A Clinical Approach to the Diagnosis of Traumatic Encephalopathy Syndrome: A Review.
OBJECTIVE
Chronic traumatic encephalopathy (CTE) refers to pathologic changes that have been found in some individuals with a history of repetitive traumatic impact to the head (hereinafter referred to as head trauma). These changes cannot be assessed during the clinical evaluation of a living patient.


METHODS
The neuropathologic features, taxonomy, history, role of biomarkers in diagnosis, and existing criteria of CTE are reviewed. Previous criteria have been proposed to approach the living patient; however, a unified, specific approach is needed for the practicing clinician. We propose a new diagnostic construct for the clinical syndrome associated with repetitive exposure to head trauma: traumatic encephalopathy syndrome. This clinical paradigm will provide the framework for a diagnosis of probable, possible, and unlikely traumatic encephalopathy syndrome, with included discussion regarding the minimum exposure, nature of the clinical course, and additional clinical features needed for diagnosis.


CONCLUSIONS
While prospective longitudinal studies are ongoing to further elucidate the association of exposure to head trauma, clinical features, and the development of pathologic changes, a corresponding clinical construct for diagnosis is necessary.
Department of Neurology, NorthShore University Health System, Glenview, Illinois.
Nicole
N
Reams
Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor.
James T
JT
Eckner
Department of Physical Medicine and Rehabilitation, University of Michigan Health System, Ann Arbor.
Andrea A
AA
Almeida
Department of Psychiatry, University of Michigan Health System, Ann Arbor.
Andrea L
AL
Aagesen
Department of Neurology, University of Michigan Health System, Ann Arbor.
Bruno
B
Giordani
Department of Psychiatry, University of Michigan Health System, Ann Arbor.
Hank
H
Paulson
Department of Psychiatry, University of Michigan Health System, Ann Arbor.
Matthew T
MT
Lorincz
Department of Psychiatry, University of Michigan Health System, Ann Arbor.
Jeffrey S
JS
Kutcher
D015415:Biomarkers / Q000378:metabolism; D000070627:Chronic Traumatic Encephalopathy / Q000175:diagnosis* / Q000266:history / Q000503:physiopathology / Q000628:therapy; D049673:History, 20th Century; D006801:Humans; D008137:Longitudinal Studies
D015415:Biomarkers