Chronic Traumatic Encephalopathy

Katherine W. Turk, MD; Andrew E. Budson, MD p. 187-207 February 2019, Vol.25, No.1 doi: 10.1212/CON.0000000000000686
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PURPOSE OF REVIEW: This article provides a discussion on the current state of knowledge of chronic traumatic encephalopathy (CTE), with an emphasis on clinical features and emerging biomarkers of the condition.

RECENT FINDINGS: The results of several large brain bank case series among subjects with a history of contact sports or repetitive head trauma have indicated that a high frequency of CTE may exist in this population. However, the true prevalence of CTE among individuals with a history of head trauma remains unknown, given that individuals who experienced cognitive, behavioral, and mood symptoms during life are more likely to have their brains donated for autopsy at death and epidemiologic studies of the condition are lacking. Neuropathologic consensus criteria have been published. Research-based clinical criteria have been proposed and are beginning to be applied, but the definitive diagnosis of CTE in a living patient remains impossible without effective biomarkers for the condition, which is an active area of study.

SUMMARY: The field of CTE research is rapidly growing and parallels many of the advances seen for other neurodegenerative conditions, such as Alzheimer disease decades ago.

Address correspondence to Dr Katherine W. Turk, VA Boston Healthcare System, 150 S Huntington Ave, 151-C, Jamaica Plain, MA 02130, kturk@bu.edu.

RELATIONSHIP DISCLOSURE: Dr Turk receives research/grant support from the Alzheimer’s Association. Dr Budson has served as a consultant for Axovant Sciences, Inc, and Eli Lilly and Company and has received personal compensation for speaking engagements from Eli Lilly and Company. Dr Budson receives research/grant support from the US Department of Veterans Affairs (I01CX000736) and publishing royalties from Elsevier and Oxford University Press.

UNLABELED USE OF PRODUCTS/INVESTIGATIONAL USE DISCLOSURE: Drs Turk and Budson discuss the unlabeled/investigational use of several classes of medications for chronic traumatic encephalopathy, including cholinesterase inhibitors for memory-related issues, selective serotonin reuptake inhibitors for mood and behavioral issues, memantine for attentional issues in those with advanced dementia, and atypical antipsychotics for those who are disinhibited and violent.

© 2019 American Academy of Neurology.