Chronic traumatic encephalopathy

• CTE can only be diagnosed via autopsy
• CTE is most frequently associated with professional athletes, though this population is also exposed to more risk factors than mild traumatic brain injury alone, including chronic pain +/- opioid misuse, repeated exposures to anesthesia, alcohol, depression, OSA, weight gain over time, cardiac risk factors, among others
  • The Harvard Football Players Health Study sought to identify significant and prevalent modifiable risk factors in football players, comparing players with large number of concussions and examining factors associated with good vs poor cognition related quality of life.
    • Depression, anxiety, pain, and physical impairment were very strongly associated with moderate/severe impairment in cognition related quality of life
      • Pain and physical functioning was particularly notable despite the two groups not differing in surgical procedures
    • Short sleep duration and low physical activity were also very strongly associated; additional factors included current smoking, no low intensity exercise, weight training, or high intensity exercise, sleep apnea, cardiovascular disease, stroke history, hypertension, diabetes

References

Roberts AL, et al. Modifiable risk factors for poor cognitive function in former American-style football players: findings from the Harvard football players health study. 2021. Journal of Neurotrauma 38:189-195. https://pubmed.ncbi.nlm.nih.gov/32640866/