Chronic traumatic encephalopathy: a literary review
Gorden, Zachary Newton
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As early as the 1920's it has been established that repetitive brain trauma, through activities such as boxing, can lead to progressive neurological degeneration. This was termed Dementia Pugilistica until the more recent and greater encompassing term Chronic Traumatic Encephalopathy came into use. Chronic Traumatic Encephalopathy is a progressive neurodegenerative disease that is believed to be caused, or at least associated with, repetitive brain trauma on the concussive and sub concussive level. Clinically, Chronic Traumatic Encephalopathy is associated with a bevy of abnormal symptoms; ranging from personality changes, behavioral abnormalities, memory and mood disturbances as well as certain Parkinsonian symptoms like speech and gait abnormalities. Pathologically, Chronic Traumatic Encephalopathy is distinguished by a certain gross scale criteria, including but not limited too: wide spread atrophy of the brain tissue (most notably the cerebral hemispheres) and dilation of the ventricles and fenestration of the cavum septum pellucidum. The microscopic pathology of Chronic Traumatic Encephalopathy is also well established; it consists of extensive tau-immunoreactive neurofibrillary tangles and neuropil neurites concentrated in the depths of the sulci and perivascularly. In roughly half the cases of Chronic Traumatic Encephalopathy there is deposition of beta-amyloid plaques along with the tau-immunoreactive neurofibrillary tangles. Chronic Traumatic Encephalopathy can only be diagnosed post-mortem, leading to a vast array of issues in the detection and treatment of the disease. Much research has gone into potential diagnostic techniques that could greatly alter the lives of the athletes, military and civilians who are su±Iering from the symptoms of this disease. There is strong belief that early detection methods will be found, and these ideas center around in vivo imaging techniques, such as; Functional Magnetic Resonance Imaging and Single Photon Emission Computed Tomography, that would allow for physicians to pathologies before their overwhelming detriment. There is also study into proposed biomarkers, such as apolipoprotein-E, that could give indication of a higher susceptibility to degenerative neurologic disease such as Chronic Traumatic Encephalopathy.
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