If you’re a football fan, you’ve probably heard of chronic traumatic encephalopathy (CTE). However, while more people are aware of this condition, it remains widely misunderstood.

What is CTE?

CTE is a brain condition that develops from repeated head injuries. “CTE doesn’t result from a single event,” says neurological surgeon William Thorell, MD. “Additionally, it’s a neurodegenerative process, like Alzheimer’s or Parkinson’s disease.” Neurodegenerative means CTE permanently impairs nerve cell function in the brain over time. This damage leads to lasting changes in behavior and mental ability. 

Although people in the U.S. most commonly associate CTE with football, it can occur from anything that causes repeated head injury. Researchers have found CTE in the brains of players across many contact or combat sports, and military members who’ve experienced explosions.

However, it’s important to note that not everyone who suffers a concussion (or even multiple concussions) will develop CTE. 

CTE Symptoms

As a degenerative disease, CTE has both early and advanced symptoms. 

Early CTE symptoms include:

• Emotional instability.
• Headache
• Mental health issues, like depression.
• Difficulty concentrating.
• Memory loss.

Advanced CTE symptoms include:

• Trouble speaking.
• Involuntary and uncontrollable muscle movements.
• Aggressive behavior.
• Loss of coordination.
• Self-harming thoughts or behaviors.

The timeline for progression varies from person to person. Likewise, it is difficult to attribute these symptoms specifically to CTE as they are similar to other neurological conditions.

Risk factors for CTE

“Anyone who has experienced repeated impacts to the head could have an increased risk for CTE,” says Dr. Thorell. “There are also some genetic profiles that seem to be a little more at risk.”

Diagnosing CTE

Because CTE shares many similarities with other neurodegenerative diseases, providers can’t definitively diagnose it in a living person. Still, a thorough medical history, neurologic exam and imaging can help a neurologist make a presumptive diagnosis.

“However, definitively diagnosing CTE requires a pathologic diagnosis,” says Dr. Thorell. “This type of diagnosis means a pathologist must autopsy a patient’s brain and determine if the findings are consistent with CTE — such as looking for tau proteins.”

When to see a provider about CTE

“Once you recognize any of the symptoms of CTE, you should see someone,” says Dr. Thorell. “Other conditions can cause these symptoms, and you’ll want to know whether they’re from CTE or not.”

For example, some brain tumors can cause many of the symptoms of CTE. These tumors may  be treatable or benign, so the sooner you detect and treat them, the better. “You can start with an appointment with your primary provider to start the conversation about symptoms and develop a plan to monitor them to see if they improve or worsen,” says Dr. Thorell.

Using your primary provider can help rule out other conditions or any fixable problems. If your condition worsens, you can visit a neurologist for a more comprehensive neurological exam.

Delaying CTE progression

While there is no cure for CTE, there are things you can do to keep yourself as healthy as possible for as long as possible. These activities include:

• Eating a well-rounded diet.
• Limiting alcohol consumption.
• Don’t smoke.
• Exercise regularly.
• Avoid excess sugar.
• Maintain a healthy weight.

“The things that keep you healthy ensure your heart and brain are the healthiest they can be,” says Dr. Thorell. “Likewise, these actions prevent heart disease, which is associated with stroke, which, in turn, is associated with dementing illnesses.”

Understanding CTE

While providers know more about CTE than they did in the past, many questions remain. “We don’t understand everything about CTE, and we need to continue to learn,” says Dr. Thorell.

Similarly, although you may have heard of CTE, there are many misconceptions. For example, everyone who plays football or a contact or combat sport isn’t guaranteed to have CTE. “You don’t want to be flippant about the risks, but it’s a complicated issue,” says Dr. Thorell. “It’s not just that you get hit in the head and are sure to get CTE; there’s much more to it than that.”