CTE neuropathology alone is associated with dementia and cognitive symptoms.

INTRODUCTION

This studyexamined the independent contribution of chronic traumatic encephalopathy (CTE) neuropathology to symptoms.

METHODS

The sample included 614 brain donors with (n = 366) and without (n = 248) autopsy-confirmed CTE. Brain donors with other major neurodegenerative disease diagnoses were excluded. Informants completed cognitive and neuropsychiatric measures. Dementia was determined during diagnostic consensus conferences.

RESULTS

CTE stage IV (of IV) was associated with 4.48 (95% confidence interval [CI] = 1.97-10.90) increased odds of having dementia. CTE stage III had an odds ratio of 2.12 (95% CI = 1.91-3.77). Higher CTE stage was associated with greater informant-reported cognitive symptoms (p < 0.01). There were no associations with mood/behavioral scales.

DISCUSSION: CTE stage III/IV neuropathology was associated with dementia and cognitive symptoms: those with stage IV were 4.5 times more likely to have dementia than those without CTE. It is uncertain if low-stage CTE clinically manifests, and mood/behavioral symptoms likely have multifactorial causes and/or a fluctuating course.

HIGHLIGHTS: Stage III and IV chronic traumatic encephalopathy (CTE) are independently associated with increased odds of having dementia. Higher CTE stage was associated with greater informant-reported cognitive symptoms. Stage I and II CTE were not associated with cognitive symptoms or dementia. CTE of any severity was not associated with informant-reported mood or behavioral symptoms.