Adding to Complexity – CTE Found in Patient With “the Absence of any Known Head Injury”

An interesting article was published in the latest edition of the International Journal of Pathology and Clinical Research diagnosing what is believed to be the first known case of an individual having Chronic Traumatic Encephalopathy who did not have a history of concussions.

In the article, titled “Chronic Traumatic Encephalopathy-like Neuropathological Findings Without a History of Trauma” a 45 year old man who was found dead in his sleep had his brain examined post mortem and CTE like changes were revealed.  This was noteworthy to researchers as the patient had no known history of head trauma.  The authors note as follows

To our knowledge, this is the first description of a patient with neuropathological features of CTE-MND in the absence of a history traumatic brain injury. Interestingly, despite cortical tau pathology, our patient never exhibited cognitive impairment, which speculatively could be explained by the relative sparing of the nucleus basalis of Meynert. This highlights the uncertainty surrounding the pathogenesis and pathophysiology of CTE and underscores the need for further detailed studies to elucidate the causative role of trauma. Nevertheless, our case report has several important limitations. For example, the lack of a trauma history comes only from the recollection of the patient’s wife and early life subconcussive blows cannot be entirely excluded. There are also inherent limitations to drawing conclusions from the results of a single patient.

To date, repetitive traumatic brain injury has been shown to be associated with no neuropathological changes, with CTE alone, with -CTE and another neurodegenerative disease, or with non-CTE neurodegeneration. Since CTE is a postmortem diagnosis, the majority of samples have come from brains of symptomatic individuals referred by family; these individuals are more likely to demonstrate some type of neuropathology thus introducing a selection bias. Our case adds to this complexity given the observation that CTE-like changes can occur in the absence of any known head injury; casting doubt that trauma is always the inciting etiological factor. Future studies should assess whether CTE-like pathology is prevalent in non-concussed patient populations.

The full article can be found here.

 

Advertisements

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out / Change )

Twitter picture

You are commenting using your Twitter account. Log Out / Change )

Facebook photo

You are commenting using your Facebook account. Log Out / Change )

Google+ photo

You are commenting using your Google+ account. Log Out / Change )

Connecting to %s