Researchers at the Boston University Center for the Study of Traumatic Encephalopathy published the largest case study to date describing 68 cases of chronic traumatic encephalopathy in deceased athletes and military veterans with repetitive brain trauma.
Christine Baugh, a co-author of the study and research coordinator at CSTE, said in a phone interview that the study is important to the undergraduates at BU, since there is a large population of athletes.
“It’s important for students to think, ‘This is something that can affect me or us,’ it’s not just Alzheimer’s disease which affects someone far down the line,” Baugh said.
The study, published Monday in the December issue of the medical journal, “Brain,” is the largest case series of CTE, doubling the number of CTE cases published internationally.
“This is the largest case study that has been published to date in regards to CTE,” Baugh said. “This paper is the first of its kind, not only does it discuss the disease, but also the different stages of the disease–from the most mild form to the most afflicted stage.”
The research focused on the association of repetitive brain trauma with CTE, a slowly progressive degenerative brain disease, Baugh said. Brain trauma includes concussions and sub-concussive exposures, especially those in military combat and contact sports, such as football and hockey.
“This study extends our knowledge concerning the spectrum of the clinical and pathological abnormalities associated with CTE,” said Dr. Ann McKee, a professor at BU School of Medicine and director of the Neuropathology Service for VA New England Healthcare System and co-director of the CSTE, in the press release.
McKee led the study conducted by the BU CSTE with the Veterans Affairs Boston Healthcare System, in collaboration with the Sports Legacy Institute.
The researchers examined 68 cases of CTE in deceased men between the ages of 17 and 98, half of which were former professional football players, according to the release. All but four of the cases were athletes. A number of the cases were veterans, some with an athletic background.
The study also included one individual who had a history of damaging head-banging habits. This individual led the researchers to believe repetitive brain trauma is significant enough to cause CTE in some cases, according to the release.
One-third of CTE cases studied were also diagnosed with other neurodegenerative diseases and most had symptoms of motor weaknesses and muscle twitches years before Stage One symptoms began, according to the release.
Researchers interviewed the families of the deceased brain donors and examined medical records to develop a criteria for the diagnosis of CTE and categorize the development into four stages.
During Stage One, 89 percent of those pathologically diagnosed with CTE showed symptoms of cognitive, behavioral or mood impairments. In Stage Two, symptoms also included depression, violent tempers and shot-term memory loss. Stage Three showed signs of cognitive impairment and difficulties planning, organizing, multitasking and making decisions. Stage Four showed signs similar to dementia, or impairments enough to impact daily life.
“Knowing more about the stages is important for many reasons,” Baugh said. “By knowing more about the stages of the disease, we’re able to see how the disease progresses.”
Athletes whose brains were studied in this research include NFL Hall of Fame tight end John Mackey and NFL Hall of Fame running back Ollie Matson, both of who died from complications with dementia and were later diagnosed with CTE.
Researchers at the CSTE and Boston VA are working on developing methods of diagnosing CTE while a patient is alive, which has not been possible yet.
“The ability to diagnose CTE while someone is alive is an important next step to allow us to address some of these important issues, as well as develop and test treatment and prevention strategies for the disease,” said Robert Stern, co-author of the report and a professor of neurology and neurosurgery at BU, in the release.
Baugh said their findings are not representative of the general population, since they are focusing on athletes and veterans and can only study the brains donated.
“However, it’s meant to put the issue out there,” she said. “It’s bigger than we thought two or three or five years ago.”