CTE

New Study Could Help Diagnose CTE Before Death

The new findings include data that could make it easier for researchers to diagnose the neurodegenerative disease during life.

Clinical knowledge about chronic traumatic encephalopathy (CTE) has come a long way, but there is still much to learn about this neurodegenerative disorder caused by repeated head injuries over time. While doctors have identified suspected CTE cases in patients while they are alive, the disease can only be fully confirmed through an autopsy after death. 

But now, a new study coauthored by School of Public Health researchers at Boston University’s CTE Center provides the most definitive data to date that links CTE pathology to symptoms patients experience during life.

Published in the journal Molecular Neurodegeneration, the first-of-its-kind study connects cognitive, behavioral, and functional symptoms to the disease, which is characterized by a buildup of a protein called p-tau in several areas of the brain. The study quantified the amount of p-tau that accumulated in the brain of deceased athletes and found that higher amounts of this protein were associated with more severe symptoms.

“The fact that we show a clear dose-response relationship between the amount of CTE pathology and the severity of cognitive and functional symptoms, brings us one step closer to being able to diagnose the disease in the living,” says study coauthor Yorghos Tripodis, professor of biostatistics.

For the analysis, CTE Center researchers from SPH and Boston University Chobanian & Avedisian School of Medicine measured the amount of p-tau pathology across 11 brain regions in 364 brains from donors with autopsy-confirmed CTE. The team also interviewed family and friends of the brain donors about their loved one’s cognitive, functional, mood, and behavioral symptoms, and asked them to rate these symptoms in standardized assessments. Then they examined the relationship between the p-tau pathology and the symptom levels.

The researchers found that the amount of p-tau pathology across the brain, predominantly in the frontal lobe, was associated with more cognitive and functional symptoms. The amount of p-tau pathology in the frontal lobe was also associated with more neurobehavioral symptoms, but they observed a higher correlation with cognitive symptoms. 

With these results, researchers inch closer to building criteria for doctors to utilize, with the hope of being able to fully diagnose CTE in patients while they are still alive. 

Although anyone with repeated brain trauma can develop the disease, CTE is primarily associated with athletes who play American football and other high-contact sports. The risks associated with this disease continue to raise ethical and safety questions around the measures that should be taken to protect the health and well-being of recreational, budding, and professional athletes of all ages. 

The study’s senior and corresponding author is Jesse Mez, co-director of clinical research at the CTE Center and associate professor of neurology at the Chobanian & Avedisian School of Medicine. At SPH, coauthors also include doctoral student Eukyung Yang; alum Zachary Baucom; Brett Martin, statistical manager at the Biostatistics & Epidemiology Data Analytics Center (BEDAC); and Joseph Palmisano, associate director of data management for BEDAC.