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Boston University researchers hope CTE can be diagnosed in living patients

27 September 2017

Chronic traumatic encephalopathy (CTE), a progressive degenerative brain disease found in people with a history of repeated head trauma, can now be detected only after death, through an autopsy. The brown stain indicates tangles of tau protein.

CTE is a neurodegenerative brain disease that has been linked to football players.

"The ability to diagnose CTE in living individuals will allow for research into prevention and treatment of the disease", the BU press release states.

Previous studies have evaluated other potential biomarkers for CTE, including identifying the protein tau using brain imaging. "Once we can successfully diagnose CTE in living individuals, we will be much closer to discovering treatments for those who suffer from it", McKee said. Concussions can be a factor, but it can also be caused by continued lesser traumas that don't cause concussions.

The protein in question, CLL11, is made in the choroid plexus, the part of the brain that produces cerebrospinal fluid. These symptoms are also associated with other conditions, which makes identifying CTE by symptoms alone an impossible task.

In a new study published Tuesday in the journal PLOS ONE, researchers from BU and the VA Boston Healthcare System studied the brains of 23 former football players who were diagnosed with CTE, in addition to those of 50 non-athletes who suffered from Alzheimer's disease and 18 non-athlete controls.

I won't pretend to understand exactly what that means, but the basic takeaway here is this: if researchers or doctors can pick up on anything that suggests a person is impacted by CTE, this should dramatically lead to protecting that person's long-term health before it is too late. These levels were even higher for players who had played the game longer. However, researchers have high hopes.

As BU explained, more studies are needed to determine "whether increased levels of CCL11 are an early or late finding in the CTE disease process". "These are critical next steps", she said.

Dr Ann McKee, the scientist who performed the analysis of Aaron Hernandez's brain, was a senior author on the study. "A clear organic/biologic diagnosis disarms the sometimes automatic, but inaccurate, presumptions about laziness, personality, or lack of willpower". Levels increase with age, and this is believed to be tied to inflammation. The need for an alternative to brain scans is especially relevant for football players, Merrill noted. All of those studies have involved analyzing brains from deceased football players, and the information gathered has been important to gain more knowledge about the long-term impact of playing football. There were 110 of 111 brains of former pro players that tested positive for CTE. Along with Hernadez, CTE has been diagnosed in San Diego Charger and Hall of Famer Junior Seau, as well as the Philadelphia Eagles' Kevin Turner and the Oakland Raiders' Ken Stabler, to name a few.

McKee acknowledges that a doctor's job is to take care of a patient, not a test result.

Researchers are still unclear on how CTE affects behavior, but a growing swell of studies is offering some answers.

Because CTE is so hard to diagnose, there is no way of estimating how many people in the US may have it.

This is Hernandez's brain scan: It shows the classic features of CTE. However, this group was not random and didn't constitute a representative sample of all National Football League players, as many of these brain specimens were donated by family members specifically because they suspected CTE had played a role in the person's demise.

Boston University researchers hope CTE can be diagnosed in living patients