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Updated: May 8, 2026

In Vivo Protocol of Controlled Subconcussive Head Impacts for the Validation of Field Study Data
Published on: April 18, 2019
Clinical presentation of chronic traumatic encephalopathy
Robert A Stern1, Daniel H Daneshvar, Christine M Baugh
1From the Center for the Study of Traumatic Encephalopathy (R.A.S., D.H.D., C.M.B., D.R.S., P.H.M., D.O.R., N.G.F., J.M.S., C.A.R., T.D.S., V.E.A., C.J.N., R.C.C., A.C.M.), BU Alzheimer's Disease Center (R.A.S., T.D.S., L.E.G., A.E.B., N.W.K., A.C.M.), Departments of Neurology (R.A.S., C.M.B., D.R.S., V.E.A., A.E.B., N.W.K., A.C.M.), Neurosurgery (R.A.S., R.C.C.), and Pathology (T.D.S., N.W.K., A.C.M.), Molecular Genetics Core Facility (I.S.), Boston University School of Medicine; Sports Legacy Institute (L.M., C.J.N., R.C.C.), Waltham; VA Boston Healthcare System (T.D.S., V.E.A., A.E.B., N.W.K., A.C.M.); Departments of Psychiatry, Neurology, Pathology & Laboratory Medicine, Ophthalmology, Biomedical Engineering, and Electrical & Computer Engineering (L.E.G.), Boston University School of Medicine and College of Engineering; and Department of Neurosurgery (R.C.C.), Emerson Hospital, Concord, MA.
Chronic Traumatic Encephalopathy (CTE) often presents with cognitive, behavioral, and mood issues. This study found two main clinical presentations: a behavior/mood variant and a cognitive variant in athletes.
Area of Science:
- Neuropathology
- Neuroscience
- Sports Medicine
Background:
- Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease linked to repetitive head trauma.
- Understanding the clinical spectrum of CTE is crucial for diagnosis and management.
Purpose of the Study:
- To investigate the clinical presentations of neuropathologically confirmed Chronic Traumatic Encephalopathy (CTE).
- To identify distinct clinical patterns associated with CTE in athletes.
Main Methods:
- Analysis of 36 adult male subjects with confirmed CTE from the Boston University CTE Center brain bank.
- Retrospective clinical history collection from next-of-kin, blinded to neuropathologic findings.
- Exclusion of subjects with comorbid neurodegenerative or motor neuron diseases.
Main Results:
- A combination of cognitive, behavioral, and mood impairments was frequently observed.
- Nearly all subjects exhibited cognitive deficits.
- Two distinct clinical presentations were identified: a younger-onset behavior/mood variant (n=22) and an older-onset cognitive variant (n=11).
Conclusions:
- CTE appears to manifest in at least two primary clinical forms.
- These variants are characterized by either initial behavioral/mood disturbances or cognitive decline.
- Identifying these presentations may aid in earlier recognition of CTE.
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Traumatic Brain Injury l: Introduction
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Encephalitis l: Introduction
Encephalitis ll: Pathophysiology

