# Chronic Traumatic Encephalopathy --- **Chronic traumatic encephalopathy** is a progressive [[brain]] [[injury]] that is thought to be caused by repeated blows to the head. It's particularly associated with contact sports, such as boxing or American football. Most of the available studies are based on ex-athletes. CTE was previously known as "punch drunk" syndrome and dementia pugilistica. But these terms are no longer used because it's now known that the condition is not limited to ex-boxers. There's still some debate about how common CTE is and how it should be diagnosed. Currently, only supportive treatments are available and research is focused on finding a reliable technique to diagnose the condition. Any prolonged activity that involves repeated blows to the head or recurrent episodes of concussion is thought to increase the risk of getting CTE. But CTE and concussion are separate conditions. Many people who are concussed do not go on to develop CTE, but evidence suggests a pattern of repeated minor head injuries increases the risk. The only way to prevent CTE is to avoid repetitive head injuries. Although many head injuries are difficult to predict or avoid, there are things you can do to reduce your risk. For example, you should: - wear the recommended protective equipment during contact sports - follow your doctor's recommendations about returning to play after concussion - make sure any contact sport you or your child take part in is supervised by a properly qualified and trained person - get medical advice if any symptoms of a previous head injury return Mood and behavior symptoms Among individuals diagnosed with CTE, some report mood and behavior symptoms that can appear as early as the patient’s 20s. Common changes seen include: Impulse control problems Aggression Mood swings Depression Paranoia Anxiety Cognitive symptoms Most patients with CTE eventually experience progressive problems with thinking and memory, including: Short-term memory loss Confusion Impaired judgment Dementia Cognitive symptoms tend to appear later in life, often in a patient’s 40s or 50s. Patients may exhibit one or both symptom clusters. In some cases, symptoms worsen with time (even if the patient suffers no additional head impacts). In other cases, symptoms may be stable for years before worsening. Sleep symptoms A 2020 study from the VA-BU-CLF Brain Bank suggested that problems with sleep, specifically symptoms associated with REM behavior disorder, may be related to CTE pathology. ___