Chronic Traumatic Encephalopathy: A Review of Clinical Diagnosis, Animal Models, Sex Differences, and A Revised Return-to-Play Protocol

摘要

Chronic traumatic encephalopathy (CTE) is a progressive neurodegenerative disease marked by debilitating cognitive and behavioral symptoms. CTE is thought to be caused by traumatic brain injuries (TBIs), though it remains unclear how the frequency, duration and intensity of TBIs contribute to CTE vulnerability. It is estimated that as many as 4M sports-related TBIs may occur annually in the US, though mild TBIs are often underreported and/or undiagnosed. As participation in athletics is arguably a voluntary and controllable risk factor for TBI, it is important to identify and understand factors that might affect an athlete’s’ likelihood of developing CTE. This review summarizes CTE symptomology and pathology, reviews relevant findings from animal models of TBI/CTE, discusses clinical criteria and emerging technologies used for diagnosis, reviews the extent to which sex differences may contribute to TBI severity and/or recovery and, finally, presents a data-driven protocol for return-to-play procedures for student athletes in contact sports.