Przewlekła encefalopatia pourazowa – Diagnostyka i diagnoza

Przewlekła encefalopatia pourazowa
Diagnostyka i diagnoza

Przewlekła encefalopatia pourazowa (CTE) to postępująca choroba neurodegeneracyjna powiązana z powtarzającymi się urazami głowy, której definitywna diagnoza możliwa jest jedynie pośmiertnie na podstawie charakterystycznych zmian neuropatologicznych, takich jak okołonaczyniowe złogi hiperfosforylowanego białka tau (p-tau) w neuronach i astrocytach, nieregularne rozmieszczenie tych złogów w głębokich warstwach kory mózgowej oraz splątki astrocytarne i neurofibrylarne w różnych strukturach mózgu. Kryteria diagnostyczne ustalone przez NINDS i NIBIB obejmują także ocenę próbek ze śródmózgowia, mostu i rdzenia przedłużonego. W praktyce klinicznej stosuje się kryteria zespołu encefalopatii pourazowej (TES), które uwzględniają ekspozycję na urazy głowy, postępujące zaburzenia poznawcze i neurobehawioralne utrzymujące się co najmniej 12 miesięcy, jednak ich zastosowanie jest obecnie ograniczone do celów badawczych i nie potwierdza jednoznacznie obecności zmian neuropatologicznych charakterystycznych dla CTE.

Diagnostyka przewlekłej encefalopatii pourazowej (CTE)

Diagnostyka pośmiertna – złoty standard rozpoznania CTE
Zespół encefalopatii pourazowej (TES) – próba diagnostyki przyżyciowej
Techniki obrazowania w diagnostyce CTE
Biomarkery płynowe w diagnostyce CTE
Kluczowe projekty badawcze w diagnostyce CTE
Wyzwania w diagnostyce CTE
Postępowanie diagnostyczne u pacjentów z podejrzeniem CTE

Przyszłość diagnostyki CTE
Ograniczenia obecnych metod diagnostycznych

Znaczenie rozwoju diagnostyki CTE
Kolejne rozdziały

Diagnostyka przewlekłej encefalopatii pourazowej (CTE)

Przewlekła encefalopatia pourazowa (Chronic Traumatic Encephalopathy, CTE) jest postępującą chorobą neurodegeneracyjną związaną z wielokrotnymi urazami głowy, w tym wstrząśnieniami mózgu i powtarzającymi się subklinicznymi urazami. Obecnie diagnostyka CTE stanowi jedno z największych wyzwań w neurologii, ponieważ definitywne rozpoznanie możliwe jest wyłącznie pośmiertnie, poprzez badanie próbek tkanki mózgowej podczas autopsji.¹²

Diagnostyka pośmiertna – złoty standard rozpoznania CTE

Diagnoza CTE opiera się na ocenie pośmiertnej tkanki mózgowej, która wykazuje charakterystyczne zmiany neuropatologiczne. Kryteria diagnostyczne zostały ustalone podczas konferencji konsensusowych zorganizowanych przez National Institute of Neurological Disorders and Stroke (NINDS) oraz National Institute of Biomedical Imaging and Bioengineering (NIBIB).³

Złoty standard diagnozy CTE obejmuje stwierdzenie następujących zmian patologicznych:⁴⁵

Obecność ognisk okołonaczyniowych złogów hiperfosforylowanego białka tau (p-tau) w neuronach i astrocytach
Nieregularne rozmieszczenie złogów p-tau z predylekcją do głębokich warstw zakrętów kory mózgowej
Skupiska podpajęczynówkowych i okołokomorowych splątków astrocytarnych w korze mózgowej, międzymózgowiu, jądrach podstawy i pniu mózgu
Splątki neurofibrylarne w korze mózgowej zlokalizowane preferencyjnie w powierzchownych warstwach

⁶

W procesie diagnostycznym pośmiertnym zaleca się również pobieranie i ocenę próbek ze śródmózgowia, mostu i rdzenia przedłużonego, ponieważ zmiany patologiczne w pniu mózgu związane z p-tau stanowią cechę wspomagającą rozpoznanie CTE.⁷

Zespół encefalopatii pourazowej (TES) – próba diagnostyki przyżyciowej

Wobec braku możliwości definitywnego rozpoznania CTE za życia pacjenta, naukowcy opracowali kryteria kliniczne dla zespołu encefalopatii pourazowej (Traumatic Encephalopathy Syndrome, TES), który ma odzwierciedlać obraz kliniczny związany z neuropatologicznymi zmianami charakterystycznymi dla CTE.⁸⁹

Kryteria diagnostyczne TES według NINDS obejmują:¹⁰¹¹

Znaczne narażenie na powtarzające się urazy głowy (np. minimum pięć lat uprawiania futbolu amerykańskiego, z czego co najmniej dwa lata na poziomie szkoły średniej lub wyższym)
Postępujący przebieg zaburzeń poznawczych (szczególnie w zakresie pamięci epizodycznej lub krótkotrwałej i/lub funkcji wykonawczych, takich jak planowanie, organizacja, osąd i wielozadaniowość) lub dysregulacja neurobehawioralna (w tym wybuchowość, impulsywność, napady gniewu, wybuchy przemocy i labilność emocjonalna) lub obie te cechy
Utrzymywanie się objawów przez co najmniej 12 miesięcy
Wykluczenie innych stanów neurologicznych, psychiatrycznych lub medycznych, które mogłyby w pełni wyjaśniać objawy kliniczne

¹²¹³

Należy podkreślić, że kryteria TES służą głównie celom badawczym i nie są jeszcze powszechnie stosowane przez lekarzy w codziennej praktyce klinicznej do stawiania diagnozy CTE.¹⁴ Diagnoza TES nie oznacza również pewności co do obecności zmian neuropatologicznych charakterystycznych dla CTE.¹⁵

Techniki obrazowania w diagnostyce CTE

Trwają intensywne badania nad opracowaniem metod obrazowania, które mogłyby pomóc w diagnostyce CTE za życia pacjenta:¹⁶¹⁷

Rezonans magnetyczny (MRI)

Standardowe badania strukturalne MRI i tomografia komputerowa (CT) mają ograniczoną wartość diagnostyczną w CTE, ponieważ zmiany w mózgu nie zawsze są widoczne lub mogą być podobne do innych chorób.¹⁸ Jednak w najnowszych badaniach wykazano, że MRI może być wstępnym narzędziem do diagnozowania CTE u żyjących osób.¹⁹

Badacze z Boston University School of Medicine zauważyli, że obrazowanie metodą rezonansu magnetycznego może przybliżyć nas do wykrywania CTE u żyjących pacjentów, choć wciąż konieczne jest rozróżnienie, czy wzorce obserwowane w MRI są specyficzne dla CTE i czy odróżniają tę chorobę od choroby Alzheimera i innych przyczyn demencji.²⁰

Zaawansowane techniki MRI

Obrazowanie tensora dyfuzji (DTI) – technika ukierunkowana na wykrywanie nieprawidłowości w istocie białej mózgu, powszechnych w CTE w wyniku stresu mechanicznego na aksony po urazie²¹
Funkcjonalny rezonans magnetyczny (fMRI) – pozwala na ocenę funkcjonalnych zmian w mózgu²²
Spektroskopia rezonansu magnetycznego (MRS) – umożliwia analizę zmian biochemicznych w tkance mózgowej²³
Obrazowanie podatności magnetycznej (SWI) – może wykrywać mikrokrwawienia związane z urazami głowy²⁴

²⁵

Pozytonowa tomografia emisyjna (PET)

Szczególne nadzieje wiązane są z opracowaniem znaczników PET, które wiążą się specyficznie z białkiem tau:²⁶

W badaniach wykorzystuje się znaczniki radioaktywne, które wiążą się z białkiem tau i amyloidem w mózgu, emitując radioaktywność²⁷
Jednak badania walidacyjne wykazały ograniczoną wartość niektórych znaczników PET (np. FTP-PET) w diagnostyce CTE, co podkreśla potrzebę dalszych badań²⁸

²⁹

Obecnie trwa wieloośrodkowe badanie kliniczne, które ma na celu ocenę, czy PET może być wykorzystywany do diagnozy CTE u żyjących pacjentów. Jest to trzecia i ostatnia faza badania diagnostycznego, będąca wynikiem ponad 15 lat badań.³⁰³¹

Biomarkery płynowe w diagnostyce CTE

Równolegle prowadzone są badania nad biomarkerami, które można wykryć w płynach ustrojowych:³²

Biomarkery krwi

Biomarkery oparte na badaniu krwi są szczególnie obiecujące ze względu na łatwość pobierania próbek i potencjał do wykorzystania w profilaktyce CTE. Idealny biomarker krwi powinien być:³³

Diagnostycznie dokładny – zdolny do prawidłowego rozróżnienia między pacjentami cierpiącymi na CTE a osobami zdrowymi
Selektywny dla CTE – umożliwiający rozróżnienie CTE od innych tauopatii, np. choroby Alzheimera
Wykonalny – łatwo wykrywalny i mierzalny we krwi

³⁴

Badane biomarkery krwi obejmują:³⁵³⁶

Różne izoformy fosforylowanego białka tau – niektóre wykazały zdolność do rozróżniania CTE od innych chorób neurodegeneracyjnych³⁷
sTREM2 (rozpuszczalny receptor wyzwalający ekspresję na komórkach mieloidalnych 2)³⁸
CCL11 (chemokina 11 o motywie C-C)³⁹
NFL (neurofilament łańcucha lekkiego)⁴⁰
GFAP (kwaśne białko włókienkowe gleju)⁴¹
Biomarkery egzosomalne – egzosomy to obiecujące źródło biomarkerów odzwierciedlających wewnętrzne środowisko mózgu⁴²

⁴³

Biomarkery płynu mózgowo-rdzeniowego (PMR)

Chociaż pobieranie PMR jest bardziej inwazyjne niż pobieranie krwi, badania biomarkerów w PMR również są prowadzone w celu identyfikacji markerów CTE.⁴⁴ Analiza PMR może dostarczyć cennych informacji na temat obecności białek i biomarkerów związanych z CTE.⁴⁵

Kluczowe projekty badawcze w diagnostyce CTE

Wiele ośrodków badawczych pracuje nad udoskonaleniem metod diagnostycznych CTE, między innymi:⁴⁶

DIAGNOSE CTE Research Project

Projekt DIAGNOSE CTE (Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy) to wieloośrodkowe badanie biomarkerów neurooobrazowych i płynowych dla wykrywania CTE przyżyciowo.⁴⁷ Główne cele projektu obejmują:

Opracowanie przyżyciowych biomarkerów płynowych i neuroobrazowych dla CTE
Charakterystykę obrazu klinicznego CTE
Udoskonalenie i walidację klinicznych kryteriów diagnostycznych (TES)
Zbadanie ekspozycji na powtarzające się urazy głowy, czynników genetycznych i innych czynników ryzyka
Zapewnienie zasobów zanonimizowanych danych i próbek biologicznych dla szerszej społeczności badawczej

⁴⁸⁴⁹

Każdy uczestnik badania przechodzi trzydniową wizytę wyjściową obejmującą ocenę historii medycznej, badania neurologiczne i poznawcze, badania obrazowe (MRI i PET), badanie płynu mózgowo-rdzeniowego oraz kwestionariusze dotyczące nastroju i zachowania.⁵⁰

