Chronic traumatic encephalopathy (CTE) is a degenerative brain disease caused by repetitive head trauma. CTE is characterized by tau protein deposits in the brain that can cause behavioral, mood, and cognitive issues. Boston University has been researching CTE since 1996 and studying cases in boxers, football players, hockey players, and others exposed to repetitive brain trauma. Future areas of study include improved detection methods, risk factors, and potential treatments.

1. Jalin Couper &
Jason
Freeman
DAILY IMPACT: A LOOK
INTO CHRONIC
TRAUMATIC
ENCEPHALOPATHY

2.  Concussions
 What is CTE?
 Stages of CTE
 First Documented Cases
 Boston University’s Research
 Case Studies:
 Boxing
 Football
 Hockey
 Future Research
OVERVIEW

3. 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
CONCUSSION

4. •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
WHAT IS CHRONIC TRAUMATIC
ENCEPHALOPATHY (CTE)?

5. •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.
TAU PROTEIN

6. COMPARISON
BETWEEN
HEALTH AND
UNHEALTHY
NEURONS

7. COMPARISON

8. 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.
3 STAGES OF CTE

9. •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
FIRST DOCUMENTED

10. BOSTON UNIVERSITY
 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

11. •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.
BOXING

12. •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
73 YEAR OLD BOXER

13.  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
AMERICAN FOOTBALL

14. JOHN GRIMSLEY
AMYGDALA & TEMPORAL CORTEX

15.  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

16. 18-YEAR-OLD
FRONTAL CORTEX

17. COMMON INCIDENTS
“please, see that my brain is given to the NFL’s brain bank”

18.  Relatively new in the CTE research
 4 confirmed cases in former NHL players
 Role of fighting and hits to the head
ICE HOCKEY

19.  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

20. DEREK BOOGAARD
FRONTAL CORTEX

21. FUTURE RESEARCH