Extending the range of differential diagnosis of chronic traumatic encephalopathy of the boxer: Insights from a case report

Abstract

Sports activities associated with repetitive cranial trauma have become a fad and are popular in gyms and even among children. It is important to consistently characterize the consequences of such sports activities in order to better advise society on the real risks to the central nervous system. We present the case of a former boxer reporting cognitive and behavioral symptoms that began six years after his retirement as a boxer, evolving progressively with parkinsonian and cerebellar features suggestive of probable chronic traumatic encephalopathy (CTE). Using our case as a paradigm, we extended the range of differential diagnosis of CTE, including corticobasal degeneration, multiple system atrophy, vitamin B12 deficiency, neurosyphilis, frontotemporal dementia and Alzheimer’s disease.

Neuropsychological Study on the Effects of Boxing Upon Athletes' Memory

“…This study provided a reliable foundation in exploring the impact of boxing on the memory of athletes from a neuropsychological perspective. Past studies on brain injury of boxers have focused on organic injuries such as acute brain injury (brain edema and cerebral hemorrhage), Alzheimer's disease, and axonal injury following retirement (2,31). Such studies that consider neuroimaging and neuropathology (20,27) are unable to recognize early decline in cognition with low sensitivity.…”

Management of Neuropsychiatric Symptoms for Chronic Traumatic Encephalopathy

“…Patients may experience a wide breadth of neurological and psychiatric deficits so it is important that primary care, neurologist, psychologists, and psychiatrists work together to identify and manage patients who may have CTE. Some commonly reported clinical manifestations of CTE include depression, anxiety, paranoia, impulsivity, aggression, inattention, difficulty concentrating, memory problems, language impairments, headache, dysarthria, and motor abnormalities [1,2,6,[19][20][21][22][23][24][25][26]. The symptoms, however, are non-specific and are present in various other neurodegenerative diseases.…”

Pharmacological interventions in corticobasal degeneration: a review

“…1,2 Recent research revealed that CBD could be caused by different pathological conditions, often resulting in erroneous diagnoses. 3 CBD presents high morbidity and poor prognosis because of the lack of effective therapy at present. Treatment is symptomatic and based on features of other similar diseases due to the scarcity of studies focused on CBD.…”

“… 1 , 2 Recent research revealed that CBD could be caused by different pathological conditions, often resulting in erroneous diagnoses. 3 …”

“…When older people show functional loss, they experience a variety of negative outcomes, such as higher rates of use of hospital services, institutionalization, and increased risk of death. 3 The progression of healthy aging to dementia must be considered a continuum, both in terms of the slow manifestation of the impairment of cognitive functions, as well as functional limitation. 4 Originally, mild cognitive impairment (MCI) was considered a condition in which someone has minor cognitive decline, not severe enough to interfere significantly with daily life and Dement Neuropsychol 2020 September;14(3):243-247…”