|Type of paper:||Literature review|
Chronic Traumatic Encephalopathy refers to "a neurodegenerative disease seemingly linked to a history of recurrent brain trauma" (Sparks et al., 2017). In that regard, athletes who are in repetitive collision are at a high risk of suffering from CTE. Researchers have discovered unique pathological characteristics of CTE and various clinical symptoms, currently referred to as Traumatic Encephalopathy Syndrome (TES). These symptoms mostly vary between individuals, do not affect individuals specifically affected by CTE pathology, and frequently correlate with numerous other factors (Mufson et al., 2018). This review provides a description of the behavioral, cognitive, and emotional changes connected to CTE. This is an account of the reason why various athletes are prone to these effects.
Symptoms and Characteristics of CTE
Chronic Traumatic Encephalopathy is connected to symptoms such as irritability, depression, aggression, impulsivity, short-term loss and suicidal tendencies that that start 8-10 years after encountering brain injury. As the disease advances, more serious neurological symptoms continue showing including Parkinsonism, dementia, and gait and speech defects. In its later stages, it is possible to mistake CTE and Alzheimer's disease due to their similarities. CTE variations are unique and easily differentiated from other tauopathies. There are various features of CTE including "medial temporal lobe, atrophy of the cerebral cortex, and cavum septum pellucidum, extensive p-tau-immunoreactive neurofibrillary tangles, and brainstem nuclei" (Sparks et al., 2017).
Effects and Diseases Associated with CTE
In 2002, Mike Webster, as Hall of Famer at Pittsburgh Steeler Centre died and an examination of his brain was conducted. The examination provided details of the findings carried out by Dr. Bennet Omalu of Pittsburgh's School of Medicine. The brain examination's results were the primary proof of the link that existed between the common "neurodegenerative" effects connected to Chronic Traumatic Encephalopathy and the occurrence of continuous brain injury as a result of playing football. 40% of the individuals who tested positive for the brain injury were the played defense and offense in their teams (Mckee et al., 2013). The findings from the investigation provided support for previous research that showed a replication of trifling head injury that happens often in football is the riskiest to players and not the infrequent brutal impact that leads to concussions.
Previously, while diagnosing a player with Chronic Traumatic Encephalopathy, it was common for the researchers to collect a significant brain sample from the athlete for the autopsy. A brain examination after death made early diagnosis impracticable and complex in the prevention and treatment of the neurodegenerative condition that results from recurring head injury. In attempting the identification of Chronic Traumatic Encephalopathy prior to death, an injection of a chemical into a number of former NFL by athletes by researchers was carried out.
The researchers then tried to examine the brains of the former NFL athletes who are still alive. In 2013, a report by the ESPN, which showed results of a brain scan on Fred McNeil and other athletes revealed an unusual protein accumulation of tau mainly in the brain area responsible for controlling emotions and memory. Dr. Gary Small revealed that even though the results are preliminary, "if they hold up in future studies, this may be an opportunity to identify CTE before players have symptoms so we can develop a preventative treatment" (Mckee et al., 2013).
Although a player who takes part in NFL has never experienced concussions, the effects of collisions may have severe psychological effects. It was noted by researchers that the brain's front region strained when there is head to head collision during games; the front of the brain is tasked with controlling behavior. Consequently, damaging it can lead to violence and mood swings. In the beginning, Chronic Traumatic Encephalopathy is dangerous and individuals who are affected initially find out the lack of memory, attention, and concentration that gradually leads to disorientation and confusion (Mufson et al., 2018). Eventually, the disease culminates in irrational behavior, lack of insight, depression, poor judgment, and dementia. There is less likelihood of NFL retirees to experience anger, and older athletes were diagnosed with memory-related diseases at higher intervals compared to the rest of the population.
Dr. McKee analyzed the brain tissue while Robert Stem conducted an interview with families of deceased NFL players concerning the behaviors and lives of the athletes. Whereas a treatment is used to be discovered for Chronic Traumatic Encephalopathy, the researchers are edging closer with the ongoing research and testing (The Sport Journal, 2018). After they were found to be suffering from CTE, a number of NFL players made a decision to go through therapy sessions with the hope of turning around the brain damage they had encountered. Even though there is still an exploration by researchers into the treatment of brain injury using hyperbaric chamber therapy, the NFL players who went through the therapy sessions have gained from oxygen treatment and brain imaging (The Sport Journal, 2018). Air pressure multiplies threefold greater than normal, inside the hyperbaric chamber, providing a boost in oxygen intake in the lungs and distributing it hence enabling the fight against bacteria as well as releasing growth factors which facilitate healing.
The regions that are predominantly affected when an individual has CTE are dorsolateral, superior, and lateral frontal cortices (Banks, 2017). These regions' pathology may be a sign of an underlying poor insight, the inadequacy of the executive function, and disinhibition that is common in the individuals even during CTE's initial stages. Pathology in the amygdala and the inferior temporal lobe could accelerate feelings of explosivity, impulsivity, irritability, and aggression that are mostly experienced as initial symptoms of CTE (Banks, 2017). Pathological involvement of the nucleus basalis may have an effect on the observed cognitive symptoms. Additionally, pathological involvement of the brainstem, inferior, and subcallosal frontal cortex might be linked to the regular symptoms of mood swings and depression. Hippocampal pathology, anterior thalamic, and mammillary contribute to memory loss, gradual dementia, and cognitive impairment (Banks, 2017).
Chronic Traumatic Encephalopathy "is a neurodegenerative condition that is associated with repetitive mild TBI." There are numerous problems that need more detailed investigation, for instance, the extent of head trauma that is causal, how frequent, what type, and whether some athletes are more prone compared to others. However, the preliminary findings on research have shown that some warfighters and players may experience long-term effects of TBI, which have been believed to be mild for a long time.
Banks, S. J. (2017). Chronic Traumatic Encephalopathy (CTE). In Neuro-Geriatrics (pp. 183-194). Springer, Cham.
McKee, A. C., Stein, T. D., Nowinski, C. J., Stern, R. A., Daneshvar, D. H., Alvarez, V. E., ... & Riley, D. O. (2013). The spectrum of disease in chronic traumatic encephalopathy. Brain, 136(1), 43-64.
Mufson, E. J., He, B., Ginsberg, S. D., Carper, B. A., Bieler, G. S., Crawford, F. C., ... & Perez, S. E. (2018). Gene Profiling of Nucleus Basalis Tau Containing Neurons in Chronic Traumatic Encephalopathy: A Chronic Effects of Neurotrauma Consortium Study. Journal of neurotrauma, (ja).
Sparks, P., Lawrence, T., & Hinze, S. (2017). Neuroimaging in the Diagnosis of Chronic Traumatic Encephalopathy: A Systematic Review. Clinical journal of sport medicine: official journal of the Canadian Academy of Sport Medicine.
The Sport Journal. (2018). Chronic Traumatic Encephalopathy (CTE) and Former National Football League Player Suicides. [online] Available at: http://thesportjournal.org/article/chronic-traumatic-encephalopathy-cte-and-former-national-football-league-player-suicides..
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