Chronic traumatic encephalopathy is a rare neurodegenerative disease that develops in people who have many years of hits to the head. We often hear about CTE in former football players, but it can also occur in rodeo riders, soldiers, or someone who has experienced years of intimate partner violence. Jeremy Tanner, MD is an Assistant Professor of Neurology at the Biggs Institute for Alzheimer’s and Neurodegenerative Diseases, and according to him, it’s not about how hard you’re hit, but how often and for how many years.
“Many do not experience clinical concussions where they lose consciousness,” Tanner said, “It's the years of exposure to head impact that seems to be the strongest correlate with CTE.”
People with CTE can develop problems with cognition, including memory loss and challenges to executive function, which can include difficulties with planning, organization, engaging in activities, and processing information to make decisions.
Assistant Professor of Neurology
Biggs Institute for Alzheimer’s and Neurodegenerative Diseases
The University of Texas Health Science Center at San Antonio
More troubling, however, can be what’s called neurobehavioral dysregulation.
“There can be difficulties with impulse control,” Tanner said. “Having a short fuse, irritability, anger, explosive outbursts.”
The neurobehavioral dysregulation in CTE has been linked with lethal violence, including a former NFL player who shot and killed six people and a professional wrestler who killed his wife and seven-year-old son. Both men died by suicide after the murders, and several other suicides have been linked to CTE.
In all of these cases, the person was diagnosed after their death. It is not currently possible to definitively diagnose CTE during life. Tanner hopes to change that and will lead the San Antonio arm of a multi-year study involving former college and professional football players.
“The goal is to be able to diagnose it during life,” Tanner said. “Whether it's using an MRI and looking for certain imaging features, using a clinical exam or cognitive testing and finding certain patterns that help us to identify when it's present, or testing some of the new blood-based biomarkers and using that to guide to guide future tests.”
Tanner said early intervention can make a difference.
“We don't have a way to slow the disease, but we have a way to help with the symptoms of the disease,” he said. “Our hope is, in the future, to be able to slow, stop and prevent the disease.”
“But the first step is understanding it and diagnosing it,” Tanner added.
The upcoming study is a follow-up to the Diagnose CTE Research Project, and will have a research site in San Antonio and four other locations across the country.
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