Chronic Traumatic Encephalopathy (CTE)

Can medical cannabis help with the symptoms of chronic traumatic encephalopathy? Find out more below. 

What is Chronic Traumatic Encephalopathy?

Chronic Traumatic Encephalopathy (CTE) is a degenerative brain disease caused by repeated head injuries. CTE is most commonly found in athletes who participate in contact sports like football, boxing, and hockey and in military veterans who have experienced traumatic brain injuries (TBI) during combat.

Symptoms of CTE can include mood disorders such as depression and anxiety, memory loss, and cognitive impairment. In the later stages of the disease, patients may also experience progressive dementia and movement disorders.

Currently, CTE can only be definitively diagnosed post-mortem through examination of the brain tissue for characteristic tau protein abnormalities. However, medical professionals are developing new diagnostic techniques for earlier disease identification.

There is no cure for CTE, and treatment focuses on managing symptoms.

What is a Tau Protein? 

Tau proteins are a type of protein found in the brain that helps to stabilize and support the structure of neurons, which are the cells responsible for transmitting information throughout the brain. In healthy brains, tau proteins are usually found in a stable, folded conformation, allowing them to function effectively.

However, in CTE and other neurodegenerative conditions, tau proteins can become misfolded and accumulate into clumps called neurofibrillary tangles (NFTs) inside neurons. This accumulation can interfere with the normal functioning of the neurons, leading to cell death and other adverse effects.

In CTE, precisely, the accumulation of tau protein and the resulting NFTs are thought to be caused by repeated head trauma. As the brain is subjected to repeated impacts, the tau proteins can become damaged and begin to clump together. Over time, these clumps can grow larger and spread throughout the brain, leading to the characteristic NFTs seen in CTE.

The accumulation of NFTs in CTE is thought to cause various symptoms, including memory loss, confusion, and changes in behavior and mood. It is also believed to contribute to the disease’s progressive nature, as the accumulation of NFTs can worsen over time.

Research into tau proteins and CTE is ongoing, and much is still to be learned about the precise mechanisms involved. However, by understanding the role of tau proteins in the development of CTE, researchers and healthcare professionals can better develop treatments and preventative measures for this condition.

What causes Chronic Traumatic Encephalopathy?

• Repeated head trauma: Repeated head trauma, such as concussions, can cause CTE. This is often seen in contact sports like football, boxing, and hockey. CTE can also be caused by repeated mild head injuries, such as those sustained in a car accident or falling off a bike.
• Age of exposure: The earlier someone is exposed to head trauma, the more likely they are to develop CTE. The brain still develops in childhood and adolescence, and repeated head trauma can disrupt this process.
• Genetics: Certain genetic factors may make someone more susceptible to developing CTE after head trauma. Studies have shown that mutations in the gene for the protein tau, which is involved in the development of CTE, can increase the risk of developing the condition.
• Gender: Women may be less likely to develop CTE than men, although more research is needed to confirm this.
• Lifestyle factors: Certain lifestyle factors, such as drug and alcohol abuse, may increase the risk of developing CTE. This is because these substances can damage the brain and make it more vulnerable to head trauma.

Not everyone who experiences head trauma will develop CTE, and the severity of the condition can vary widely. However, by understanding the causes of CTE, we can take steps to prevent and mitigate the effects of head trauma.

Are there Signs & Symptoms?

• Memory loss: CTE can cause short-term and long-term memory loss, making it difficult for individuals to remember recent events or details from their past.
• Difficulty with concentration and attention: Individuals with CTE may need help focusing on tasks or paying attention for long periods.
• Impaired judgment and decision-making: CTE can cause individuals to make poor decisions or have difficulty thinking through complex problems.
• Mood changes: Individuals with CTE may experience mood swings, irritability, depression, anxiety, and other changes in behavior and personality.
• Impulsivity: CTE can cause individuals to act impulsively or take risks without considering the potential consequences.
• Aggression and violent behavior: Some individuals with CTE may become more aggressive or prone to violent outbursts.
• Headaches and dizziness: Individuals with CTE may experience frequent headaches, dizziness, and other symptoms related to their brain function.
• Difficulty with balance and coordination: CTE can cause individuals to have trouble with balance and coordination, leading to falls and other accidents.

Diagnosis & Treatment Options

Currently, there is no definitive diagnostic test for Chronic Traumatic Encephalopathy (CTE) while a person is still alive, and diagnosis is typically made post-mortem through brain tissue examination. However, doctors and researchers can make a presumptive diagnosis of CTE based on the person’s history of head trauma, their symptoms, and the results of other tests, such as neuroimaging and cognitive testing.

Here are some of the diagnostic and treatment approaches that may be used in the management of CTE:

Diagnostic Approaches:

• Medical history and physical exam: A doctor will ask about the person’s history of head trauma, including the number and severity of past concussions or other head injuries. They will also perform a physical exam to evaluate the person’s neurological function.
• Cognitive testing: A doctor may use a battery of tests to assess the person’s cognitive function, including memory, attention, and problem-solving abilities.
• Neuroimaging: CT and MRI scans may assess brain structure and function.

Treatment Approaches:

• Cognitive and behavioral therapy: Treatment for CTE often involves cognitive and behavioral therapy to help the person manage their symptoms and improve their quality of life. This may include working with a therapist to develop coping strategies for memory loss and other cognitive impairments and addressing mood and behavioral changes.
• Medications: Currently, no medicines are approved explicitly for treating CTE, but some medications may be used to manage specific symptoms, such as depression or anxiety.
• Lifestyle changes: Lifestyle changes, such as getting enough rest, eating a healthy diet, and avoiding alcohol and drugs, can help to manage symptoms and reduce the risk of further brain injury.

Can medical cannabis help? 

There is limited scientific evidence on the effectiveness of medical cannabis for treating Chronic Traumatic Encephalopathy (CTE), as research on the topic is still in the early stages. However, some preliminary studies have suggested that medical cannabis may have the potential as a treatment option for specific symptoms of CTE, such as pain, anxiety, and sleep disturbances.

One study published in the Journal of Neurotrauma in 2014 found that treatment with a synthetic cannabinoid (a compound similar to those found in medical cannabis) could reduce brain inflammation and improve cognitive function in mice with brain injury, including those that mimicked the effects of CTE. Another study published in the Journal of Head Trauma Rehabilitation in 2017 found that medical cannabis use was associated with improved mood and decreased anxiety and depression in individuals with a history of traumatic brain injury.

While these studies suggest that medical cannabis may have the potential as a treatment option for some of the symptoms of CTE, more research is needed to understand its effectiveness and safety for this condition entirely. Additionally, medical cannabis is not currently approved by the FDA as a treatment for CTE, and there is no standardized dosing or guidelines for its use in this context.