Oczekuje się, że biomarkery, takie jak skany PET i testy krwi obecnie badane w ramach projektu DIAGNOSE CTE, zostaną w ciągu najbliższych kilku lat zintegrowane z kryteriami diagnostycznymi, co przyczyni się do poprawy dokładności diagnostycznej i umożliwi właściwe wykorzystanie kryteriów do diagnozowania pacjentów w klinice.⁵¹

Wyzwania w diagnostyce CTE

Postawienie diagnozy CTE napotyka na liczne wyzwania:⁵²

Nakładanie się objawów z innymi chorobami – CTE jest często mylona z chorobą Alzheimera, otępieniem czołowo-skroniowym, zaburzeniami nastroju i psychotycznymi, chorobą Parkinsona oraz stwardnieniem zanikowym bocznym (ALS)⁵³
Współwystępowanie innych patologii – u niektórych pacjentów CTE może współistnieć z innymi patologiami neurodegeneracyjnymi, takimi jak choroba Alzheimera⁵⁴
Brak specyficznych biomarkerów – głównym problemem dla wielu proponowanych biomarkerów jest ich brak selektywności dla CTE⁵⁵
Potrzeba podejścia wielodyscyplinarnego – ze względu na złożoność diagnozy TES/CTE zalecane jest podejście multidyscyplinarne⁵⁶

⁵⁷

Postępowanie diagnostyczne u pacjentów z podejrzeniem CTE

Mimo braku możliwości definitywnego rozpoznania CTE za życia, lekarze mogą przeprowadzić szereg badań w celu oceny pacjentów z podejrzeniem tej choroby i wykluczenia innych potencjalnych przyczyn objawów:⁵⁸

Szczegółowy wywiad medyczny – ze szczególnym uwzględnieniem historii urazów głowy, uprawiania sportów kontaktowych lub ekspozycji na wybuchy (w przypadku weteranów wojskowych)⁵⁹
Badanie neurologiczne – ocena funkcji neurologicznych⁶⁰
Testy neuropsychologiczne – ocena funkcji poznawczych, pamięci, uwagi i innych zdolności związanych z mózgiem⁶¹
Badania obrazowe mózgu – w tym MRI i CT, które mogą pomóc wykluczyć inne schorzenia⁶²
Badania krwi i moczu – wykluczenie innych przyczyn objawów neurologicznych⁶³
Ocena psychiatryczna – ocena zaburzeń nastroju i zachowania⁶⁴

⁶⁵

Jeśli lekarz specjalista może wykluczyć inne przyczyny objawów, może postawić wstępną diagnozę CTE, szczególnie u osób z wysokim ryzykiem ekspozycji na powtarzające się urazy głowy.⁶⁶⁶⁷

Przyszłość diagnostyki CTE

Przyszłość diagnostyki CTE rysuje się w kilku kierunkach:⁶⁸

Dalszy rozwój biomarkerów – zarówno obrazowych, jak i płynowych, które umożliwią bardziej precyzyjną diagnostykę CTE za życia⁶⁹
Walidacja i udoskonalenie kryteriów TES – w celu zwiększenia ich dokładności diagnostycznej⁷⁰
Badania longitudinalne – łączące obrazowanie, ocenę neurobehawioralną i podejścia biochemiczne w celu ustalenia solidnych biomarkerów CTE⁷¹
Opracowanie specyficznych znaczników PET – dla hiperfosforylowanego białka tau związanego z CTE, z redukcją wiązania pozacelowego⁷²

⁷³

Publikacja kryteriów diagnostycznych NINDS dla TES jest istotnym krokiem w kierunku osiągnięcia celu, jakim jest diagnozowanie CTE za życia oraz promowanie badań mających na celu lepsze zrozumienie, leczenie i ostatecznie zapobieganie CTE.⁷⁴

Ograniczenia obecnych metod diagnostycznych

Mimo postępów w badaniach nad diagnostyką CTE, nadal istnieją znaczące ograniczenia:⁷⁵

Brak definitywnych testów przyżyciowych – obecnie nie istnieją testy, które mogłyby definitywnie diagnozować CTE za życia pacjenta⁷⁶
Ograniczenia obrazowania PET – choć badanie PET jest potężnym narzędziem ujawniającym nieprawidłowości w mózgu, nie jest jeszcze w stanie diagnozować CTE⁷⁷
Konieczność dalszej walidacji biomarkerów – żaden pojedynczy biomarker płynowy nie jest wystarczający ani zatwierdzony do diagnozy⁷⁸
Potrzeba lepszego zrozumienia przebiegu klinicznego – nadal istnieje potrzeba dokładniejszego scharakteryzowania progresji i przebiegu naturalnego CTE⁷⁹

⁸⁰

Mimo tych ograniczeń, intensywne badania prowadzone na całym świecie przybliżają nas do opracowania skutecznych metod diagnostycznych, które pomogą identyfikować CTE na wczesnym etapie i umożliwią opracowanie skutecznych strategii leczenia i zapobiegania.⁸¹⁸²

Znaczenie rozwoju diagnostyki CTE

Rozwój metod diagnostycznych CTE za życia pacjenta ma kluczowe znaczenie z kilku powodów:⁸³

Wcześniejsza interwencja – umożliwienie wczesnego wdrożenia interwencji mających na celu spowolnienie progresji choroby
Leczenie objawowe – lepsze ukierunkowanie leczenia objawowego na konkretne problemy pacjenta
Stymulacja badań nad nowymi terapiami – przyspieszenie rozwoju leków, które mogą leczyć CTE
Profilaktyka – lepsze zrozumienie czynników ryzyka, co pomoże w opracowaniu skutecznych strategii profilaktycznych
Poprawa jakości życia – możliwość wdrożenia spersonalizowanych planów zarządzania chorobą, które poprawią jakość życia pacjentów

⁸⁴⁸⁵

Jak trafnie ujął to dr Bailes, jeden z pionierów badań nad diagnostyką CTE: „Nie można pomóc pacjentowi z jego chorobą, jeśli można mu powiedzieć, że ją ma, dopiero gdy nie żyje”.⁸⁶

