A critical review of chronic traumatic encephalopathy

Grant L. Iverson*, Andrew J. Gardner, Paul McCrory, Ross Zafonte, Rudy J. Castellani

*Corresponding author for this work

Research output: Contribution to journalReview articlepeer-review

82 Scopus citations

Abstract

Chronic traumatic encephalopathy (CTE) has been described in the literature as a neurodegenerative disease with: (i) localized neuronal and glial accumulations of phosphorylated tau (p-tau) involving perivascular areas of the cerebral cortex, sulcal depths, and with a preference for neurons within superficial cortical laminae; (ii) multifocal axonal varicosities and axonal loss involving deep cortex and subcortical white matter; (iii) relative absence of beta-amyloid deposits; (iv) TDP-43 immunoreactive inclusions and neurites; and (v) broad and diverse clinical features. Some of the pathological findings reported in the literature may be encountered with age and other neurodegenerative diseases. However, the focality of the p-tau cortical findings in particular, and the regional distribution, are believed to be unique to CTE. The described clinical features in recent cases are very similar to how depression manifests in middle-aged men and with frontotemporal dementia as the disease progresses. It has not been established that the described tau pathology, especially in small amounts, can cause complex changes in behavior such as depression, substance abuse, suicidality, personality changes, or cognitive impairment. Future studies will help determine the extent to which the neuropathology is causally related to the diverse clinical features.

Original languageEnglish (US)
Pages (from-to)276-293
Number of pages18
JournalNeuroscience and Biobehavioral Reviews
Volume56
DOIs
StatePublished - Sep 1 2015
Externally publishedYes

Keywords

  • Athletes
  • Brain injury
  • Concussion
  • Dementia
  • Dementia pugilistica

ASJC Scopus subject areas

  • Neuropsychology and Physiological Psychology
  • Cognitive Neuroscience
  • Behavioral Neuroscience

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