Robert A Stern1, Daniel H Daneshvar, Christine M Baugh, Daniel R Seichepine, Philip H Montenigro, David O Riley, Nathan G Fritts, Julie M Stamm, Clifford A Robbins, Lisa McHale, Irene Simkin, Thor D Stein, Victor E Alvarez, Lee E Goldstein, Andrew E Budson, Neil W Kowall, Christopher J Nowinski, Robert C Cantu, Ann C McKee. 1. From the Center for the Study of Traumatic Encephalopathy (R.A.S., D.H.D., C.M.B., D.R.S., P.H.M., D.O.R., N.G.F., J.M.S., C.A.R., T.D.S., V.E.A., C.J.N., R.C.C., A.C.M.), BU Alzheimer's Disease Center (R.A.S., T.D.S., L.E.G., A.E.B., N.W.K., A.C.M.), Departments of Neurology (R.A.S., C.M.B., D.R.S., V.E.A., A.E.B., N.W.K., A.C.M.), Neurosurgery (R.A.S., R.C.C.), and Pathology (T.D.S., N.W.K., A.C.M.), Molecular Genetics Core Facility (I.S.), Boston University School of Medicine; Sports Legacy Institute (L.M., C.J.N., R.C.C.), Waltham; VA Boston Healthcare System (T.D.S., V.E.A., A.E.B., N.W.K., A.C.M.); Departments of Psychiatry, Neurology, Pathology & Laboratory Medicine, Ophthalmology, Biomedical Engineering, and Electrical & Computer Engineering (L.E.G.), Boston University School of Medicine and College of Engineering; and Department of Neurosurgery (R.C.C.), Emerson Hospital, Concord, MA.
Abstract
OBJECTIVE: The goal of this study was to examine the clinical presentation of chronic traumatic encephalopathy (CTE) in neuropathologically confirmed cases. METHODS: Thirty-six adult male subjects were selected from all cases of neuropathologically confirmed CTE at the Boston University Center for the Study of Traumatic Encephalopathy brain bank. Subjects were all athletes, had no comorbid neurodegenerative or motor neuron disease, and had next-of-kin informants to provide retrospective reports of the subjects' histories and clinical presentations. These interviews were conducted blind to the subjects' neuropathologic findings. RESULTS: A triad of cognitive, behavioral, and mood impairments was common overall, with cognitive deficits reported for almost all subjects. Three subjects were asymptomatic at the time of death. Consistent with earlier case reports of boxers, 2 relatively distinct clinical presentations emerged, with one group whose initial features developed at a younger age and involved behavioral and/or mood disturbance (n = 22), and another group whose initial presentation developed at an older age and involved cognitive impairment (n = 11). CONCLUSIONS: This suggests there are 2 major clinical presentations of CTE, one a behavior/mood variant and the other a cognitive variant.
OBJECTIVE: The goal of this study was to examine the clinical presentation of chronic traumatic encephalopathy (CTE) in neuropathologically confirmed cases. METHODS: Thirty-six adult male subjects were selected from all cases of neuropathologically confirmed CTE at the Boston University Center for the Study of Traumatic Encephalopathy brain bank. Subjects were all athletes, had no comorbid neurodegenerative or motor neuron disease, and had next-of-kin informants to provide retrospective reports of the subjects' histories and clinical presentations. These interviews were conducted blind to the subjects' neuropathologic findings. RESULTS: A triad of cognitive, behavioral, and mood impairments was common overall, with cognitive deficits reported for almost all subjects. Three subjects were asymptomatic at the time of death. Consistent with earlier case reports of boxers, 2 relatively distinct clinical presentations emerged, with one group whose initial features developed at a younger age and involved behavioral and/or mood disturbance (n = 22), and another group whose initial presentation developed at an older age and involved cognitive impairment (n = 11). CONCLUSIONS: This suggests there are 2 major clinical presentations of CTE, one a behavior/mood variant and the other a cognitive variant.
