What EEG findings are characteristic of chronic traumatic encephalopathy (CTE)?

Updated: Oct 09, 2019
  • Author: Eli S Neiman, DO, FACN; Chief Editor: Selim R Benbadis, MD  more...
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Chronic traumatic encephalopathy (CTE) evolved from the term "dementia pugilistica,” which describes the dementia found in many boxers. CTE is a progressive degenerative disease that causes dementia and depression, particularly in athletes subjected to multiple concussions or sub-concussive blows to the head. It has also been called “sports-related concussion syndrome,” but can be seen in many forms of non-sports-related brain trauma as well. The neuropathology has evolved to specify a unique type of tauopathy found in perivascular spaces at the depth of sulci and other features not typically seen in neurodegenerative tauopathies. Currently, there are no treatments for CTE and the disease can only be diagnosed by direct tissue examination, including full autopsies. Little research has been done on the evolving EEG patterns noted in these traumatic brain injury patients that develop this encephalopathy dementia-type complex. [91, 92]

The athlete post-career adjustment (AP-CA) model was developed to better evaluate athletes with risk of CTE. The AP-CA consists of four elements: neurotrauma, chronic pain, substance use, and career transition stress. Any of these elements can account for a significant number of CTE symptoms. Additionally, depression may be present, which can be a chronic, lifelong comorbid condition. Neurotrauma is a necessary condition for the development of CTE symptomology. [93]

Traumatic brain injury (TBI) has long been associated with the development of dementia and may be a risk factor for other neurodegenerative disorders that can be associated with dementia. TBI results in white matter tract and neural network disruptions, as well as amyloid pathology and other neurodegenerative proteinopathies. [94]  Risk factors for TBI-associated dementia include the following:

  • Any blast or blunt physical force to the head as long as there is violent head displacement
  • Decreased cognitive and/or neuronal reserve and the related variable of older age at TBI
  • The presence of apolipoprotein E ɛ4 alleles, a genetic risk factor for AD

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