DAILY IMPACT: A LOOK

INTO CHRONIC Jalin Couper &

Jason
TRAUMATIC Freeman

ENCEPHALOPATHY
 OVERVIEW

Concussions
What is CTE?
Stages of CTE
First Documented Cases
Boston Universitys Research
Case Studies:
Boxing
Football
Hockey
Future Research
 CONCUSSION

Concussions are a brain injury and are defined

as a complex pathophysiological process
affecting the brain, induced by biomechanical
forces.
80-90% are resolved in 7-10 days
Symptoms may include:
Headache
Loss of consciousness
Behavioural changes
Cognitive impairment
Sleep disturbances
 WHAT IS CHRONIC TRAUMATIC
ENCEPHALOPATHY (CTE)?

CTE is defined as the long-term neurological

consequence of repetitive head trauma, ranging from
concussive to sub-concussive hits.
Main Symptoms include
Memory disturbances
Behavioural and personality changes
Parkinsonism
Speech impediments
Gait abnormalities
 TAU PROTEIN

Tau is a protein that works to stabilize

microtubules located in the neurons of the
central nervous system
Mictrotubules: transport nutrients, organelles
and other essential material from body to the
axon
Neurofibrillary Tangles: when tau protein
separates from microtubules and form tangles
this stops transmissions along neurons .
COMPARISON
BET WEEN
HEALTH AND
UNHEALTHY
NEURONS
COMPARISON
 3 STAGES OF CTE

1.First stage is characterized by affective

disturbances and psychotic symptoms.
2.Second stage social irritability, erratic
behavior, memory loss, and initial symptoms
of Parkinson disease are present.
3.Third stage is described as general cognitive
dysfunction progressing to dementia and is
often accompanied by Parkinsonism along
with speech and gait abnormalities.
 FIRST DOCUMENTED

First discovered in 1928 by Dr. Martland, described it as

Punch Drunk where it was later defined as Dementia
Pugislistica due to symptoms first being found in boxers
Punch drunk is a definitive brain injury
due to single or repeated blows to the
head or jaw which results in multiple
hemorrhages in the deeper portions of
the cerebrum
It was later renamed CTE in the 1960s as it was found in
multiple sports besides boxing
 BOSTON UNIVERSIT Y

Established a CTE research center in 1996

Conduct research on
Neuropathology & Pathogenesis
Clinical presentation
Genetics & other risk factors
Biomarkers
Methods of detection during life
Prevention & treatment
DETECT Study
Diagnosis and Evaluating Traumatic Encephalopathy Using Clinical Tests
LEGEND Study
Longitudinal Examination to Gather Evidence of Neurodegenerative Disease
 BOXING

Estimated that approximately 17% of retired

professional boxers will express some signs of CTE.
Boxers in the early 1900s would participate in 400-
700 fights throughout their career, some would fight
in 30-40 fights a day.
 73 YEAR OLD BOXER

Started boxing at age 11, fought as an amateur for 9 years

and professionally for 3 years, retiring at the age of 33.
He developed increasing levels of anxiety, aggression,
agitation and would even periodically become verbally and
physically aggressive towards his wife.
After neurological testing he was found to be disoriented,
inattentive, with poor immediate and remote memory along
with impaired visuospatial skills. Neuropsychological testing
further showed deficits in all cognitive domains.
By 70 symptoms such as severe swallowing difficulties,
speech impediments and a slow, shuffling gait began to
arise
 AMERICAN FOOTBALL

Interest to CTE researchers due to amount and magnitude of

impacts in a season
420-2492 impacts in a college football season
Potential for 2000 impacts for a high school football player
Upwards of 18 000 impacts before playing pro
 JOHN GRIMSLEY
A M YG DALA & T E M P ORAL C OR T E X
 18-YEAR-OLD

Earliest evidence of CTE ever recorded

Multi-sport athlete including high school football
Although asymptomatic, shows CTE development is
independent of age
18-YEAR-OLD
F RON TAL C ORT E X
 COMMON INCIDENTS

please, see that my brain is given to the NFLs brain bank

 ICE HOCKEY

Relatively new in the CTE research

4 confirmed cases in former NHL players
Role of fighting and hits to the head
 DEREK BOOGAARD

Died at the age of 28 from drug overdose

Played 6 seasons in the NHL for the Minnesota Wild & New
York Rangers
Played the enforcer role for his team with 70 career fights
DEREK BOOGAARD
F RON TAL C ORT E X
FUTURE RESEARCH