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Materiały źródłowe

#1 Chronic Traumatic Encephalopathy (CTE): Symptoms & Treatment
https://my.clevelandclinic.org/health/diseases/17686-chronic-traumatic-encephalopathy-cte
Chronic traumatic encephalopathy (CTE) is a brain condition that can develop due to repeated head impacts and concussions. […] Theres no conclusive way to diagnose CTE while a person is alive. The only way to do that is to examine samples of a persons brain under a microscope, which is only possible during an autopsy after death. […] While experts may not be able to confirm CTE before death, they can still make a presumptive diagnosis based on your symptoms and a physical and neurological exam. […] Identifying an altered form of the tau protein in a specific pattern in the brain is the way CTE is currently diagnosed. […] The most common tests dont diagnose CTE. Instead, they rule out other conditions. […] Theres no cure for CTE. Treatments for some of the symptoms are possible, and these vary depending on your symptoms, medical history and more.
#2 Chronic Traumatic Encephalopathy: Update on Current Clinical Diagnosis and Management
https://pmc.ncbi.nlm.nih.gov/articles/PMC8069746/
Chronic traumatic encephalopathy is a disease afflicting individuals exposed to repetitive neurotrauma. Unfortunately, diagnosis is made by postmortem pathologic analysis, and treatment options are primarily symptomatic. […] Like most neurodegenerative diseases, CTE can only be diagnosed by postmortem neuropathologic examination of the brain tissue revealing pathognomonic lesions consisting of irregular patterns of perivascular p-tau aggregates in neurons, astrocytes, and cell processes at the depths of the cortical sulci. […] The diagnostic criteria and neuropathologic features of CTE are well defined but perfecting in-vivo diagnosis of CTE remains elusive; CTE is only definitively diagnosed at autopsy. […] Although clinical features can be characterized in-vivo, definitive diagnosis of CTE still requires an autopsy, prompting Montinegro et al. to propose a new diagnostic criterion, known as trauma encephalopathy syndrome (TES). […] While CTE remains a histologic diagnosis, identification of radiographic signs and correlates of disease severity remains a high priority. […] The identification of fluid biomarkers from blood or CSF is under active investigation for pre-morbid diagnosis of CTE.
#3
https://link.springer.com/article/10.1007/s00401-023-02540-w
Over the last 17 years, there has been a remarkable increase in scientific research concerning chronic traumatic encephalopathy (CTE). […] Presently, CTE can be definitively diagnosed only by postmortem neuropathological examination; the corresponding clinical condition is known as traumatic encephalopathy syndrome (TES). […] The criteria for the neuropathological diagnosis of CTE were established by two consensus conferences convened by the National Institute of Neurological Disorders and Stroke (NINDS) and National Institute of Biomedical Imaging and Bioengineering (NIBIB). […] The diagnosis of CTE required: (1) the presence of perivascular foci of p-tau NFTs and astrocytic tangles; (2) an irregular cortical distribution of p-tau NFTs and astrocytic tangles with a predilection for the depth of cerebral sulci; (3) clusters of subpial and periventricular astrocytic tangles in the cerebral cortex, diencephalon, basal ganglia, and brainstem; and (4) NFTs in the cerebral cortex located preferentially in the superficial layers.
#4
https://link.springer.com/article/10.1007/s00401-023-02540-w
Over the last 17 years, there has been a remarkable increase in scientific research concerning chronic traumatic encephalopathy (CTE). […] Presently, CTE can be definitively diagnosed only by postmortem neuropathological examination; the corresponding clinical condition is known as traumatic encephalopathy syndrome (TES). […] The criteria for the neuropathological diagnosis of CTE were established by two consensus conferences convened by the National Institute of Neurological Disorders and Stroke (NINDS) and National Institute of Biomedical Imaging and Bioengineering (NIBIB). […] The diagnosis of CTE required: (1) the presence of perivascular foci of p-tau NFTs and astrocytic tangles; (2) an irregular cortical distribution of p-tau NFTs and astrocytic tangles with a predilection for the depth of cerebral sulci; (3) clusters of subpial and periventricular astrocytic tangles in the cerebral cortex, diencephalon, basal ganglia, and brainstem; and (4) NFTs in the cerebral cortex located preferentially in the superficial layers.
#5 Chronic traumatic encephalopathy | Radiology Reference Article | Radiopaedia.org
https://radiopaedia.org/articles/chronic-traumatic-encephalopathy?lang=us
Chronic traumatic encephalopathy (CTE) is a neurodegenerative tauopathy that is thought to result from mild repetitive head injury. The diagnosis can only be made by neuropathological examination. […] Chronic traumatic encephalopathy refers to a specific neuropathological diagnosis, often made post-mortem. Traumatic encephalopathy syndrome refers to the clinical syndrome presumed to be associated with these neuropathological changes. […] No disease-modifying treatment exists and thus management is supportive.
#6
https://link.springer.com/article/10.1007/s00401-023-02540-w
Over the last 17 years, there has been a remarkable increase in scientific research concerning chronic traumatic encephalopathy (CTE). […] Presently, CTE can be definitively diagnosed only by postmortem neuropathological examination; the corresponding clinical condition is known as traumatic encephalopathy syndrome (TES). […] The criteria for the neuropathological diagnosis of CTE were established by two consensus conferences convened by the National Institute of Neurological Disorders and Stroke (NINDS) and National Institute of Biomedical Imaging and Bioengineering (NIBIB). […] The diagnosis of CTE required: (1) the presence of perivascular foci of p-tau NFTs and astrocytic tangles; (2) an irregular cortical distribution of p-tau NFTs and astrocytic tangles with a predilection for the depth of cerebral sulci; (3) clusters of subpial and periventricular astrocytic tangles in the cerebral cortex, diencephalon, basal ganglia, and brainstem; and (4) NFTs in the cerebral cortex located preferentially in the superficial layers.
#7
https://link.springer.com/article/10.1007/s00401-023-02540-w
The first and second consensus panels recommended that the midbrain, pons, and medulla be sampled and evaluated, as brainstem p-tau pathology is a supportive feature of CTE. […] The panel concluded by refining the definition of the pathognomonic lesion to emphasize that the perivascular p-tau aggregates necessarily involve neurons, with or without p-tau in astrocytes, and are found in deeper cortical layers than the subpial and superficial regions. […] The preponderance of the evidence suggests a high likelihood of a causal relationship between RHI and CTE, a conclusion that is strengthened by the absence of any evidence for plausible alternative hypotheses.
#8 New Criteria Published for Diagnosing the Clinical Syndrome of Chronic Traumatic Encephalopathy During Life | Chobanian & Avedisian School of Medicine
https://www.bumc.bu.edu/camed/2021/03/16/new-criteria-published-for-diagnosing-the-clinical-syndrome-of-chronic-traumatic-encephalopathy-during-life/
Newly published National Institute of Neurological Disorders and Stroke (NINDS) Consensus Diagnostic Criteria for Traumatic Encephalopathy Syndrome (TES) are the first expert consensus criteria developed for the clinical disorder associated with Chronic Traumatic Encephalopathy (CTE) brain pathology. […] At this time, CTE can only be diagnosed after death through a neuropathological examination of brain tissue. […] There has been no accepted approach or agreed upon criteria for the diagnosis of CTE and its clinical manifestations during life until now. […] The new paper, published online in the journal, Neurology, describes that process and provides researchers with detailed criteria for diagnosing study participants with TES and with a provisional level of certainty for the individual having CTE brain pathology.
#9 Chronic Traumatic Encephalopathy (CTE): Symptoms and Treatment
https://brainfoundation.org.au/disorders/chronic-traumatic-encephalopathy/
Chronic traumatic encephalopathy is not fully understood, but research has established a clear link between repetitive concussive or subconcussive blows to the head and CTE. […] Diagnosis of chronic traumatic encephalopathy is challenging because the symptoms often overlap with other neurological conditions such as Alzheimers disease, Parkinsons disease, or depression. Currently, a definitive diagnosis of CTE can only be made post-mortem, by examining brain tissue during an autopsy. […] However, there are guidelines for diagnosing traumatic encephalopathy syndrome (TES), which is the clinical disorder associated with neuropathologically diagnosed CTE. […] Diagnosis requires: 1) substantial exposure to repetitive head impacts; 2) core clinical features of cognitive impairment and/or neurobehavioral dysregulation; 3) progressive disease course; and 4) clinical features are not fully accounted for by any other neurologic, psychiatric, or medical conditions.
#10 New Criteria Published for Diagnosing the Clinical Syndrome of Chronic Traumatic Encephalopathy During Life | Chobanian & Avedisian School of Medicine
https://www.bumc.bu.edu/camed/2021/03/16/new-criteria-published-for-diagnosing-the-clinical-syndrome-of-chronic-traumatic-encephalopathy-during-life/
To be diagnosed with TES with these new criteria, the individual must have: substantial exposure to repetitive head impacts from contact sports, military service, or other causes (e.g., a minimum of five years of organized American football, with two or more of those years played at the high school level or beyond); and a progressive course of cognitive impairment (specifically in episodic or short-term memory and/or executive functioning, such as planning, organization, judgment, and multi-tasking) or neurobehavioral dysregulation (including explosiveness, impulsivity, rage, violent outbursts, and emotional lability) or both. […] The primary goal of these new NINDS Consensus Diagnostic Criteria for TES is to facilitate further CTE research. […] The authors of the paper stress that these criteria are not meant to be used by health care providers to make a clinical diagnosis of CTE.
#11 Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome | Alzheimer’s Research & Therapy | Full Text
https://alzres.biomedcentral.com/articles/10.1186/s13195-014-0068-z
In vivo diagnosis of CTE is needed to conduct research on risk factors and epidemiology and to perform clinical trials for prevention and treatment. […] Sensitive and specific biomarkers for CTE are being developed and include structural and neurochemical imaging techniques and positron emission tomography (PET) with new ligands that selectively bind to p-tau. […] The clinical diagnosis of TES is not meant to imply a certainty of underlying CTE neuropathological changes (for example, p-tau accumulation). […] The proposed research diagnostic criteria for TES include five general criteria, three core clinical features, and nine supportive features that are used to define subtypes of TES: a behavioral/mood variant, a cognitive variant, a mixed variant, and TES dementia. […] The current proposed research diagnostic criteria for TES are meant to be a starting point that should be modified and updated as new research findings in the field become available and as future research using these criteria are published.
#12 Review of TES/CTE: Diagnosis, Criteria, and Challenges | myneuronews.com
https://myneuronews.com/2024/10/01/review-of-tes-cte-diagnosis-criteria-and-challenges/
Chronic Traumatic Encephalopathy (CTE) has gained significant attention in recent years due to its association with repetitive head injuries, particularly among athletes and military personnel. […] Diagnosing CTE while the patient is alive remains an ongoing challenge, as definitive diagnosis requires postmortem examination. However, new clinical diagnostic criteria for Traumatic Encephalopathy Syndrome (TES) aim to provide a framework for diagnosing the condition earlier and improving patient care. […] Unfortunately, a confirmed diagnosis of CTE can only be made postmortem through neuropathological examination. Therefore, TES is used as a working diagnosis based on clinical criteria during a patients lifetime. […] There are multiple sets of clinical criteria used to diagnose TES, each varying slightly in their approach. However, all sets of criteria share some key features: exposure to repetitive head impacts, the progressive nature of the symptoms, and the persistence of symptoms for at least one year.
#13 New Criteria Published for Diagnosing the Clinical Syndrome of Chronic Traumatic Encephalopathy During Life | Chobanian & Avedisian School of Medicine
https://www.bumc.bu.edu/camed/2021/03/16/new-criteria-published-for-diagnosing-the-clinical-syndrome-of-chronic-traumatic-encephalopathy-during-life/
To be diagnosed with TES with these new criteria, the individual must have: substantial exposure to repetitive head impacts from contact sports, military service, or other causes (e.g., a minimum of five years of organized American football, with two or more of those years played at the high school level or beyond); and a progressive course of cognitive impairment (specifically in episodic or short-term memory and/or executive functioning, such as planning, organization, judgment, and multi-tasking) or neurobehavioral dysregulation (including explosiveness, impulsivity, rage, violent outbursts, and emotional lability) or both. […] The primary goal of these new NINDS Consensus Diagnostic Criteria for TES is to facilitate further CTE research. […] The authors of the paper stress that these criteria are not meant to be used by health care providers to make a clinical diagnosis of CTE.
