CTE is a form of encephalopathy that is progressively degenerative in nature and has been diagnosed post-mortem in many individuals with a history of multiple concussions and other forms of head injury, including, most recently veterans exposed to IED blasts. Although, studies and diagnostic evidence are still in their infancy stage, all signposts lead to it being part of the “signature injury” associated with the wars in Iraq and Afghanistan.
In 2012, the first study conducted by Boston University and Veterans Affairs Boston Healthcare System, demonstrated that “exposure to a single blast equivalent to a typical improvised explosive device (IED) results in CTE and long-term brain impairments.”
The symptoms of CTE mimic those of traumatic brain injury (TBI) and are only beginning to be understood. The symptoms include depression, anxiety, memory loss, aggression, and disturbances in balance and gait.
Recently, researchers announced that the hallmark of CTE is the accumulation of an abnormal protein called TAU that strangles the brain cells in areas that control memory, emotions and other functions.
Definite diagnosis for CTE can only be confirmed posthumously through brain autopsies. Such was the case of many retired NFL players including well-known Junior Seau, who committed suicide, whose post-mortem brain pathology report showed evidence of CTE. However, there is hope for early detection of CTE using Position Emission Tomography (PET) as a tool to allow for a diagnosis on a living patient. A research completed by the University of California in 2013, showed for the first time ever, CTE in living-retired National Football League players. According to the study, the scan lit up for TAU protein in all former players, concentrated in the areas that control memory, emotions and other functions consistent with the distribution of TAU in CTE brains following autopsy.
Unfortunately, in my review of treatment records of veterans with TBI or concussions, I have not come across a PET scan study done by the VA. Perhaps it is due to the high cost of the study, estimated to be around $5000.00. This is despite the fact that nearly 20% of the more than 2.5 million service members deployed to the Middle East since 2003, have sustained at least one traumatic brain injury and almost 8% demonstrate persistent symptoms six months post injury.
In an effort to address the long-term effects of brain injuries in the military, in 2013, President Barack Obama announced the creation of the Chronic Effects of Neurotrauma Consortium (CENC) that will examine the factors that influence the chronic effects of mild TBI in military service personnel and Veterans.
CTE has been around for a long time, but it was mostly associated with boxers. It was called “punch-drunk syndrome”. Not until the death of many NFL players was it brought back to the forefront, and now with research and scientific studies picking up steam, hopefully, the VA will broaden their view of the characteristics and sequela of traumatic brain injuries.