195 Chronic Traumatic Encephalopathy (CTE): Clinical and Pathological Insights

INTRODUCTION Introduction: Chronic Traumatic Ence-phalopathy (CTE) is a progressive degenerative disease of the brain found in athletes and military veterans with a history of repetitive brain trauma, including symptomatic concussions as well as asymptomatic subconcussive hits to the head. The diagnosis, at this time, can only be made by post-mortem examination of brain and is based on the presence of hyperphosphorylated tau protein andneurofibrillary tangles around small blood vessels at the depths of the cortical sulci... Originally, CTE was thought to only occur in boxers however recent research has shown that other athletes, such as American football players, are at risk for the disorder. The diagnosis of CTE was first reported by Dr Bennet Omalu in 2005..Dr Ann McKee and researchers at Boston University have reported to date on 92 of 96 former NFL players diagnosed with CTE. Clinical symptoms of CTE include memory loss, confusion, impaired judgment, impulse control problems, aggression, depression, and, eventually, progressive dementia. METHODS This presentation will concentrate on the clinical evaluation of 50 + former NFL players with suspected CTE 2 of whom were also evaluated post mortem by Dr Ann McKee and researchers at Boston University. All subjects provided detailed general medical, concussion and sub concussive event, and sports medicine histories. All subjects underwent detailed neurological examinations including mini-mental status exams, clinical dementia rating scores, and extensive neuropsychological testing. Post-mortem neuropathological examinations were performed on 2 subjects. RESULTS >Analysis of pertinent historical events, results of neurological examination, clinical mental status testing, detailed neuropsychological scoring on the 50 + subjects will be presented as well as the neuropathological results on 2 overlapping subjects. Pathological grading of the 96 players examined at autopsy will also be reviewed and coorelated with clinical grading of the 50 + patients evaluated clinically. CONCLUSION The constellation of neurological, neuropsychological and pathological findings found in this large cohort of former American football players and the neuropathological findings will be discussed.