Authors: Bennet I Omalu; Steven T DeKosky; Ryan L Minster; M Ilyas Kamboh; Ronald L Hamilton; Cyril H Wecht Journal: Neurosurgery Date: 2005-07 Impact factor: 4.654
Authors: Renata Areza-Fegyveres; Sergio Rosemberg; Rosa Maria R P S Castro; Claudia Sellitto Porto; Valéria Santoro Bahia; Paulo Caramelli; Ricardo Nitrini Journal: Arq Neuropsiquiatr Date: 2007-09 Impact factor: 1.420
Authors: John C Morris; Catherine M Roe; Chengjie Xiong; Anne M Fagan; Alison M Goate; David M Holtzman; Mark A Mintun Journal: Ann Neurol Date: 2010-01 Impact factor: 10.422
Authors: G Friedman; P Froom; L Sazbon; I Grinblatt; M Shochina; J Tsenter; S Babaey; B Yehuda; Z Groswasser Journal: Neurology Date: 1999-01-15 Impact factor: 9.910
Authors: Ann C McKee; Robert A Stern; Christopher J Nowinski; Thor D Stein; Victor E Alvarez; Daniel H Daneshvar; Hyo-Soon Lee; Sydney M Wojtowicz; Garth Hall; Christine M Baugh; David O Riley; Caroline A Kubilus; Kerry A Cormier; Matthew A Jacobs; Brett R Martin; Carmela R Abraham; Tsuneya Ikezu; Robert Ross Reichard; Benjamin L Wolozin; Andrew E Budson; Lee E Goldstein; Neil W Kowall; Robert C Cantu Journal: Brain Date: 2012-12-02 Impact factor: 13.501
Authors: Ann C McKee; Robert C Cantu; Christopher J Nowinski; E Tessa Hedley-Whyte; Brandon E Gavett; Andrew E Budson; Veronica E Santini; Hyo-Soon Lee; Caroline A Kubilus; Robert A Stern Journal: J Neuropathol Exp Neurol Date: 2009-07 Impact factor: 3.685
Authors: Inga K Koerte; David Kaufmann; Elisabeth Hartl; Sylvain Bouix; Ofer Pasternak; Marek Kubicki; Alexander Rauscher; David K B Li; Shiroy B Dadachanji; Jack A Taunton; Lorie A Forwell; Andrew M Johnson; Paul S Echlin; Martha E Shenton Journal: Neurosurg Focus Date: 2012-12 Impact factor: 4.047
Authors: David C Perry; Virginia E Sturm; Matthew J Peterson; Carl F Pieper; Thomas Bullock; Bradley F Boeve; Bruce L Miller; Kevin M Guskiewicz; Mitchel S Berger; Joel H Kramer; Kathleen A Welsh-Bohmer Journal: J Neurosurg Date: 2015-08-28 Impact factor: 5.115
Authors: Inga K Koerte; Jakob Hufschmidt; Marc Muehlmann; Yorghos Tripodis; Julie M Stamm; Ofer Pasternak; Michelle Y Giwerc; Michael J Coleman; Christine M Baugh; Nathan G Fritts; Florian Heinen; Alexander Lin; Robert A Stern; Martha E Shenton Journal: J Neurotrauma Date: 2015-12-15 Impact factor: 5.269
Authors: Raquel C Gardner; Katherine L Possin; Christopher P Hess; Eric J Huang; Lea T Grinberg; Amber L Nolan; Brendan I Cohn-Sheehy; Pia M Ghosh; Serggio Lanata; Jennifer Merrilees; Joel H Kramer; Mitchel S Berger; Bruce L Miller; Kristine Yaffe; Gil D Rabinovici Journal: Neurol Clin Pract Date: 2015-08
Authors: Michael L Alosco; Johnny Jarnagin; Yorghos Tripodis; Michael Platt; Brett Martin; Christine E Chaisson; Christine M Baugh; Nathan G Fritts; Robert C Cantu; Robert A Stern Journal: J Neurotrauma Date: 2016-08-11 Impact factor: 5.269
Authors: Jennifer Lorigan; Hugh Kearney; Bryan Grimes; Josephine Heffernan; Alan Beausang; Jane Cryan; Michael A Farrell; Francesca M Brett Journal: Ir J Med Sci Date: 2018-11-30 Impact factor: 1.568
Authors: Allison R Kaup; Carrie Peltz; Kimbra Kenney; Joel H Kramer; Ramon Diaz-Arrastia; Kristine Yaffe Journal: J Int Neuropsychol Soc Date: 2016-10-04 Impact factor: 2.892