#14 New Criteria Published for Diagnosing the Clinical Syndrome of Chronic Traumatic Encephalopathy During Life | Chobanian & Avedisian School of Medicine
https://www.bumc.bu.edu/camed/2021/03/16/new-criteria-published-for-diagnosing-the-clinical-syndrome-of-chronic-traumatic-encephalopathy-during-life/
To be diagnosed with TES with these new criteria, the individual must have: substantial exposure to repetitive head impacts from contact sports, military service, or other causes (e.g., a minimum of five years of organized American football, with two or more of those years played at the high school level or beyond); and a progressive course of cognitive impairment (specifically in episodic or short-term memory and/or executive functioning, such as planning, organization, judgment, and multi-tasking) or neurobehavioral dysregulation (including explosiveness, impulsivity, rage, violent outbursts, and emotional lability) or both. […] The primary goal of these new NINDS Consensus Diagnostic Criteria for TES is to facilitate further CTE research. […] The authors of the paper stress that these criteria are not meant to be used by health care providers to make a clinical diagnosis of CTE.
#15 Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome | Alzheimer’s Research & Therapy | Full Text
https://alzres.biomedcentral.com/articles/10.1186/s13195-014-0068-z
In vivo diagnosis of CTE is needed to conduct research on risk factors and epidemiology and to perform clinical trials for prevention and treatment. […] Sensitive and specific biomarkers for CTE are being developed and include structural and neurochemical imaging techniques and positron emission tomography (PET) with new ligands that selectively bind to p-tau. […] The clinical diagnosis of TES is not meant to imply a certainty of underlying CTE neuropathological changes (for example, p-tau accumulation). […] The proposed research diagnostic criteria for TES include five general criteria, three core clinical features, and nine supportive features that are used to define subtypes of TES: a behavioral/mood variant, a cognitive variant, a mixed variant, and TES dementia. […] The current proposed research diagnostic criteria for TES are meant to be a starting point that should be modified and updated as new research findings in the field become available and as future research using these criteria are published.
#16 Chronic Traumatic Encephalopathy: Update on Current Clinical Diagnosis and Management
https://www.mdpi.com/2227-9059/9/4/415
Chronic traumatic encephalopathy is a disease afflicting individuals exposed to repetitive neurotrauma. Unfortunately, diagnosis is made by postmortem pathologic analysis, and treatment options are primarily symptomatic. […] We also review animal models and recent discoveries from pre-clinical studies. Furthermore, we highlight the recent advances in diagnosis using diffusor tensor imaging, functional magnetic resonance imaging, positron emission tomography, and the fluid biomarkers t-tau, sTREM2, CCL11, NFL, and GFAP. […] Like most neurodegenerative diseases, CTE can only be diagnosed by postmortem neuropathologic examination of the brain tissue revealing pathognomonic lesions consisting of irregular patterns of perivascular p-tau aggregates in neurons, astrocytes, and cell processes at the depths of the cortical sulci.
#17 Chronic traumatic encephalopathy: Diagnostic updates and advances
https://www.aimspress.com/article/doi/10.3934/Neuroscience.2022030
Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that occurs secondary to repetitive mild traumatic brain injury. Current clinical diagnosis relies on symptomatology and structural imaging findings which often vary widely among those with the disease. The gold standard of diagnosis is post-mortem pathological examination. […] In this review article, we provide a brief introduction to CTE, current diagnostic workup and the promising research on imaging and fluid biomarker diagnostic techniques. For imaging, we discuss quantitative structural analyses, DTI, fMRI, MRS, SWI and PET CT. For fluid biomarkers, we discuss p-tau, TREM2, CCL11, NfL and GFAP.
#18
https://slam.nhs.uk/chronic-traumatic-encephalopathy
Chronic traumatic encephalopathy (CTE) is a progressive brain condition that’s thought to be caused by repeated blows to the head and repeated episodes of concussion. […] Currently, only supportive treatments are available and research is focused on finding a reliable technique to diagnose the condition. […] There’s currently no test to diagnose CTE. A diagnosis is based on a history of participating in contact sports, plus the symptoms and clinical features. […] In CTE, the changes to the brain do not always show up on routine brain scans or may be similar to other conditions. […] Research is ongoing to determine whether other brain imaging techniques will be able to help diagnose CTE in the future.
#19 MRIâs May be Initial Window into CTE Diagnosis in Living; Approach May Shave Years Off Diagnosis | Chobanian & Avedisian School of Medicine
https://www.bumc.bu.edu/camed/2021/12/08/mris-may-be-initial-window-into-cte-diagnosis-in-living-approach-may-shave-years-off-diagnosis/
While chronic traumatic encephalopathy (CTE) cannot yet be diagnosed during life, a new study provides the best evidence to date that a commonly used brain imaging technique, magnetic resonance imaging (MRI), may expedite the ability to diagnose CTE with confidence in the living. […] Findings from this study show us what we can expect to see on MRI in CTE. This is very exciting because it brings us that much closer to detecting CTE in living people, said first author Michael Alosco, PhD, associate professor of neurology at BU School of Medicine, co-director of the BU Alzheimers Disease Center Clinical Core, and a lead BU CTE Center investigator. […] Alosco also added, there is more to do as we still need to understand whether the patterns we saw on MRI are specific to CTE, that is, do they differentiate CTE from Alzheimers disease and other causes of dementia.
#20 MRIâs May be Initial Window into CTE Diagnosis in Living; Approach May Shave Years Off Diagnosis | Chobanian & Avedisian School of Medicine
https://www.bumc.bu.edu/camed/2021/12/08/mris-may-be-initial-window-into-cte-diagnosis-in-living-approach-may-shave-years-off-diagnosis/
While chronic traumatic encephalopathy (CTE) cannot yet be diagnosed during life, a new study provides the best evidence to date that a commonly used brain imaging technique, magnetic resonance imaging (MRI), may expedite the ability to diagnose CTE with confidence in the living. […] Findings from this study show us what we can expect to see on MRI in CTE. This is very exciting because it brings us that much closer to detecting CTE in living people, said first author Michael Alosco, PhD, associate professor of neurology at BU School of Medicine, co-director of the BU Alzheimers Disease Center Clinical Core, and a lead BU CTE Center investigator. […] Alosco also added, there is more to do as we still need to understand whether the patterns we saw on MRI are specific to CTE, that is, do they differentiate CTE from Alzheimers disease and other causes of dementia.
#21 Chronic Traumatic Encephalopathy: Connecting Mechanisms to Diagnosis and Treatment — Journal of Young Investigators
https://www.jyi.org/2017-september/2017/9/2/chronic-traumatic-encephalopathy-connecting-mechanisms-to-diagnosis-and-treatment
However, DTI has become a popular tool for assessing brain injury as it is specialized for detecting abnormalities in brain white matter, which are common in cases of CTE as a result of the mechanical stress on axons following injury. […] In addition to DTI, functional neuroimaging techniques have demonstrated great promise in establishing connections between the neuropathology and symptomatology of CTE. […] The lack of a standardized pre-mortem diagnostic criteria for the disease makes it difficult to formulate a suitable treatment. […] Moreover, there is currently no pre-mortem diagnostic protocol for the disease, despite the fact that there is substantial evidence suggesting that in vivo diagnoses are possible.
#22 Chronic traumatic encephalopathy – Wikipedia
https://en.wikipedia.org/wiki/Chronic_traumatic_encephalopathy
Diagnosis of CTE cannot be made in living individuals; a clear diagnosis is only possible during an autopsy. […] Though there are signs and symptoms some researchers associate with CTE, there is no definitive test to prove the existence in a living person. […] The lack of distinct biomarkers is the reason CTE cannot typically be diagnosed while a person is alive. […] By the early 2010s, more progress in in-vivo diagnostic techniques for CTE had been made, using DTI, fMRI, MRI, and MRS imaging; however, more research needs to be done before any such techniques can be validated. […] PET tracers that bind specifically to tau protein are desired to aid the diagnosis of CTE in living individuals. […] A putative biomarker for CTE is the presence in serum of autoantibodies against the brain.
#23 Chronic traumatic encephalopathy – Wikipedia
https://en.wikipedia.org/wiki/Chronic_traumatic_encephalopathy
Diagnosis of CTE cannot be made in living individuals; a clear diagnosis is only possible during an autopsy. […] Though there are signs and symptoms some researchers associate with CTE, there is no definitive test to prove the existence in a living person. […] The lack of distinct biomarkers is the reason CTE cannot typically be diagnosed while a person is alive. […] By the early 2010s, more progress in in-vivo diagnostic techniques for CTE had been made, using DTI, fMRI, MRI, and MRS imaging; however, more research needs to be done before any such techniques can be validated. […] PET tracers that bind specifically to tau protein are desired to aid the diagnosis of CTE in living individuals. […] A putative biomarker for CTE is the presence in serum of autoantibodies against the brain.
#24 Chronic traumatic encephalopathy: Diagnostic updates and advances
https://www.aimspress.com/article/doi/10.3934/Neuroscience.2022030
Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that occurs secondary to repetitive mild traumatic brain injury. Current clinical diagnosis relies on symptomatology and structural imaging findings which often vary widely among those with the disease. The gold standard of diagnosis is post-mortem pathological examination. […] In this review article, we provide a brief introduction to CTE, current diagnostic workup and the promising research on imaging and fluid biomarker diagnostic techniques. For imaging, we discuss quantitative structural analyses, DTI, fMRI, MRS, SWI and PET CT. For fluid biomarkers, we discuss p-tau, TREM2, CCL11, NfL and GFAP.
#25 Chronic Traumatic Encephalopathy: Connecting Mechanisms to Diagnosis and Treatment — Journal of Young Investigators
https://www.jyi.org/2017-september/2017/9/2/chronic-traumatic-encephalopathy-connecting-mechanisms-to-diagnosis-and-treatment
However, DTI has become a popular tool for assessing brain injury as it is specialized for detecting abnormalities in brain white matter, which are common in cases of CTE as a result of the mechanical stress on axons following injury. […] In addition to DTI, functional neuroimaging techniques have demonstrated great promise in establishing connections between the neuropathology and symptomatology of CTE. […] The lack of a standardized pre-mortem diagnostic criteria for the disease makes it difficult to formulate a suitable treatment. […] Moreover, there is currently no pre-mortem diagnostic protocol for the disease, despite the fact that there is substantial evidence suggesting that in vivo diagnoses are possible.
#26 Chronic traumatic encephalopathy – Wikipedia
https://en.wikipedia.org/wiki/Chronic_traumatic_encephalopathy
Diagnosis of CTE cannot be made in living individuals; a clear diagnosis is only possible during an autopsy. […] Though there are signs and symptoms some researchers associate with CTE, there is no definitive test to prove the existence in a living person. […] The lack of distinct biomarkers is the reason CTE cannot typically be diagnosed while a person is alive. […] By the early 2010s, more progress in in-vivo diagnostic techniques for CTE had been made, using DTI, fMRI, MRI, and MRS imaging; however, more research needs to be done before any such techniques can be validated. […] PET tracers that bind specifically to tau protein are desired to aid the diagnosis of CTE in living individuals. […] A putative biomarker for CTE is the presence in serum of autoantibodies against the brain.
#27 World first could see CTE diagnosis in live patients
https://nrtimes.co.uk/world-first-could-see-cte-diagnosis-in-live-patients-tru24/
Diagnosis of chronic traumatic encephalopathy (CTE) could be possible in living patients for the first time since the condition was first described in 1928. […] A new trial spanning nine hospitals in the US will test whether doctors can diagnose CTE via a positron emission tomography (PET) scan, a nuclear imaging test that uses radioactive drugs called âtracersâ to show how organs and tissues are performing. […] Currently, CTE can only be diagnosed via autopsy. […] The tracer looks for tau and amyloid proteins in the brain and when it binds to them, it emits radioactivity. […] Doctors look to scan for dementia and other cognitive problems this way. […] Now, Dr. Bailes has helped spearhead the multi-site diagnostic trial that could give doctors the groundbreaking ability to diagnose CTE in living patients.
#28 Research Spotlight: New Research Suggests PET Test for Chronic Traumatic Encephalopathy Has Limited Value
