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Boston University study finds progressive cognitive changes most predictive of CTE pathology

Six-year study brings researchers another step closer to diagnosing CTE in the living

(BOSTON) - For the first time, researchers from Boston University School of Medicine (BUSM) have shown that progressive memory loss and problems with executive function, the ability to focus, follow directions, and problem-solve, are most predictive of CTE pathology, and increase the odds of having the disease by 3.6 times.

The new findings bring researchers another step closer to diagnosing Chronic Traumatic Encephalopathy (CTE) during life, which is crucial for developing therapies and determining how common the disease is among individuals exposed to repetitive head impacts from contact sports, military service and physical violence.

"This study significantly advances our understanding of how to diagnose CTE in life. Progressive memory and executive function symptoms are particularly valuable for predicting CTE pathology," said corresponding author Jesse Mez, MD, MS, director of the Boston University (BU) Alzheimer's Disease Center Clinical Core and a BU CTE Center Investigator. “Mood and behavior symptoms have many causes, and this study confirmed that individuals exposed to brain trauma with those symptoms should seek treatment and not automatically assume they are caused by CTE.”     

The study, “Validity of the 2014 Traumatic Encephalopathy Syndrome Criteria for CTE Pathology” was published online Wednesday in Alzheimer's & Dementia: The Journal of the Alzheimer's Association.

CTE is a progressive brain disease. Clinically, impulsivity, explosivity, depression, memory impairment and executive dysfunction have been reported symptoms of the disease. In 2014, criteria for traumatic encephalopathy syndrome (TES) were proposed for use in clinical research settings to diagnose CTE in life.

To assess the reliability and diagnostic validity of TES criteria, a team of clinicians interviewed family members of 336 VA-BU-CLF Brain Bank brain donors exposed to repetitive head impacts from contact sports, military service and/or physical violence. Neuropathologists then evaluated the brains for CTE pathology. An expert panel of clinicians then determined whether (TES) criteria (i.e. proposed criteria to diagnose CTE in life) were met.

These findings were used by an international team of experts to develop second-generation TES criteria that were announced last month. Having reliable and valid criteria to diagnose CTE in life will improve patient care and accelerate the development of effective therapies, but Mez points out the TES criteria are not yet ready for the clinic.

The Concussion Legacy Foundation (CLF) is the outreach and recruiting arm of the VA-BU-CLF Brain Bank, a collaboration between the US Department of Veterans Affairs, Boston University and CLF, where more than 8,000 athletes and military Veterans have pledged to donate their brain. We encourage anyone with a history of brain trauma to get involved in research by pledging their brain and signing up for the CLF research registry, where members are recruited to participate in clinical research studies. Those who are interested can sign-up at

For anyone with a history of brain trauma who is struggling with symptoms of suspected CTE, or caring for someone who is, you can find a new CTE Support and Resources library filled with treatment and coping strategies from experts at

Click here to read the study.

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