Late Presentation of Chronic Traumatic Encephalopathy in a Former Association Football Player.

Autor: Cullinane PW; Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology, University College London London United Kingdom.; Queen Square Brain Bank for Neurological Disorders UCL Queen Square Institute of Neurology London United Kingdom., Wrigley S; Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology, University College London London United Kingdom.; Queen Square Brain Bank for Neurological Disorders UCL Queen Square Institute of Neurology London United Kingdom., Bradshaw TY; Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology, University College London London United Kingdom., Shaw K; Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology, University College London London United Kingdom.; Queen Square Brain Bank for Neurological Disorders UCL Queen Square Institute of Neurology London United Kingdom., Shribman S; Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology, University College London London United Kingdom., de Pablo Fernandez E; Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology, University College London London United Kingdom.; Queen Square Brain Bank for Neurological Disorders UCL Queen Square Institute of Neurology London United Kingdom., Warner TT; Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology, University College London London United Kingdom.; Queen Square Brain Bank for Neurological Disorders UCL Queen Square Institute of Neurology London United Kingdom.; Queen Square Movement Disorders Centre UCL Queen Square Institute of Neurology London United Kingdom., Jaunmuktane Z; Department of Clinical and Movement Neurosciences UCL Queen Square Institute of Neurology, University College London London United Kingdom.; Queen Square Brain Bank for Neurological Disorders UCL Queen Square Institute of Neurology London United Kingdom.; Division of Neuropathology, National Hospital for Neurology and Neurosurgery University College London NHS Foundation Trust London United Kingdom.
Jazyk: angličtina
Zdroj: Movement disorders clinical practice [Mov Disord Clin Pract] 2023 Jul 14; Vol. 10 (9), pp. 1414-1418. Date of Electronic Publication: 2023 Jul 14 (Print Publication: 2023).
DOI: 10.1002/mdc3.13829
Abstrakt: Background: Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease characterized by widespread accumulation of hyperphosphorylated tau that typically occurs in people who have suffered repetitive head impacts. To date, very few cases have been reported in association football players.
Objectives: To describe the clinicopathological features of a case of CTE in an 84-year-old former football player who was clinically diagnosed as having dementia with Lewy bodies (DLB).
Methods: A retrospective review of the patient's primary care and hospital medical records was performed along with a comprehensive neuropathological examination.
Results: This patient presented at age 84 with symmetrical parkinsonism and cognitive impairment that was exacerbated by prochlorperazine. His condition was rapidly progressive with recurrent falls within 1 year. Other features included headaches, depression, anxiety, suicidal ideation, disturbed sleep and aggression. He received a clinical diagnosis of DLB and died approximately 2 years after the onset of symptoms. A post-mortem examination revealed stage 4 CTE.
Conclusions: While the contemporaneous onset of parkinsonism and cognitive symptoms in the context of possible neuroleptic sensitivity is suggestive of DLB, the additional symptoms of aggressive behavior, depression and suicidality in a former football player are consistent with the neuropathological diagnosis of CTE. This case, which is notable for the late presentation, demonstrates that CTE may masquerade as other dementias and highlights the importance of seeking a history of repetitive head impacts.
(© 2023 International Parkinson and Movement Disorder Society.)
Databáze: MEDLINE
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