Wednesday, May 14, 2014

Fwd: presentations of chronic traumatic encephalopathy


Sent: 5/13/2014 2:29:28 P.M. Eastern Daylight Time
Subj: presentations of chronic traumatic encephalopathy
Stern et al.  Neurology; 2013: 81:1122-1129
Clinical review of 36 patients, all male athletes.  They were based on autopsy studies at Boston University Center for CTAE.
11 patients had episodic memory impairment  and executive dysfunction (cognition group) initially, only later behavioral and mood disturbances.  Nine patients initially had depression and thirteen had initial behavior (explosivity, impulsivity, violence).  The behavior-mood group totalled 22.  Three patients were asymptomatic.
Age of onset of behavior / mood group was mean 51,  of cognition group, mean was 69.
Among football players, the most susceptible positions were runningback (21 %), linemen (48 %) and linebacker (10 %). 
Ten subjects were diagnosed as dementia: 10 with AD, 4 with "dementia pugilistica" or "football related" and 2 unspecified.  All 10 had stage 4 CTAE.  Seven were from the cognitive group, 2 from mood group, and 1 from behavior group. From diagnosis to death was mean 8 years. 
Mean age of onset was 57.7 years, mean age of dememntia diagnosis was 72.6 years .  4 had a history of falls, 1 of tremor.  All 10 had memory/executive dysfunction, 7 had language deficits, 2 had visuospatial deficits, 6 were described as having a "short fuse."  Mood group had 2 with predominant sadness and 2 with anxiety, 
ApoE$  homozygotes occurred more frequently than in population. 

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