https://www.massgeneral.org/news/research-spotlight/new%20research-suggests-pet-test-for-chronic-traumatic-encephalopathy-has%20limited-value
We undertook the present validation study to further clarify the potential role of PET in diagnosing CTE in living players. […] These results call into question the use of FTP-PET to identify premortem CTE. […] Our results suggest that clinicians working with former football players should question the role and perhaps avoid using FTP-PET scanning for the diagnostic evaluation of CTE.
#29 Promising trial could help diagnose CTE in live patients | Endeavor Health
https://www.endeavorhealth.org/articles/groundbreaking-trial-cte-diagnosis
A promising trial is taking place in nine hospitals across the country, including Endeavor Health Evanston Hospital. If successful, the trial will enable doctors to diagnose chronic traumatic encephalopathy (CTE) in living patients for the first time since doctors first described the condition in 1928. […] Currently, CTE can only be diagnosed via autopsy. […] Now, Dr. Bailes has helped spearhead the multi-site diagnostic trial that could give doctors the groundbreaking ability to diagnose CTE in living patients. […] This new diagnostic trial will confirm if doctors can diagnose CTE via a positron emission tomography (PET) scan, a nuclear imaging test that uses radioactive drugs called âtracersâ to show how organs and tissues are performing. […] This is the third and final phase of the diagnostic trial and the result of more than 15 years of research. […] The hope is that if we can diagnose it while the patient is living, maybe we can treat some of the symptoms.
#30 Promising trial could help diagnose CTE in live patients | Endeavor Health
https://www.endeavorhealth.org/articles/groundbreaking-trial-cte-diagnosis
A promising trial is taking place in nine hospitals across the country, including Endeavor Health Evanston Hospital. If successful, the trial will enable doctors to diagnose chronic traumatic encephalopathy (CTE) in living patients for the first time since doctors first described the condition in 1928. […] Currently, CTE can only be diagnosed via autopsy. […] Now, Dr. Bailes has helped spearhead the multi-site diagnostic trial that could give doctors the groundbreaking ability to diagnose CTE in living patients. […] This new diagnostic trial will confirm if doctors can diagnose CTE via a positron emission tomography (PET) scan, a nuclear imaging test that uses radioactive drugs called âtracersâ to show how organs and tissues are performing. […] This is the third and final phase of the diagnostic trial and the result of more than 15 years of research. […] The hope is that if we can diagnose it while the patient is living, maybe we can treat some of the symptoms.
#31 World first could see CTE diagnosis in live patients
https://nrtimes.co.uk/world-first-could-see-cte-diagnosis-in-live-patients-tru24/
Diagnosis of chronic traumatic encephalopathy (CTE) could be possible in living patients for the first time since the condition was first described in 1928. […] A new trial spanning nine hospitals in the US will test whether doctors can diagnose CTE via a positron emission tomography (PET) scan, a nuclear imaging test that uses radioactive drugs called âtracersâ to show how organs and tissues are performing. […] Currently, CTE can only be diagnosed via autopsy. […] The tracer looks for tau and amyloid proteins in the brain and when it binds to them, it emits radioactivity. […] Doctors look to scan for dementia and other cognitive problems this way. […] Now, Dr. Bailes has helped spearhead the multi-site diagnostic trial that could give doctors the groundbreaking ability to diagnose CTE in living patients.
#32 Blood-Based Biomarkers in Chronic Traumatic Encephalopathy Diagnosis | Encyclopedia MDPI
https://encyclopedia.pub/entry/48576
Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease consistently associated with repetitive traumatic brain injuries (TBIs), which makes multiple professions, such as contact sports athletes and the military, especially susceptible to its onset. […] There are currently no approved biomarkers to diagnose CTE, thus it can only be confirmed through a post-mortem brain autopsy. […] Several imaging and cerebrospinal fluid biomarkers have shown promise in the diagnosis. However, blood-based biomarkers can be more easily obtained and quantified, increasing their clinical feasibility and potential for prophylactic use. […] The inability to diagnose CTE ante-mortem impedes prophylaxis, early diagnosis, and potential symptomatic treatment in the groups with a high TBI risk. […] An ideal blood-based biomarker should be diagnostically accurate, i.e., be able to correctly discern between patients suffering from CTE and patients who are not; selective towards CTE, i.e., be able to discern CTE from other tauopathies, for example, AD; and feasible, i.e., be easily detectable and quantifiable from blood.
#33 Blood-Based Biomarkers in Chronic Traumatic Encephalopathy Diagnosis | Encyclopedia MDPI
https://encyclopedia.pub/entry/48576
Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease consistently associated with repetitive traumatic brain injuries (TBIs), which makes multiple professions, such as contact sports athletes and the military, especially susceptible to its onset. […] There are currently no approved biomarkers to diagnose CTE, thus it can only be confirmed through a post-mortem brain autopsy. […] Several imaging and cerebrospinal fluid biomarkers have shown promise in the diagnosis. However, blood-based biomarkers can be more easily obtained and quantified, increasing their clinical feasibility and potential for prophylactic use. […] The inability to diagnose CTE ante-mortem impedes prophylaxis, early diagnosis, and potential symptomatic treatment in the groups with a high TBI risk. […] An ideal blood-based biomarker should be diagnostically accurate, i.e., be able to correctly discern between patients suffering from CTE and patients who are not; selective towards CTE, i.e., be able to discern CTE from other tauopathies, for example, AD; and feasible, i.e., be easily detectable and quantifiable from blood.
#34 Blood-Based Biomarkers in Chronic Traumatic Encephalopathy Diagnosis | Encyclopedia MDPI
https://encyclopedia.pub/entry/48576
Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease consistently associated with repetitive traumatic brain injuries (TBIs), which makes multiple professions, such as contact sports athletes and the military, especially susceptible to its onset. […] There are currently no approved biomarkers to diagnose CTE, thus it can only be confirmed through a post-mortem brain autopsy. […] Several imaging and cerebrospinal fluid biomarkers have shown promise in the diagnosis. However, blood-based biomarkers can be more easily obtained and quantified, increasing their clinical feasibility and potential for prophylactic use. […] The inability to diagnose CTE ante-mortem impedes prophylaxis, early diagnosis, and potential symptomatic treatment in the groups with a high TBI risk. […] An ideal blood-based biomarker should be diagnostically accurate, i.e., be able to correctly discern between patients suffering from CTE and patients who are not; selective towards CTE, i.e., be able to discern CTE from other tauopathies, for example, AD; and feasible, i.e., be easily detectable and quantifiable from blood.
#35 Blood-Based Biomarkers in the Diagnosis of Chronic Traumatic Encephalopathy: Research to Date and Future Directions
https://www.mdpi.com/1422-0067/24/16/12556
Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease consistently associated with repetitive traumatic brain injuries (TBIs), which makes multiple professions, such as contact sports athletes and the military, especially susceptible to its onset. […] There are currently no approved biomarkers to diagnose CTE, thus it can only be confirmed through a post-mortem brain autopsy. […] Several imaging and cerebrospinal fluid biomarkers have shown promise in the diagnosis. […] However, blood-based biomarkers can be more easily obtained and quantified, increasing their clinical feasibility and potential for prophylactic use. […] This article aimed to comprehensively review the studies into potential blood-based biomarkers of CTE, discussing common themes and limitations, as well as suggesting future research directions.
#36 Chronic Traumatic Encephalopathy: Update on Current Clinical Diagnosis and Management
https://www.mdpi.com/2227-9059/9/4/415
The diagnostic criteria and neuropathologic features of CTE are well defined but perfecting in-vivo diagnosis of CTE remains elusive; CTE is only definitively diagnosed at autopsy. […] Although clinical features can be characterized in-vivo, definitive diagnosis of CTE still requires an autopsy, prompting Montinegro et al. to propose a new diagnostic criterion, known as trauma encephalopathy syndrome (TES). […] While CTE remains a histologic diagnosis, identification of radiographic signs and correlates of disease severity remains a high priority. […] The identification of fluid biomarkers from blood or CSF is under active investigation for pre-morbid diagnosis of CTE. […] While no single fluid biomarker is sufficient or approved for diagnosis, several studies are continually investigating further fluid biomarker candidates. […] The diagnostic innovations are summarized in Table 1.
#37 Blood-Based Biomarkers in the Diagnosis of Chronic Traumatic Encephalopathy: Research to Date and Future Directions
https://www.mdpi.com/1422-0067/24/16/12556
The main issue for many proposed biomarkers is their lack of selectivity for CTE. […] However, several molecules, such as different phosphorylated tau isoforms, were able to discern CTE from different neurodegenerative diseases. […] Further, the results from studies on exosomal biomarkers suggest that exosomes are a promising source of biomarkers, reflective of the internal environment of the brain. […] Nonetheless, more longitudinal studies combining imaging, neurobehavioral, and biochemical approaches are warranted to establish robust biomarkers for CTE.
#38 Chronic Traumatic Encephalopathy: Update on Current Clinical Diagnosis and Management
https://www.mdpi.com/2227-9059/9/4/415
Chronic traumatic encephalopathy is a disease afflicting individuals exposed to repetitive neurotrauma. Unfortunately, diagnosis is made by postmortem pathologic analysis, and treatment options are primarily symptomatic. […] We also review animal models and recent discoveries from pre-clinical studies. Furthermore, we highlight the recent advances in diagnosis using diffusor tensor imaging, functional magnetic resonance imaging, positron emission tomography, and the fluid biomarkers t-tau, sTREM2, CCL11, NFL, and GFAP. […] Like most neurodegenerative diseases, CTE can only be diagnosed by postmortem neuropathologic examination of the brain tissue revealing pathognomonic lesions consisting of irregular patterns of perivascular p-tau aggregates in neurons, astrocytes, and cell processes at the depths of the cortical sulci.
#39 Chronic Traumatic Encephalopathy: Update on Current Clinical Diagnosis and Management
https://www.mdpi.com/2227-9059/9/4/415
Chronic traumatic encephalopathy is a disease afflicting individuals exposed to repetitive neurotrauma. Unfortunately, diagnosis is made by postmortem pathologic analysis, and treatment options are primarily symptomatic. […] We also review animal models and recent discoveries from pre-clinical studies. Furthermore, we highlight the recent advances in diagnosis using diffusor tensor imaging, functional magnetic resonance imaging, positron emission tomography, and the fluid biomarkers t-tau, sTREM2, CCL11, NFL, and GFAP. […] Like most neurodegenerative diseases, CTE can only be diagnosed by postmortem neuropathologic examination of the brain tissue revealing pathognomonic lesions consisting of irregular patterns of perivascular p-tau aggregates in neurons, astrocytes, and cell processes at the depths of the cortical sulci.
#40 Chronic Traumatic Encephalopathy: Update on Current Clinical Diagnosis and Management
https://www.mdpi.com/2227-9059/9/4/415
Chronic traumatic encephalopathy is a disease afflicting individuals exposed to repetitive neurotrauma. Unfortunately, diagnosis is made by postmortem pathologic analysis, and treatment options are primarily symptomatic. […] We also review animal models and recent discoveries from pre-clinical studies. Furthermore, we highlight the recent advances in diagnosis using diffusor tensor imaging, functional magnetic resonance imaging, positron emission tomography, and the fluid biomarkers t-tau, sTREM2, CCL11, NFL, and GFAP. […] Like most neurodegenerative diseases, CTE can only be diagnosed by postmortem neuropathologic examination of the brain tissue revealing pathognomonic lesions consisting of irregular patterns of perivascular p-tau aggregates in neurons, astrocytes, and cell processes at the depths of the cortical sulci.
#41 Chronic Traumatic Encephalopathy: Update on Current Clinical Diagnosis and Management
https://www.mdpi.com/2227-9059/9/4/415
Chronic traumatic encephalopathy is a disease afflicting individuals exposed to repetitive neurotrauma. Unfortunately, diagnosis is made by postmortem pathologic analysis, and treatment options are primarily symptomatic. […] We also review animal models and recent discoveries from pre-clinical studies. Furthermore, we highlight the recent advances in diagnosis using diffusor tensor imaging, functional magnetic resonance imaging, positron emission tomography, and the fluid biomarkers t-tau, sTREM2, CCL11, NFL, and GFAP. […] Like most neurodegenerative diseases, CTE can only be diagnosed by postmortem neuropathologic examination of the brain tissue revealing pathognomonic lesions consisting of irregular patterns of perivascular p-tau aggregates in neurons, astrocytes, and cell processes at the depths of the cortical sulci.
