So last week we talked about traumatic brain injury (TBI) and chronic traumatic encephalopathy (CTE). There is actually a big difference between TBI and CTE even though they both have to do with damage to the brain from trauma.
CTE is a progressive degenerative disease found in people who have suffered repetitive brain trauma, including hits to the head that did not result in TBI symptoms. Individuals with CTE usually have symptoms of dementia, memory loss, aggression, confusion, depression and suicidal ideations that may occur many years after the injuries.
CTE was previously called dementia pugilistica or “punch-drunk”, in boxing circles. CTE has been most commonly found in athletes participating in soccer, ice hockey, American football, motocross, stunt performers, and basically anyone who has experienced repetitive brain trauma. Recently, soldiers in the battlefield are showing signs of CTE and in 2013, President Barack Obama announced the creation of the Chronic Effects of Neurotrauma Consortium or CENC, a federally funded research project devised to address the long-term effects of mild traumatic brain injury in military service personnel and Veterans.
In September 2015, researchers with the Department of Veterans Affairs and Boston University announced that they had identified CTE in 87 of 91 (96 percent) deceased NFL players that they had examined and in 79 percent of all football players.
The primary physical aspects of CTE include shrinking of the brain, atrophy of the frontal and temporal lobes, enlargement of the ventricles, atrophy of the hippocampus, thalamus, brainstem and cerebellum. Under a microscope, there are abnormal deposits called tau and beta amyloid proteins as well as dense neurofibrillary tangles – basically all signs of chronic brain scarring.
Concussion or mild traumatic brain injury are the most common types of brain injuries.
A TBI is frequently defined as a head injury with a temporary loss of brain function, causing a variety of physical, cognitive, and emotional symptoms, which may or may not be subtle.
The mainstay of treatment involves monitoring and rest. Most symptoms resolve in about 3 weeks and it is generally recommended to be sure that another concussion does not occur within a 2 month time period. However, individuals sustaining multiple concussions may find that it becomes progressively easier to get another concussion, even from milder impacts.
Classic signs of a concussion are some change in mentation, headache, loss of consciousness, irritability, amnesia, slowed reaction times and sleep disturbances. Be aware that the definitions of concussions greatly vary, although many organizations are forming to standardize the diagnosis and treatment of concussions.
Usually, there is no microscopic changes visible under the microscope, but there is a theory that the neurons are somehow damaged.
The description of CTE and TBI certainly sounds scary, but like all scientific theories, the hypothesis that repeated concussions or impacts definitively cause CTE cannot be proven. However, to date no evidence has come up to falsify this hypothesis. A rapidly growing body of evidence from postmortem studies conducted at major universities and the National Football League support the current theory. Like anything in life, the truth will eventually come out in the science.
So there it is, the differences between CTE and TBI, even they are of the same bird, they really are different from one another.
Stay tuned for the next post!
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Doc Edwards has extensive experience in dealing with concussions, especially when they arise from a sports injury. As there are limited resources for most people affected by a concussion, my goal is to provide guidance in how to deal with concussions from several different standpoints including nutritional optimization, exercises to improve cognitive function, testing options, and return to play discussions.