Pathophysiology
of concussions
A concussion is a biomechanically induced brain injury characterized by the absence of gross anatomic lesions. The brain floats in cerebrospinal fluid that is encased inside the skull. With the help of the three protection layers of the meninges-dura mater, arachnoid, pia mater- the brain can withstand many minor blows to the head without causing further damage. Once a major trauma occurs to the head, a concussion is a result.
Neurotoxicity: energetic metabolism disturbances cause the mitochondria to dysfunction causing symptoms and vulnerability. Concussed brain cells are more likely to be vulnerable, so when a second concussion hits, the cells have irreversible damage. Also known as Second Impact Syndrome (SIS), happens when a second blow to the head occurs when the athlete is still previously concussed. N-acetylaspartate (NAA), a brain specific amino acid that helps when neuronal metabolic functions. It is stored in the neurons and also helps regulate intercompartmental cycling, while playing an intricate role in the Central Nervous System. The amino acid steps in when post-traumatic biochemical damage occurs.
Chronic Traumatic Encephalopathy (CTE)
Background of CTE
Chronic Traumatic Encephalopathy (CTE) is a progressive degenerative disease of the brain found in people who have had a history of repeated brain traumas. After many reoccurring hits to the brain, a trigger is set off that produces a progression degenerative brain tissue. An abnormal protein is also formed called Tau, which is also linked to Alzheimer’s Disease (AD). Tau starts behaving differently after repetitive brain trauma, and disrupts the brain cell’s ability to communicate with other cells. Cells that are under diseased conditions begin to act with nuclear pores differently, causing a change to the cell’s properties. Patients with AD and CTE in return have fewer nuclear pores, and the pores have a common link to be stuck to each other.
Symptoms of CTE
Difficulty thinking
Impulsive Behavior
Depression
Apathy
Short-term memory loss
Difficulty planning or implementing
Emotional instability
Substance abuse
Suicidal thoughts or behavior
Irritability
Aggression
Speech and Language difficulties
Motor impairment
Impaired gait
Trouble swallowing (dysphagia)
Vision problems
Trouble smelling
Dementia
Facts About CTE
There are stages of CTE, but stage I is hard to detect. The stages can be detected by from “Very Mild” to “Very Severe.” There is not enough scientist research to determine the true effects of the protein tau, and how it interferes with each stage of CTE. Currently Pathologists have only examined the amounts of tau in CTE samples, so there could be other gauges to determine the severity of the disease.
CTE can only be examined during an autopsy to measure the decreased brain cells, so patients must be dead to determine the extent of the disease.
