The following is a summary of “Longitudinal Changes in Regional Brain Volumes and Cognition of Professional Fighters With Traumatic Encephalopathy Syndrome,” published in the September 2023 issue of Neurology by Kleven et al.
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease that can only be diagnosed definitively after death. Traumatic encephalopathy syndrome (TES) is a clinical syndrome proposed to be the clinical presentation of CTE. Researchers started a retrospective study to determine the association between TES and subsequent cognitive or MRI volumetric decline.
They conducted a secondary analysis of the Professional Athletes Brain Health Study (PABHS) involving professional fighters (34 years and older). All athletes were categorized as either TES positive (TES+) or TES negative (TES−) according to the 2021 clinical criteria. Linear mixed models were employed to assess the differences in MRI regional brain volumes and cognitive performance between these groups.
The results showed 130 fighters meeting the inclusion criteria for consensus conference; 52 fighters (40%) were diagnosed as TES+. Fighters with a TES+ diagnosis were older and had lower education. Differences were observed in all MRI volumetric measurements between the TES+ and TES− groups. The rate of volumetric change indicated a notably greater increase for lateral ventricles (estimate = 5,196.65; 95% CI = 2642.65, 7750.66) and inferior lateral ventricles (estimate = 354.28; 95% CI = 159.90, 548.66), along with a decrease for the hippocampus (estimate = −385.04, 95% CI = −580.47, −189.62), subcortical gray matter (estimate =−4,641.08; 95% CI = −6,783.98, −2,498.18), total gray value (estimate = −26,492.00; 95% CI = −50,402.00, −2,582.32), and posterior corpus callosum (estimate = −147.98; 95% CI = −222.33, −73.62). The rate of cognitive decline was significantly greater for reaction time (estimate = 56.31; 95% CI = 26.17, 86.45) and other standardized cognitive scores in the TES+ group.
They concluded that 2021 TES criteria can be used to distinguish between professional fighters 35 years and older with and without cognitive decline.