#42 Blood-Based Biomarkers in the Diagnosis of Chronic Traumatic Encephalopathy: Research to Date and Future Directions
https://www.mdpi.com/1422-0067/24/16/12556
The main issue for many proposed biomarkers is their lack of selectivity for CTE. […] However, several molecules, such as different phosphorylated tau isoforms, were able to discern CTE from different neurodegenerative diseases. […] Further, the results from studies on exosomal biomarkers suggest that exosomes are a promising source of biomarkers, reflective of the internal environment of the brain. […] Nonetheless, more longitudinal studies combining imaging, neurobehavioral, and biochemical approaches are warranted to establish robust biomarkers for CTE.
#43 Chronic traumatic encephalopathy: Diagnostic updates and advances
https://www.aimspress.com/article/doi/10.3934/Neuroscience.2022030
Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease that occurs secondary to repetitive mild traumatic brain injury. Current clinical diagnosis relies on symptomatology and structural imaging findings which often vary widely among those with the disease. The gold standard of diagnosis is post-mortem pathological examination. […] In this review article, we provide a brief introduction to CTE, current diagnostic workup and the promising research on imaging and fluid biomarker diagnostic techniques. For imaging, we discuss quantitative structural analyses, DTI, fMRI, MRS, SWI and PET CT. For fluid biomarkers, we discuss p-tau, TREM2, CCL11, NfL and GFAP.
#44 Blood-Based Biomarkers in Chronic Traumatic Encephalopathy Diagnosis | Encyclopedia MDPI
https://encyclopedia.pub/entry/48576
While imaging and cerebrospinal fluid (CSF) biomarkers of CTE have been investigated with many yielding promising results, they are expensive and invasive techniques, respectively, thus limiting their use in prophylaxis and diagnosis. […] This entry comprehensively summarizes the studies into potential blood-based biomarkers of CTE, discussing common themes and limitations, as well as suggesting future research directions. […] Nonetheless, more longitudinal studies combining imaging, neurobehavioral, and biochemical approaches are warranted to establish robust biomarkers for CTE.
#45 Diagnosing Chronic Traumatic Encephalopathy: Tests and Procedures
https://www.darwynhealth.com/brain-health/brain-disorders/delirium-and-dementia/chronic-traumatic-encephalopathy/diagnosing-chronic-traumatic-encephalopathy-tests-and-procedures/?lang=en
Imaging techniques play a crucial role in the diagnosis of Chronic Traumatic Encephalopathy (CTE). These techniques help in identifying brain abnormalities associated with CTE and provide valuable insights into the extent and severity of the condition. […] Cerebrospinal fluid (CSF) analysis plays a crucial role in the diagnosis of Chronic Traumatic Encephalopathy (CTE). CSF is a clear, colorless fluid that surrounds the brain and spinal cord, acting as a protective cushion. By analyzing CSF, doctors can gain valuable insights into the presence of CTE-related proteins and biomarkers. […] Post-mortem examination plays a crucial role in confirming a diagnosis of Chronic Traumatic Encephalopathy (CTE). While certain clinical tests and imaging techniques can provide valuable insights, the definitive confirmation of CTE can only be achieved through the analysis of brain tissue after death.
#46 Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy Research Project
https://datacatalog.med.nyu.edu/dataset/10669
Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy (DIAGNOSE CTE) was a longitudinal multi-site study of diagnostic methods for CTE and potential risk factors for the disease. […] The primary objectives of the study are to collect and analyze neuroimaging and fluid biomarkers for the detection of CTE during life, characterize its clinical presentation, examine disease progression, refine and validate clinical diagnostic criteria, investigate risk factors for CTE, and develop a resource with anonymized data and biological samples for further analysis by the research community. […] Each participant completed a three day baseline visit consisting of a medical history assessment, neurological and cognitive exams, diagnostic imaging exams (i.e., MRI and PET), cerebrospinal fluid (CSF) testing, and questionnaires on mood and behavior. […] Data from DIAGNOSE-CTE is available upon request to qualified researchers through the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System.
#47 Developing methods to detect and diagnose chronic traumatic encephalopathy during life: rationale, design, and methodology for the DIAGNOSE CTE Research Project | Alzheimer’s Research & Therapy | Full Text
https://alzres.biomedcentral.com/articles/10.1186/s13195-021-00872-x
Chronic traumatic encephalopathy (CTE) cannot yet be diagnosed during life. […] The objectives of this multicenter project are to: develop in vivo fluid and neuroimaging biomarkers for CTE; characterize its clinical presentation; refine and validate clinical research diagnostic criteria (i.e., traumatic encephalopathy syndrome [TES]); examine repetitive head impact exposure, genetic, and other risk factors; and provide shared resources of anonymized data and biological samples to the research community. […] Findings from the DIAGNOSE CTE Research Project should facilitate detection and diagnosis of CTE during life, and thereby accelerate research on risk factors, mechanisms, epidemiology, treatment, and prevention of CTE. […] CTE is a neuropathological diagnosis and cannot currently be diagnosed during life because its clinical presentation has been until recently ill-defined, and because validated in vivo biomarkers for the detection of CTE neuropathology do not yet exist.
#48 Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy Research Project
https://datacatalog.med.nyu.edu/dataset/10669
Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy (DIAGNOSE CTE) was a longitudinal multi-site study of diagnostic methods for CTE and potential risk factors for the disease. […] The primary objectives of the study are to collect and analyze neuroimaging and fluid biomarkers for the detection of CTE during life, characterize its clinical presentation, examine disease progression, refine and validate clinical diagnostic criteria, investigate risk factors for CTE, and develop a resource with anonymized data and biological samples for further analysis by the research community. […] Each participant completed a three day baseline visit consisting of a medical history assessment, neurological and cognitive exams, diagnostic imaging exams (i.e., MRI and PET), cerebrospinal fluid (CSF) testing, and questionnaires on mood and behavior. […] Data from DIAGNOSE-CTE is available upon request to qualified researchers through the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System.
#49 Developing methods to detect and diagnose chronic traumatic encephalopathy during life: rationale, design, and methodology for the DIAGNOSE CTE Research Project | Alzheimer’s Research & Therapy | Full Text
https://alzres.biomedcentral.com/articles/10.1186/s13195-021-00872-x
Chronic traumatic encephalopathy (CTE) cannot yet be diagnosed during life. […] The objectives of this multicenter project are to: develop in vivo fluid and neuroimaging biomarkers for CTE; characterize its clinical presentation; refine and validate clinical research diagnostic criteria (i.e., traumatic encephalopathy syndrome [TES]); examine repetitive head impact exposure, genetic, and other risk factors; and provide shared resources of anonymized data and biological samples to the research community. […] Findings from the DIAGNOSE CTE Research Project should facilitate detection and diagnosis of CTE during life, and thereby accelerate research on risk factors, mechanisms, epidemiology, treatment, and prevention of CTE. […] CTE is a neuropathological diagnosis and cannot currently be diagnosed during life because its clinical presentation has been until recently ill-defined, and because validated in vivo biomarkers for the detection of CTE neuropathology do not yet exist.
#50 Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy Research Project
https://datacatalog.med.nyu.edu/dataset/10669
Diagnostics, Imaging, and Genetics Network for the Objective Study and Evaluation of Chronic Traumatic Encephalopathy (DIAGNOSE CTE) was a longitudinal multi-site study of diagnostic methods for CTE and potential risk factors for the disease. […] The primary objectives of the study are to collect and analyze neuroimaging and fluid biomarkers for the detection of CTE during life, characterize its clinical presentation, examine disease progression, refine and validate clinical diagnostic criteria, investigate risk factors for CTE, and develop a resource with anonymized data and biological samples for further analysis by the research community. […] Each participant completed a three day baseline visit consisting of a medical history assessment, neurological and cognitive exams, diagnostic imaging exams (i.e., MRI and PET), cerebrospinal fluid (CSF) testing, and questionnaires on mood and behavior. […] Data from DIAGNOSE-CTE is available upon request to qualified researchers through the Federal Interagency Traumatic Brain Injury Research (FITBIR) Informatics System.
#51 New Criteria Published for Diagnosing the Clinical Syndrome of Chronic Traumatic Encephalopathy During Life | Chobanian & Avedisian School of Medicine
https://www.bumc.bu.edu/camed/2021/03/16/new-criteria-published-for-diagnosing-the-clinical-syndrome-of-chronic-traumatic-encephalopathy-during-life/
It is expected that biomarkers, such as PET scans and blood tests currently being studied in the DIAGNOSE CTE Research Project, will be integrated into the criteria to improve diagnostic accuracy in the next few years, resulting in the appropriate use of the criteria to diagnose patients in the clinic. […] The publication of these NINDS Consensus Diagnostic Criteria for TES is a major step in achieving the goal of diagnosing CTE in life and in promoting research to better understand, treat, and ultimately prevent CTE.
#52 Review of TES/CTE: Diagnosis, Criteria, and Challenges | myneuronews.com
https://myneuronews.com/2024/10/01/review-of-tes-cte-diagnosis-criteria-and-challenges/
One of the most significant challenges in diagnosing TES/CTE is that the symptoms overlap with those of other neurodegenerative diseases, making differential diagnosis crucial. […] A key feature of TES/CTE is the progressive nature of the symptoms, meaning they worsen over time, even after head trauma has ceased. […] The search for biomarkers that could help diagnose TES/CTE while the patient is still alive is ongoing. […] Given the complexity of diagnosing TES/CTE, a multidisciplinary approach is recommended. […] While significant strides have been made in understanding TES/CTE, the condition remains difficult to diagnose accurately during life. The current diagnostic criteria provide a foundation, but further research into biomarkers and imaging techniques is essential for advancing diagnosis and treatment.
#53 Content – Chronic Traumatic Encephalopathy (CTE) – Topic guides at Dementia Australia Library Service
https://dementia-org.libguides.com/CTE
Chronic Traumatic Encephalopathy (CTE) dementia by Dementia AustraliaPublication Date: 2022 Information about Chronic traumatic encephalopathy (CTE) dementia, a condition affecting brain function due to repeated head injuries over time. It describes symptoms, treatment and management options, and tips to support someone with the condition. […] A Healthcare Providers Guide To Chronic Traumatic Encephalopathy (CTE): Diagnosis, pharmacologic management, non-pharmacologic management, and other considerationsCTE is often mistaken for Alzheimers disease, frontotemporal dementia, mood and psychotic disorders, Parkinsons disease, and amyotrophic lateral sclerosis (ALS). In some patient, CTE can coexist with other neurodegenerative pathologies such as Alzheimers disease. […] Chronic traumatic encephalopathy is a common co-morbidity, but less frequent primary dementia in former soccer and rugby players (2019)Lee, E.B., Kinch, K., Johnson, V.E. et al. Chronic traumatic encephalopathy is a common co-morbidity, but less frequent primary dementia in former soccer and rugby players. Acta Neuropathol 138, 389399 (2019) There is growing concern over the association between exposure to traumatic brain injury (TBI) and increased risk of a variety of neuropsychiatric and neurocognitive outcomes, in particular those linked to a specific neurodegenerative pathology known as chronic traumatic encephalopathy (CTE)
#54 Content – Chronic Traumatic Encephalopathy (CTE) – Topic guides at Dementia Australia Library Service
https://dementia-org.libguides.com/CTE
Chronic Traumatic Encephalopathy (CTE) dementia by Dementia AustraliaPublication Date: 2022 Information about Chronic traumatic encephalopathy (CTE) dementia, a condition affecting brain function due to repeated head injuries over time. It describes symptoms, treatment and management options, and tips to support someone with the condition. […] A Healthcare Providers Guide To Chronic Traumatic Encephalopathy (CTE): Diagnosis, pharmacologic management, non-pharmacologic management, and other considerationsCTE is often mistaken for Alzheimers disease, frontotemporal dementia, mood and psychotic disorders, Parkinsons disease, and amyotrophic lateral sclerosis (ALS). In some patient, CTE can coexist with other neurodegenerative pathologies such as Alzheimers disease. […] Chronic traumatic encephalopathy is a common co-morbidity, but less frequent primary dementia in former soccer and rugby players (2019)Lee, E.B., Kinch, K., Johnson, V.E. et al. Chronic traumatic encephalopathy is a common co-morbidity, but less frequent primary dementia in former soccer and rugby players. Acta Neuropathol 138, 389399 (2019) There is growing concern over the association between exposure to traumatic brain injury (TBI) and increased risk of a variety of neuropsychiatric and neurocognitive outcomes, in particular those linked to a specific neurodegenerative pathology known as chronic traumatic encephalopathy (CTE)
