Do concussions cause CTE?
Not necessarily. Concussions are the most common type of head injury and many people have a concussion at some point in life. But for persons exposed to numerous head impacts over years, who may also occasionally experience a concussion, we think it’s the smaller, repetitive head impacts that are the main risk factor for getting CTE. These injuries add up, causing repeated stretching and pulling in the brain. In some athletes, it just so happens that the same activity causing a concussion causes these more frequent, smaller head impacts.
It’s important to remember that concussion is not the same thing as CTE. It’s fairly common for someone to get a concussion in their lifetime, often in childhood. Children fall while climbing trees or bump heads while on the playground. Most people recover from a concussion fully in a matter of weeks without any real risk of developing CTE. But it’s uncommon for most people to experience hundreds or thousands of head impacts in a lifetime. It is these repetitive hits that most often lead to CTE.
Why does it take years for this disease to progress?
We’re not yet sure. What is clear is that most exposures to repetitive head impacts occur in athletes and veterans at relatively young ages, rarely past early adulthood. The head injuries for the most part stop whenever someone ends their athletic career or is discharged from the military, yet the first symptoms associated with CTE may not occur until years or decades later. Also, we don’t have a clear enough understanding of why some people will develop the disease while others don’t, despite similar longstanding exposures to repetitive head impacts.
We do know there are observable brain changes on research MRIs that suggest that repetitive head impacts may not only cause brain injury but impede brain development during key periods of adolescence and early adulthood.
Is there a treatment for CTE?
Unfortunately, there isn’t, and there is no cure. Doctors will treat individual symptoms, like depression or anxiety, and we know things like staying physically active, socially engaged, eating a healthy diet and getting quality sleep will help keep the brain healthy during life. But with CTE, we try to use harm reduction strategies, such as educating people on the risks that could lead to the disease.
Can CTE be prevented?
The best way to prevent CTE is to avoid activities that cause head injuries. For high-contact sports, this means limiting contact to the head, and athletes have a responsibility to tell a coach or trainer if they have concussive symptoms after a head injury. It’s also important to know that there are no concussion-proof or CTE-proof helmets. In fact, most people to have ever been diagnosed with CTE wore helmets for many years. However, many helmets are very effective at preventing skull fractures and some forms of catastrophic brain injury.
Of course, participating in sports is good for people of any age. But the main concern right now is balancing athletic activity with safety in sports that are known to cause brain injury for some people. As of now, a big challenge is trying to prevent CTE when there’s no good way to make a clinical diagnosis in life. What we want to be able to know for sure is how much is too much for an individual athlete — at what point would it seem that the chance of developing CTE is just too risky to continue.