE) is a progressive neurodegeneration associated with repetitive head impacts. Understanding Neurologic Injury and Traumatic Encephalopathy (UNITE) is a U01 project recently funded by the National Institute of Neurological Disorders and Stroke and the National Institute of Biomedical Imaging and Bioengineering. The goal of the UNITE project is to examine the neuropathology and clinical presentation of brain donors designated as "at risk" for the development of CTE based on prior athletic or military exposure...
October 12, 2015: Alzheimer's Research & Therapy
Mark Sundman, P Murali Doraiswamy, Rajendra A Morey
Traumatic brain injury (TBI) has been increasingly accepted as a major external risk factor for neurodegenerative morbidity and mortality. Recent evidence indicates that the resultant chronic neurobiological sequelae following head trauma may, at least in part, contribute to a pathologically distinct disease known as Chronic Traumatic Encephalopathy (CTE). The clinical manifestation of CTE is variable, but the symptoms of this progressive disease include impaired memory and cognition, affective disorders (i...
2015: Frontiers in Neuroscience
Victor L Villemagne, Nobuyuki Okamura
In vivo tau imaging allows a deeper understanding of tau deposition in the brain, providing insights into the causes, diagnosis and treatment of primary and secondary tauopathies such as Alzheimer's disease, progressive supranuclear palsy, corticobasal syndrome, chronic traumatic encephalopathy, and some variants of frontotemporal lobar degeneration. The cross-sectional and longitudinal assessment of the temporal and spatial patterns of tau deposition in the brain will allow a better understanding of the role tau plays in ageing as well as its relationship with cognition, genotype, and neurodegeneration...
February 2016: Current Opinion in Neurobiology
Raquel C Gardner, Katherine L Possin, Christopher P Hess, Eric J Huang, Lea T Grinberg, Amber L Nolan, Brendan I Cohn-Sheehy, Pia M Ghosh, Serggio Lanata, Jennifer Merrilees, Joel H Kramer, Mitchel S Berger, Bruce L Miller, Kristine Yaffe, Gil D Rabinovici
In the aftermath of multiple high-profile cases of chronic traumatic encephalopathy (CTE) in professional American football players, physicians in clinical practice are likely to face an increasing number of retired football players seeking evaluation for chronic neurobehavioral symptoms. Guidelines for the evaluation and treatment of these patients are sparse. Clinical criteria for a diagnosis of CTE are under development. The contribution of CTE vs other neuropathologies to neurobehavioral symptoms in these players remains unclear...
August 2015: Neurology. Clinical Practice
Melanie Dani, Paul Edison, David J Brooks
Abnormally aggregated tau protein is central to the pathophysiology of Alzheimer's disease, frontotemporal dementia variants, progressive supranuclear palsy, corticobasal degeneration and chronic traumatic encephalopathy. The post-mortem cortical density of hyperphosphorylated tau tangles correlates with pre-morbid cognitive dysfunction and neuron loss. Selective PET ligands including [18F]THK5117, [18F]THK5351, [18F]AV1451 (T807) and [11C]PBB3 now provide in vivo imaging information about the timing and distribution of tau in the early phases of neurodegenerative diseases...
January 2016: Parkinsonism & related Disorders
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