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New test may detect chronic traumatic encephalopathy before symptoms appear

The New York Times reported this week on a new medical study involving boxers and chronic traumatic encephalopathy (CTE).  CTE has gained prominence as professional football players' autopsies continue to demonstrate evidence of brain injury that was previously considered a product only of blows to the head suffered by professional boxers.   Indeed, the disease was formerly known as dementia pugilistica.  Today, as one after another NFL player is prematurely struck down by memory problems, depression, and intellectual dysfunction, the disease is gaining notoriety among a completely different population.  The suicide of 62-year old Ray Easterling, former Atlanta Falcon, after years of premature dementia, is only the most recent example.  The disease has gained additional notoriety as returning Mideast war veterans have experienced a high rate of post traumatic stress syndrome, CTE and suicide.

Preliminary findings from the Professional Fighters Brain Health Study suggest that MRI scans can pick up changes in the brain--a reduction of size of the hippocampus and thalamus---as much as six years before cognitive symptoms are appreciated.  If theses findings are accurate, and if changes in behavior could retard or halt the development of the disease, MRI scans might enable physicians to diagnose and interrupt the development of CTE before it begins to progress to early dementia.

This news--and the development of early detection capability--could benefit not only boxers and football players, but also war veterans and personal injury/auto accident victims.  Currently CTE can be detected and diagnosed only after death when changes in brain structure are identified on autopsy.  It would be marvelous news if early changes could be identified so that progression might be halted and diagnoses could be firmly established.  Soldiers might not be sent for repeat deployments once they are at high risk or show evidence of CTE; professional athletes would be retired without additional insults to the brain; legitimate injury victims and others could substantiate their claims of otherwise subjective symptomatology.

The preliminary findings seem to suggest that boxers show evidence of CTE on MRI after six years in the ring, but develop symptoms of cognitive difficulty only after about 12 years in the ring.  The study does not confirm, of course, that the progression can be halted after diagnosis if repeated insults are avoided.

Thompson O’Neil, P.C.
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