Postmortem Autopsy-Confirmation of Chronic Traumatic Encephalopathy

CTE is a subject which should be of interest to every athlete and their family that engages in contact head sports.  Your sports career will be relatively short, the rest of your life will be long. CTE will make it even longer and less pleasurable.

A ground breaking scientific study of CTE casts scientific credibility on what was previously a subjective diagnosis.  The study could make earlier diagnosis of what could be a chronic disability.

Currently, only presumptive diagnosis of chronic traumatic encephalopathy (CTE) can be made in living patients.

 We present a modality that may be instrumental to the definitive diagnosis of CTE in living patients based on brain autopsy confirmation of [F-18]FDDNP-PET findings in an American football player with CTE. [F-18]FDDNP-PET imaging was performed 52 mo before the subject's death. 

The following symptoms were present before death

Summary of Symptoms Reported by Our Patient's Wife and Next-of-Kin at the Time of his [F-18]-FDDNP-PET Scanning

1.	Difficulty recalling names of familiar people and recent past events.
2.	Problems with tracking conversations.
3.	Began losing personal objects.
4.	Became short-tempered, often felt panicked, was less organized.
5.	Became fixated on ideas and less interested in activities he previously enjoyed.
6.	Transformed from a kind, mild-mannered “gentle giant” to a very agitated person.
	a. Exhibited angry outbursts that were out of character.
7.	Behaved inappropriately as if “his filter was gone.”
8.	Evaluated by a psychiatrist, diagnosed with depression, and “probable CTE.”

Our patient exhibited negative family history for dementia or major psychiatric illness. According to his wife and next-of-kin, he exhibited progressive cognitive decline for many years after retirement from the NFL.

CONCLUSION

In conclusion, our results may suggest that the in vivo identification of CTE substrates in living patients may not only be based on the presence or absence of proteinopathies, but also on the identification of the differential and selective topographic vulnerability unique to CTE, which [F-18]FDDNP-PET may be demonstrating. Further prospective studies are needed to assess whether [F18]FDDNP PET can serve as a useful adjunct in the diagnosis of CTE in living patients.

Postmortem Autopsy-Confirmation of Antemortem [F-18]FDDNP-PET Scans in a Football Player With Chronic Traumatic Encephalopathy | Neurosurgery | Oxford Academic