Articles
CTE and Alzheimer's; different diseases
- Created on Tuesday, 11 October 2011 13:33
- Last Updated on 24.05.2012
- Published Date
Alzheimer’s disease and Chronic Traumatic Encephalopathy (CTE) are both “neurodegenerative diseases.” That is, they are brain diseases that result in the progressive destruction of brain cells, eventually leading to cognitive, behavioral, and other impairments.
Both diseases also lead to dementia. The distinction between Alzheimer’s and dementia is very often misunderstood, even by many doctors. “Dementia” is a clinical syndrome defined by memory and other cognitive impairments that are severe enough to cause difficulties in social and/or occupational functioning (i.e., reduced independence in functioning).
Dementia is not an illness or a disease. Dementia is not a “mild” form of Alzheimer’s. Rather, it is analogous to “fever,” in that it tells you that you are sick, but doesn’t say what is causing the problem. Similarly, dementia means that there is something wrong with the brain’s functioning, but not what is causing it.
Several illnesses and diseases can lead to dementia, including Alzheimer’s disease which accounts for approximately 75% of all cases of dementia. However, several other neurodegenerative diseases result in dementia, including CTE. Alzheimer’s and CTE are distinct diseases.
Both Alzheimer’s and CTE can only be accurately diagnosed postmortem through a neuropathological examination of the brain.
There have been several new scientific breakthroughs over the past few years that now allow doctors and scientists to be much more accurate in diagnosing Alzheimer’s during life. However, at this time, there is no method of diagnosing CTE during life, although our group at the Boston University Center for the Study of Traumatic Encephalopathy (CSTE) recently received a grant from the National Institutes of Health to begin developing these types of tests.
One of the major differences between Alzheimer’s and CTE involves what causes each of the diseases. There is no known specific risk factor that leads to Alzheimer’s.
For CTE, however, it is believed that repetitive brain trauma (including concussions and subconcussive blows to the head) is a necessary, but not sufficient risk factor. That is, everyone that has been found to have CTE in postmortem examination has had a history of repetitive brain trauma, including athletes (e.g., football and hockey players, boxers and wrestlers), as well as others, such as combat military personnel, developmentally disabled individuals who repeatedly bang their heads, and victims of domestic abuse.
Boxers and football players (especially lineman) appear to be the most likely to get the disease because of the repetitive brain trauma exposure. But, it is important to note that not everyone with a history of repetitive brain trauma will develop CTE.
Our center is currently conducting research into the other potential additive risk factors, such as genetics, age of initial brain trauma exposure, frequency and overall duration of exposure, etc. This research will hopefully lead us to understand why one person gets the disease and another person does not.
This line of investigation, along with our new study to develop methods of diagnosing CTE during life, will eventually lead to effective treatments and prevention strategies.
Robert A. Stern, Ph.D. is a Professor of Neurology and Neurosurgery; Co-Director, Center for the Study of Traumatic Encephalopathy; Director, Clinical Core, BU Alzheimer's Disease Center, Boston University School of Medicine.
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