The Neuropathological and Clinical Diagnostic Criteria of Chronic Traumatic Encephalopathy: A Critical Examination in Relation to Other Neurodegenerative Diseases

Benjamin L. Brett, Kristin Wilmoth, Peter Cummings, Gary S. Solomon, Michael A. Mccrea, Scott L. Zuckerman

Research output: Chapter in Book/Report/Conference proceedingChapter

Abstract

This work critically reviews chronic traumatic encephalopathy (CTE), with a specific focus on the single criterion necessary and sufficient for diagnosis. Herein, CTE is compared to other well-established neurodegenerative entities including Alzheimer's disease and dementia with Lewy bodies. Each neurodegenerative disorder is reviewed in five pertinent areas: 1) historical perspective, 2) guideline formation process, 3) clinical diagnostic criteria, 4) pathological diagnostic criteria, and 5) validation of previously described diagnostic criteria (e.g., sensitivity and specificity). These comparisons indicate that CTE is a disease in the earliest stages of formation and has yet to undergo rigorous development and refinement similar to other neurodegenerative diseases. Suggested future revisions to the diagnostic criterion of CTE include establishing a lower threshold for accumulation of pathology, as well as accounting for the presence of concomitant neuropathology and comorbid neurodegenerative disorders. Currently, while initial efforts have been attempted, agreed upon antemortem clinical criteria do not exist. As has been the scientific standard with similar neurodegenerative disorders, antemortem diagnostic guidelines should first be refined through subcommittees of neuroscientists from diverse institutional backgrounds with a subclassification of levels of diagnostic certainty (possible, probably, and definite). Validation studies should then assess the predictive value and accuracy of proposed antemortem diagnostic criteria in relation to potential pathological criteria.

Original languageEnglish (US)
Title of host publicationHandbook of Traumatic Brain Injury and Neurodegeneration
EditorsRudy J. Castellani
PublisherIOS Press
Pages97-114
Number of pages18
ISBN (Electronic)9781643680644
DOIs
StatePublished - 2020
Externally publishedYes

Publication series

NameAdvances in Alzheimer's Disease
Volume7
ISSN (Print)2210-5727
ISSN (Electronic)2210-5735

Keywords

  • Chronic traumatic encephalopathy
  • concussion
  • football
  • neurodegenerative diseases
  • sports
  • traumatic brain injury

ASJC Scopus subject areas

  • Clinical Neurology

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