#55 Blood-Based Biomarkers in the Diagnosis of Chronic Traumatic Encephalopathy: Research to Date and Future Directions
https://www.mdpi.com/1422-0067/24/16/12556
The main issue for many proposed biomarkers is their lack of selectivity for CTE. […] However, several molecules, such as different phosphorylated tau isoforms, were able to discern CTE from different neurodegenerative diseases. […] Further, the results from studies on exosomal biomarkers suggest that exosomes are a promising source of biomarkers, reflective of the internal environment of the brain. […] Nonetheless, more longitudinal studies combining imaging, neurobehavioral, and biochemical approaches are warranted to establish robust biomarkers for CTE.
#56 Review of TES/CTE: Diagnosis, Criteria, and Challenges | myneuronews.com
https://myneuronews.com/2024/10/01/review-of-tes-cte-diagnosis-criteria-and-challenges/
One of the most significant challenges in diagnosing TES/CTE is that the symptoms overlap with those of other neurodegenerative diseases, making differential diagnosis crucial. […] A key feature of TES/CTE is the progressive nature of the symptoms, meaning they worsen over time, even after head trauma has ceased. […] The search for biomarkers that could help diagnose TES/CTE while the patient is still alive is ongoing. […] Given the complexity of diagnosing TES/CTE, a multidisciplinary approach is recommended. […] While significant strides have been made in understanding TES/CTE, the condition remains difficult to diagnose accurately during life. The current diagnostic criteria provide a foundation, but further research into biomarkers and imaging techniques is essential for advancing diagnosis and treatment.
#57 Review of TES/CTE: Diagnosis, Criteria, and Challenges | myneuronews.com
https://myneuronews.com/2024/10/01/review-of-tes-cte-diagnosis-criteria-and-challenges/
One of the most significant challenges in diagnosing TES/CTE is that the symptoms overlap with those of other neurodegenerative diseases, making differential diagnosis crucial. […] A key feature of TES/CTE is the progressive nature of the symptoms, meaning they worsen over time, even after head trauma has ceased. […] The search for biomarkers that could help diagnose TES/CTE while the patient is still alive is ongoing. […] Given the complexity of diagnosing TES/CTE, a multidisciplinary approach is recommended. […] While significant strides have been made in understanding TES/CTE, the condition remains difficult to diagnose accurately during life. The current diagnostic criteria provide a foundation, but further research into biomarkers and imaging techniques is essential for advancing diagnosis and treatment.
#58 Chronic traumatic encephalopathy (CTE) dementia | Dementia Australia
https://www.dementia.org.au/about-dementia/chronic-traumatic-encephalopathy-cte-dementia
Currently there is no single test that can diagnose chronic traumatic encephalopathy (CTE) dementia. […] A medical specialist will only make a diagnosis of CTE dementia after careful assessment. This might include: brain scans, including a magnetic resonance imaging (MRI) scan, a detailed medical history, a physical examination, blood and urine tests, a psychiatric assessment, memory and thinking tests. […] If the medical specialist can rule out any other causes, they may diagnose you with CTE dementia. […] You might be diagnosed with chronic traumatic encephalopathy, but not dementia. If that happens, talk to your doctor about your dementia-like symptoms. There may be another cause.
#59 Chronic traumatic encephalopathy
https://www.nhs.uk/conditions/chronic-traumatic-encephalopathy/
Chronic traumatic encephalopathy (CTE) is a brain condition thought to be linked to repeated head injuries and blows to the head. […] If you have symptoms of chronic traumatic encephalopathy (CTE), a GP will ask you about your symptoms and if you’ve played a lot of contact sports in the past or have had several head injuries or concussions. […] But you may not be formally diagnosed with CTE as this can only be done once you’ve died. […] Chronic traumatic encephalopathy (CTE) cannot be cured, but medicines and other treatments can help your symptoms.
#60 Chronic traumatic encephalopathy (CTE) dementia | Dementia Australia
https://www.dementia.org.au/about-dementia/chronic-traumatic-encephalopathy-cte-dementia
Currently there is no single test that can diagnose chronic traumatic encephalopathy (CTE) dementia. […] A medical specialist will only make a diagnosis of CTE dementia after careful assessment. This might include: brain scans, including a magnetic resonance imaging (MRI) scan, a detailed medical history, a physical examination, blood and urine tests, a psychiatric assessment, memory and thinking tests. […] If the medical specialist can rule out any other causes, they may diagnose you with CTE dementia. […] You might be diagnosed with chronic traumatic encephalopathy, but not dementia. If that happens, talk to your doctor about your dementia-like symptoms. There may be another cause.
#61 Diagnosing Chronic Traumatic Encephalopathy: Tests and Procedures
https://www.darwynhealth.com/brain-health/brain-disorders/delirium-and-dementia/chronic-traumatic-encephalopathy/diagnosing-chronic-traumatic-encephalopathy-tests-and-procedures/?lang=en
The initial clinical evaluation process for suspected Chronic Traumatic Encephalopathy (CTE) cases is crucial in identifying potential instances of this condition. This evaluation involves a comprehensive assessment of the patient’s medical history, symptom presentation, and physical examination. […] In summary, the initial clinical evaluation for suspected CTE cases involves a comprehensive assessment of the patient’s medical history, symptom presentation, and physical examination. By gathering detailed information about the patient’s past head injuries, assessing the presence and severity of CTE-related symptoms, and conducting a thorough physical examination, healthcare professionals can begin to identify potential cases of CTE and develop appropriate management strategies. […] Neuropsychological testing plays a crucial role in diagnosing Chronic Traumatic Encephalopathy (CTE) by assessing cognitive function, memory, attention, and other brain-related abilities. These tests help healthcare professionals evaluate the impact of head injuries on an individual’s brain function and identify any cognitive deficits or changes that may be indicative of CTE.
#62 Chronic traumatic encephalopathy (CTE)
https://www2.hse.ie/conditions/chronic-traumatic-encephalopathy/
Chronic traumatic encephalopathy (CTE) is a type of dementia. […] CTE is associated with contact sports such as boxing, rugby and American football. […] A diagnosis is usually based on a history of: participating in contact sports, symptoms. […] Your GP will talk to you about the problems you’re having. […] You may be referred to a specialist memory assessment service. […] The following tests may be used to scan your brain: magnetic resonance image (MRI) scan, computerised tomography (CT) scan.
#63 Chronic traumatic encephalopathy (CTE) dementia | Dementia Australia
https://www.dementia.org.au/about-dementia/chronic-traumatic-encephalopathy-cte-dementia
Currently there is no single test that can diagnose chronic traumatic encephalopathy (CTE) dementia. […] A medical specialist will only make a diagnosis of CTE dementia after careful assessment. This might include: brain scans, including a magnetic resonance imaging (MRI) scan, a detailed medical history, a physical examination, blood and urine tests, a psychiatric assessment, memory and thinking tests. […] If the medical specialist can rule out any other causes, they may diagnose you with CTE dementia. […] You might be diagnosed with chronic traumatic encephalopathy, but not dementia. If that happens, talk to your doctor about your dementia-like symptoms. There may be another cause.
#64 Chronic traumatic encephalopathy (CTE) dementia | Dementia Australia
https://www.dementia.org.au/about-dementia/chronic-traumatic-encephalopathy-cte-dementia
Currently there is no single test that can diagnose chronic traumatic encephalopathy (CTE) dementia. […] A medical specialist will only make a diagnosis of CTE dementia after careful assessment. This might include: brain scans, including a magnetic resonance imaging (MRI) scan, a detailed medical history, a physical examination, blood and urine tests, a psychiatric assessment, memory and thinking tests. […] If the medical specialist can rule out any other causes, they may diagnose you with CTE dementia. […] You might be diagnosed with chronic traumatic encephalopathy, but not dementia. If that happens, talk to your doctor about your dementia-like symptoms. There may be another cause.
#65 Chronic Traumatic Encephalopathy (CTE) – An Update and Overview Â | ACNR
https://acnr.co.uk/articles/chronic-traumatic-encephalopathy-and-brain-injury/
For practical neurology purposes, the term CTE will also be used to describe the clinical manifestation in this article. […] The importance of repeated evaluation and a multidisciplinary approach similar to other dementia management, encompassing a neuropsychological baseline to inform individualised strategies for the management of these complex patients, cannot be overstated. […] Neurological evaluation, neuropsychological testing and monitoring can assist in identifying the at-risk patient as well as individualised strategies for care and monitoring. […] Chronic traumatic encephalopathy should be considered in any patient with more than five years of repetitive mild traumatic brain injury exposure and a self- or informant-reported decline in daily functioning, behavioural dysregulation, and cognitive performance, guided by an increasing index of suspicion for those with a higher accumulated burden of RHIs.
#66 Chronic traumatic encephalopathy (CTE) dementia | Dementia Australia
https://www.dementia.org.au/about-dementia/chronic-traumatic-encephalopathy-cte-dementia
Currently there is no single test that can diagnose chronic traumatic encephalopathy (CTE) dementia. […] A medical specialist will only make a diagnosis of CTE dementia after careful assessment. This might include: brain scans, including a magnetic resonance imaging (MRI) scan, a detailed medical history, a physical examination, blood and urine tests, a psychiatric assessment, memory and thinking tests. […] If the medical specialist can rule out any other causes, they may diagnose you with CTE dementia. […] You might be diagnosed with chronic traumatic encephalopathy, but not dementia. If that happens, talk to your doctor about your dementia-like symptoms. There may be another cause.
#67 Chronic traumatic encephalopathy | Beacon Health System
https://www.beaconhealthsystem.org/library/diseases-and-conditions/chronic-traumatic-encephalopathy?content_id=CON-20370902
Chronic traumatic encephalopathy (CTE) is a brain disorder likely caused by repeated head injuries. The only way to definitively diagnosis CTE is after death during an autopsy of the brain. […] CTE can’t be definitively diagnosed during life except in people with high-risk exposures. Researchers are currently developing diagnostic biomarkers for CTE, but none has been validated yet. […] There is currently no way to definitively diagnose CTE during life. But experts have developed clinical criteria for traumatic encephalopathy syndrome (TES). TES is a clinical disorder associated with CTE. CTE is suspected in people who are at high risk due to repeated head trauma over years during sports or military experiences. A diagnosis requires evidence of degeneration of brain tissue and deposits of tau and other proteins in the brain. This can only be seen after death during an autopsy.
#68 Chronic traumatic encephalopathy (CTE) | Diagnosis, Treatment, & Football | Britannica
https://www.britannica.com/science/chronic-traumatic-encephalopathy
Chronic traumatic encephalopathy (CTE) can be diagnosed definitively only by postmortem autopsy, but various symptoms have been linked to the condition. […] Research suggested that an imaging technology known as positron emission tomography (PET) may be able to detect the early accumulation of tau protein in the living brain. […] Much remained to be understood about the clinical presentation, genetic and environmental risk factors, and effective means of treatment and prevention for CTE.
#69 What is CTE? | Live Science
https://www.livescience.com/health/neuroscience/what-is-cte
Efforts are underway to develop diagnostic tools for living patients with CTE. Researchers are exploring advanced brain scan techniques and markers of CTE that could be detected in blood tests. Developing reliable methods to diagnose CTE before death is essential for taking steps to prevent further injuries and creating effective CTE treatments in the future.
#70 The long road to in vivo diagnosis of chronic traumatic encephalopathy | MSKTC
https://msktc.org/publications/detail/11343
This scientific commentary refers study findings presented in an article by Iverson and Gardner, which suggests a potentially high rate for misdiagnosing traumatic encephalopathy syndrome (TES) among adults in the United States (US). […] The author of this article hopes that proposed new consensus-based TES criteria will be widely tested and further improved to permit accurate in vivo diagnosis and development of disease-modifying therapies. […] The same applies for CTE neuropathology, as those criteria continue to be refined.
#71 Blood-Based Biomarkers in the Diagnosis of Chronic Traumatic Encephalopathy: Research to Date and Future Directions
