Research Gaps and Controversies in Chronic Traumatic Encephalopathy: A Review

@article{Asken2017ResearchGA,
  title={Research Gaps and Controversies in Chronic Traumatic Encephalopathy: A Review},
  author={Breton M. Asken and Molly J. Sullan and Steven T. DeKosky and Michael S. Jaffee and Russell M. Bauer},
  journal={JAMA Neurology},
  year={2017},
  volume={74},
  pages={1255–1262}
}
Importance Scientific and lay interest in negative outcomes associated with exposure to repetitive brain trauma (RBT) continues to strengthen. Concerns about the association between RBT and dementia began more than a century ago, but have resurfaced in the last decade with the more recently described chronic traumatic encephalopathy (CTE). Chronic traumatic encephalopathy is a tauopathy associated with RBT that has become inextricably linked to conversations about sport-related concussion and… 
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References

SHOWING 1-10 OF 98 REFERENCES
Factors Influencing Clinical Correlates of Chronic Traumatic Encephalopathy (CTE): a Review
TLDR
Cognitive, emotional, and behavioral changes associated with developmental and demographic factors, and neurodevelopmental disorders should be considered as modifiers predominantly of the clinical outcomes associated with repetitive brain trauma within a broader biopsychosocial framework, though also note potential effects on neuropathological outcomes.
Chronic Traumatic Encephalopathy in Contact Sports: A Systematic Review of All Reported Pathological Cases
TLDR
It is found that a history of mTBI was the only risk factor consistently associated with CTE, and no relationships between CTE and age of death or abnormal ApoE allele were found, and the incidence of CTE remains unknown due to the lack of large, longitudinal studies.
Chronic traumatic encephalopathy: neurodegeneration following repetitive concussive and subconcussive brain trauma
TLDR
Current research efforts are focused on the creation of clinical diagnostic criteria, finding objective biomarkers for CTE, and understanding the additional risk factors and underlying mechanism that causes the disease.
Does a Unique Neuropsychiatric Profile Currently Exist for Chronic Traumatic Encephalopathy?
TLDR
It is indicated that insufficient evidence currently exists to suggest a distinct neuropsychiatric profile for CTE, and clinicians and researchers alike have a responsibility to adopt a cautious and balanced approach for antemortem assessments.
Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome
TLDR
Proposed research criteria for traumatic encephalopathy syndrome (TES) which consist of four variants or subtypes ( TES behavioral/mood variant, TES cognitive variant,TES mixed variant, and TES dementia) as well as classifications of ‘probable CTE’ and ‘possible Cte’ are presented.
Chronic traumatic encephalopathy in sport: a systematic review
TLDR
The clinicopathological differences between the ‘classic’ and ‘modern’ CTE syndrome suggest that the new syndrome needs a different nomenclature, and further research is required to clearly define the clinical phenotype of the modern CTE Syndrome and establish the underlying aetiology.
Repetitive Traumatic Brain Injury and Development of Chronic Traumatic Encephalopathy: A Potential Role for Biomarkers in Diagnosis, Prognosis, and Treatment?
TLDR
The clinical history and pathologic findings associated with CTE are reviewed, as well as imaging modalities that have demonstrated some promise for future use in the diagnosis and/or tracking of CTE or repetitive brain injury are reviewed.
Chronic traumatic encephalopathy: a spectrum of neuropathological changes following repetitive brain trauma in athletes and military personnel
TLDR
As Cte is characterized pathologically by frontal and temporal lobe atrophy, by abnormal deposits of phosphorylated tau and by 43 kDa TAR DNA binding protein and is associated clinically with behavioral and personality changes, as well as cognitive impairments, CTE is increasingly categorized as an acquired frontotemporal lobar degeneration.
Chronic traumatic encephalopathy: a potential late effect of sport-related concussive and subconcussive head trauma.
TLDR
The distinctive neuropathologic profile of the disorder lends promise for future research into its prevention, diagnosis, and treatment, including formal clinical or pathologic diagnostic criteria for CTE.
Chronic Traumatic Encephalopathy in Athletes: Progressive Tauopathy After Repetitive Head Injury
TLDR
This work reviews 48 cases of neuropathologically verified CTE recorded in the literature and document the detailed findings of CTE in 3 professionalathletes, 1 football player and 2 boxers.
...
1
2
3
4
5
...