Chronic Traumatic Encephalopathy (CTE)
CTE is a brain disease linked to years of repeated head impacts, including the many smaller knocks that never cause a diagnosed concussion. It can only be confirmed after death. The best protection is fewer head impacts, especially in young people.
‘Toughen up’ is not a brain-protection strategy. Fewer head knocks is.
What it is
- A slowly progressive disease in which an abnormal protein, tau, builds up in a distinctive pattern around small blood vessels in the brain.
- Found in people with long exposure to repeated head impacts: contact and collision sports (American football, rugby, Australian football, boxing, ice hockey, soccer heading) and military blasts.
- Risk rises with the number of years of exposure. Most people with head impacts will not develop it.
- Major health bodies now accept that repeated head impacts can cause CTE.
Possible symptoms
- Problems with memory, thinking and planning
- Mood and behaviour changes: depression, irritability, impulsivity, aggression or explosive anger
- Later: dementia and movement problems in some
- Symptoms usually appear years to decades after the exposure ends
- These symptoms have many other, treatable causes, so get assessed
Diagnosis
- CTE can only be confirmed by examining the brain after death.
- In life, doctors can diagnose “traumatic encephalopathy syndrome”, a research term for the clinical picture.
- Scans and blood tests that detect CTE during life are being studied.
- The Australian Sports Brain Bank, set up in Sydney in 2018, has found CTE in former Australian athletes.
Prevention
- Limit head impacts in training: less contact training and no unnecessary heading drills.
- Delay tackling and heading in children, and follow concussion rules strictly.
- Report and properly recover from every concussion.
If you’re worried
- See your GP about memory, mood or behaviour changes. Depression, sleep apnoea, alcohol, thyroid problems and medicines are common, treatable causes.
- If you’re having thoughts of self-harm, call Lifeline 13 11 14 or 000.
Common questions
Can CTE be diagnosed while you are alive?
Not yet with certainty. It’s confirmed only by examining the brain after death, although doctors can describe a clinical syndrome and tests are being researched.
Does one concussion cause CTE?
CTE is linked to many repeated head impacts over years, not usually a single concussion. Risk rises with the years of exposure.
What are the symptoms of CTE?
Memory and thinking problems, depression, irritability, impulsivity and aggression, sometimes progressing to dementia. These symptoms also have other treatable causes.
Helpful resources
- Australian Sports Brain BankResearch brain bank based in Sydney.
- Lifeline 13 11 1424/7 crisis support. Free.
Evidence and more information
- NINDS: Chronic traumatic encephalopathy
- Katz DI et al. NINDS consensus diagnostic criteria for traumatic encephalopathy syndrome (Neurology 2021)
maladywise.com/cte/