https://www.mdpi.com/1422-0067/24/16/12556
The main issue for many proposed biomarkers is their lack of selectivity for CTE. […] However, several molecules, such as different phosphorylated tau isoforms, were able to discern CTE from different neurodegenerative diseases. […] Further, the results from studies on exosomal biomarkers suggest that exosomes are a promising source of biomarkers, reflective of the internal environment of the brain. […] Nonetheless, more longitudinal studies combining imaging, neurobehavioral, and biochemical approaches are warranted to establish robust biomarkers for CTE.
#72 Chronic traumatic encephalopathy: Diagnostic updates and advances
https://pmc.ncbi.nlm.nih.gov/articles/PMC9826753/
In conclusion, the current clinical diagnosis of CTE relies on clinical symptomatology and structural imaging findings. While there is extensive research on imaging and fluid biomarkers in relation to TBI, there is comparatively limited research on CTE. […] The need for further research into PET biomarkers for hyperphosphorylated tau proteins specifically associated with CTE and tasked with reducing off-target binding is warranted.
#73 Developing methods to detect and diagnose chronic traumatic encephalopathy during life: rationale, design, and methodology for the DIAGNOSE CTE Research Project | Alzheimer’s Research & Therapy | Full Text
https://alzres.biomedcentral.com/articles/10.1186/s13195-021-00872-x
Provisional clinical research diagnostic criteria for CTE have been proposed, including the traumatic encephalopathy syndrome (TES) research criteria published in 2014. […] An accurate diagnosis of CTE during life will require validated biomarkers of the underlying pathophysiology of the disease. […] The primary endpoints of the study are to characterize the clinical presentation of CTE and to identify in vivo biomarkers that can support a probable CTE diagnosis. […] The DIAGNOSE CTE Research Project will lead to a rich dataset that will be used to further our understanding of CTE in terms of its clinical presentation, in vivo biomarkers, clinical research diagnostic criteria, and risk and resiliency factors for the development of CTE.
#74 New Criteria Published for Diagnosing the Clinical Syndrome of Chronic Traumatic Encephalopathy During Life | Chobanian & Avedisian School of Medicine
https://www.bumc.bu.edu/camed/2021/03/16/new-criteria-published-for-diagnosing-the-clinical-syndrome-of-chronic-traumatic-encephalopathy-during-life/
It is expected that biomarkers, such as PET scans and blood tests currently being studied in the DIAGNOSE CTE Research Project, will be integrated into the criteria to improve diagnostic accuracy in the next few years, resulting in the appropriate use of the criteria to diagnose patients in the clinic. […] The publication of these NINDS Consensus Diagnostic Criteria for TES is a major step in achieving the goal of diagnosing CTE in life and in promoting research to better understand, treat, and ultimately prevent CTE.
#75 ASBB statement on the diagnosis of CTE during life – Australian Sports Brain Bank
https://www.brainbank.org.au/cte-diagnosis/
Chronic traumatic encephalopathy (CTE) is the name given to a pathology that is found in the brains of some people exposed to repetitive head injuries. […] Our mission at ASBB is to use and promote research to help diagnose, prevent, monitor, and treat CTE. At the heart of our goals is the development of clinical tests that can diagnose CTE in people while they are living. […] At present the definitive diagnosis of CTE remains one that can only be made after death, and together with our pledgers and donor families we are working to change this. […] There are currently NO tests that can diagnose CTE during life. […] Criteria for a clinical syndrome, Traumatic Encephalopathy Syndrome (TES), are being developed to help researchers understand the potential symptoms caused by CTE during life. […] PET scanning has been proposed by some as a way to diagnose CTE. Unfortunately, this is not true. PET is a powerful tool that can reveal abnormalities in the brain, but it is not yet able to test for CTE.
#76 ASBB statement on the diagnosis of CTE during life – Australian Sports Brain Bank
https://www.brainbank.org.au/cte-diagnosis/
Chronic traumatic encephalopathy (CTE) is the name given to a pathology that is found in the brains of some people exposed to repetitive head injuries. […] Our mission at ASBB is to use and promote research to help diagnose, prevent, monitor, and treat CTE. At the heart of our goals is the development of clinical tests that can diagnose CTE in people while they are living. […] At present the definitive diagnosis of CTE remains one that can only be made after death, and together with our pledgers and donor families we are working to change this. […] There are currently NO tests that can diagnose CTE during life. […] Criteria for a clinical syndrome, Traumatic Encephalopathy Syndrome (TES), are being developed to help researchers understand the potential symptoms caused by CTE during life. […] PET scanning has been proposed by some as a way to diagnose CTE. Unfortunately, this is not true. PET is a powerful tool that can reveal abnormalities in the brain, but it is not yet able to test for CTE.
#77 ASBB statement on the diagnosis of CTE during life – Australian Sports Brain Bank
https://www.brainbank.org.au/cte-diagnosis/
Chronic traumatic encephalopathy (CTE) is the name given to a pathology that is found in the brains of some people exposed to repetitive head injuries. […] Our mission at ASBB is to use and promote research to help diagnose, prevent, monitor, and treat CTE. At the heart of our goals is the development of clinical tests that can diagnose CTE in people while they are living. […] At present the definitive diagnosis of CTE remains one that can only be made after death, and together with our pledgers and donor families we are working to change this. […] There are currently NO tests that can diagnose CTE during life. […] Criteria for a clinical syndrome, Traumatic Encephalopathy Syndrome (TES), are being developed to help researchers understand the potential symptoms caused by CTE during life. […] PET scanning has been proposed by some as a way to diagnose CTE. Unfortunately, this is not true. PET is a powerful tool that can reveal abnormalities in the brain, but it is not yet able to test for CTE.
#78 Chronic Traumatic Encephalopathy: Update on Current Clinical Diagnosis and Management
https://www.mdpi.com/2227-9059/9/4/415
The diagnostic criteria and neuropathologic features of CTE are well defined but perfecting in-vivo diagnosis of CTE remains elusive; CTE is only definitively diagnosed at autopsy. […] Although clinical features can be characterized in-vivo, definitive diagnosis of CTE still requires an autopsy, prompting Montinegro et al. to propose a new diagnostic criterion, known as trauma encephalopathy syndrome (TES). […] While CTE remains a histologic diagnosis, identification of radiographic signs and correlates of disease severity remains a high priority. […] The identification of fluid biomarkers from blood or CSF is under active investigation for pre-morbid diagnosis of CTE. […] While no single fluid biomarker is sufficient or approved for diagnosis, several studies are continually investigating further fluid biomarker candidates. […] The diagnostic innovations are summarized in Table 1.
#79 Traumatic encephalopathy syndrome: application of new criteria to a cohort exposed to repetitive head impacts | British Journal of Sports Medicine
https://bjsm.bmj.com/content/57/7/389
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disorder described in athletes with previous exposure to repetitive head impacts (RHIs). Currently, the diagnosis can only be made by pathological examination. Despite the media attention it has received, much is still unknown about the disease including its incidence/prevalence, natural history and risk factors. […] One of the difficulties in studying CTE had been the lack of an agreed on clinical diagnostic criteria. However, guided by accumulating clinical and pathological data, the first National Institute of Neurological Disease and Stroke (NINDS) Consensus Diagnostic Criteria for Traumatic Encephalopathy Syndrome (TES) was recently published. The TES criteria was designed to represent the clinical syndrome of CTE and consists of core features including substantial exposure to RHI, impairment in cognitive function and/or neurobehavioural dysregulation, a progressive course, and the absence of any other process that could account for the symptoms.
#80 Review of TES/CTE: Diagnosis, Criteria, and Challenges | myneuronews.com
https://myneuronews.com/2024/10/01/review-of-tes-cte-diagnosis-criteria-and-challenges/
One of the most significant challenges in diagnosing TES/CTE is that the symptoms overlap with those of other neurodegenerative diseases, making differential diagnosis crucial. […] A key feature of TES/CTE is the progressive nature of the symptoms, meaning they worsen over time, even after head trauma has ceased. […] The search for biomarkers that could help diagnose TES/CTE while the patient is still alive is ongoing. […] Given the complexity of diagnosing TES/CTE, a multidisciplinary approach is recommended. […] While significant strides have been made in understanding TES/CTE, the condition remains difficult to diagnose accurately during life. The current diagnostic criteria provide a foundation, but further research into biomarkers and imaging techniques is essential for advancing diagnosis and treatment.
#81 What is CTE? | Live Science
https://www.livescience.com/health/neuroscience/what-is-cte
Efforts are underway to develop diagnostic tools for living patients with CTE. Researchers are exploring advanced brain scan techniques and markers of CTE that could be detected in blood tests. Developing reliable methods to diagnose CTE before death is essential for taking steps to prevent further injuries and creating effective CTE treatments in the future.
#82 MRIâs May be Initial Window into CTE Diagnosis in Living; Approach May Shave Years Off Diagnosis | Chobanian & Avedisian School of Medicine
https://www.bumc.bu.edu/camed/2021/12/08/mris-may-be-initial-window-into-cte-diagnosis-in-living-approach-may-shave-years-off-diagnosis/
While chronic traumatic encephalopathy (CTE) cannot yet be diagnosed during life, a new study provides the best evidence to date that a commonly used brain imaging technique, magnetic resonance imaging (MRI), may expedite the ability to diagnose CTE with confidence in the living. […] Findings from this study show us what we can expect to see on MRI in CTE. This is very exciting because it brings us that much closer to detecting CTE in living people, said first author Michael Alosco, PhD, associate professor of neurology at BU School of Medicine, co-director of the BU Alzheimers Disease Center Clinical Core, and a lead BU CTE Center investigator. […] Alosco also added, there is more to do as we still need to understand whether the patterns we saw on MRI are specific to CTE, that is, do they differentiate CTE from Alzheimers disease and other causes of dementia.
#83 World first could see CTE diagnosis in live patients
https://nrtimes.co.uk/world-first-could-see-cte-diagnosis-in-live-patients-tru24/
âYou canât help a patient with their disease if you can only tell them they have it when theyâre dead,â said Dr. Bailes. […] âThe hope is that if we can diagnose it while the patient is living, maybe we can treat some of the symptoms. We also hope this will spur the pharmaceutical industry to develop drugs that can treat CTE.â
#84 ScholarWorks@Arcadia – Capstone Showcase: Review of Diagnosis & Treatment of Chronic Traumatic Encephalopathy in Adults
https://scholarworks.arcadia.edu/showcase/2023/pa/36/
Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative condition that is associated with a history of repetitive head trauma. […] This condition cannot be diagnosed until after the patient is deceased, leading to challenges for clinicians in identifying and managing patients presenting with CTE features. […] By identifying patients at risk for CTE and the presence of associated symptoms, clinicians can intervene as early as possible to prevent the progression of the disease and manage patients symptoms to ensure better quality of life. […] There is no definitive treatment for CTE, but guidelines have been established to help mitigate that potentially life altering symptoms of neurodegeneration and subsequent cognitive and motor decline. […] This paper aims to educate clinicians on modern CTE research findings regarding proposed risk factors, signs, symptoms, diagnostics, and management of CTE. […] Peer reviewed literature from recent years was evaluated to provide a summary of the current understanding of CTE, guidelines for management, and future directions for research of the condition.
#85 World first could see CTE diagnosis in live patients
https://nrtimes.co.uk/world-first-could-see-cte-diagnosis-in-live-patients-tru24/
âYou canât help a patient with their disease if you can only tell them they have it when theyâre dead,â said Dr. Bailes. […] âThe hope is that if we can diagnose it while the patient is living, maybe we can treat some of the symptoms. We also hope this will spur the pharmaceutical industry to develop drugs that can treat CTE.â
#86 World first could see CTE diagnosis in live patients
https://nrtimes.co.uk/world-first-could-see-cte-diagnosis-in-live-patients-tru24/
âYou canât help a patient with their disease if you can only tell them they have it when theyâre dead,â said Dr. Bailes. […] âThe hope is that if we can diagnose it while the patient is living, maybe we can treat some of the symptoms. We also hope this will spur the pharmaceutical industry to develop drugs that can treat CTE.â