Right now, CTE can only be officially diagnosed post-mortem. How close are we to finding a way to diagnose CTE in the living?
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CTE can be diagnosed in the living. Just like Alzheimer’s disease can be diagnosed in the living. And when you make such diagnosis, it is based on the continuation of symptoms. The prevailing clinical scenario of the patient.
To make a diagnosis, all you need is a reasonable degree of certainly. But now we, as a pathologists, need more objective measures because symptoms, to a certain degree, are subjective. We need markers: biochemical markets, radiological markers. But we should also realize that radiological markers, biochemical markers wouldn’t give 100% degree of certainly. It is not an absolute science. It’s not an absolute science like physics or mathematics.
In my opinion, taking professional football players as a cohort, I think over 90% of American football players suffer from this disease. Over 90% of players who play to the professional level have some degree of this disease. I have not examined any brain of a retired football player that came back negative.
They could have maybe minimal symptoms, mild symptoms, moderate symptoms, or severe symptoms. I meet with retired football players. Some are well-dressed, some are well-spoken, but when you talk to them personally they will admit to you that they are having problems. But they are managing their problems. They have impaired memory, they’re having mood problems. They are being treated by their psychiatrists. So I think 90 to 100% of all of them will have some residual problem from their exposure to thousands of blows to the head.
This was why, when I came across this disease, I sent a letter to the NFL: let us have a prospective study to examine the brain of every retired NFL player who died. This is the best way to confirm that we’re not speculating. When I proposed this they did not even acknowledge our letter.