What is CTE?

Since the movie Concussion, many people have heard the term CTE yet don’t know much about it.

Chronic Traumatic Encephalopathy is a degenerative brain disease that occurs when the person has a history of repetitive brain trauma. While this is most common in athletes and military veterans, it can occur to people of other professions as well. Research has also shown that kids that play contact sports before age 14 are prone to CTE at a younger age.

The myth about CTE is that it is caused by a person that is constantly concussed. However, that is not necessary. CTE requires that the person sustains hundreds if not thousands of impacts to the head. The hits do not have to cause concussions. A header in soccer, body check in sports, hitting your head on a poll. All of these examples are sub-concussive, yet contribute towards CTE.

So let’s say that Joe Smith is constantly hitting his head against a wall. Those hits are causing trauma to the cells within the brain. Unlike the cells in the rest of the body, nerve cells have a different form. Imagine the cells looking like barbells where the handle is the axon. This is the weakest point of the cell and where Tau molecules are located. If the hit is strong enough, the microtubules within the axons can break apart. This releases 3R and 4R Tau proteins that were once holding the microtubules together. 

Over time, it is possible for the Tau proteins to go through. A process called phosphorylation, a change in the Tau shape. This can cause the Tau proteins to tangle up and clump together. Eventually, there becomes a threshold where the clumps can continue to grow and spread, even without additional concussive hits. Once this happens, game over.

Left to right, brain PET scans of healthy control; former NFL player with suspected chronic traumatic encephalopathy (CTE); and person with Alzheimer’s disease (AD). Areas with highest levels of abnormal tau protein appear red/yellow; medium, green; and lowest, blue. Credit: Adapted from Barrio et al., PNAShttps://directorsblog.nih.gov/2015/04/21/brain-imaging-tackling-chronic-traumatic-encephalopathy/
Left to right, brain PET scans of healthy control; former NFL player with suspected chronic traumatic encephalopathy (CTE); and a person with Alzheimer’s disease (AD). Areas with highest levels of abnormal tau protein appear red/yellow; medium, green; and lowest, blue. Credit: Adapted from Barrio et al., PNAS https://directorsblog.nih.gov/2015/04/21/brain-imaging-tackling-chronic-traumatic-encephalopathy/

UCLA has also found that there is a unique pattern to the Tau deposits in CTE compared to Alzheimer’s. Using a PET scan, UCLA researchers were able to identify brain imaging patterns similar to the diseased brains that have already been diagnosed with CTE in live athletes. These patterns were strikingly different to healthy brains and those that had sustained one concussion. While this is a remarkable breakthrough in the research, scientists still cannot identify structural damages to brain cells immediately following a concussive or sub-concussive hit.

As research continues, we will do our best to update this page as much as possible.

So should I still let my child play football?

This is the worry that every parent has. Should you let your child play football, and if so when? Marcellus Wiley said it best, “when will you let your child start boxing?” But even if you do not allow your child to play, there is still a chance they can still develop CTE from another sport.

Another option to consider is the age they are with the amount of physical action occurring. Many youth leagues are starting to adopt new protocols to avoid hits and head trauma including soccer players wearing helmets, flag football until age 14, and pitchers wearing helmets. Speak to your physician and the athletic director if you have any questions or concerns. 

The information presented is to inform people about basic information regarding CTE. We are not a licensed medical practice and we do not pretend to be. We cannot be held liable for any misuse of this information to treat or diagnose an injury. If you become injured, contact a doctor or dial 911 immediately.