Concussions Lead to Brain Damage Articles

McKee Article
Background-review article (meta-analysis-authors doing more in depth analysis of previous studies)
They look at 51 cases of people who have had concussions (and look into depth into 3 cases (NFL guy, and 2 boxers)
Thesis: CTE (Chronic Traumatic Encephalopathy) is a sitinct diagnosis from other degenerative brain diseases and is caused by repetitive brain injuries…they argue if one accepts punch drunk syndrome than one should also accept that it can result from other sports other than boxing.
Tau protein-must be phosphoralyted to be active, overexpressed tau and hyperphosphoralyed in response to neural injury, and when hyperphosphoralyted, it forms nonfunctional tau protein tangles.

Proposed Mechanisms of CTE
1. Lateral head trauma leads to axon injury
-axon damage continues long after injury in rat models
-lateral=wave of impact so worse
2. apoE4 less able to clean up tau tangles
3. Ischemia, inflamatory response also contribute to long term damage
4. lack of alpha-synuclein in CTE brains indicate different mechanism than hereditary parkinsons or AD
-this is protein associated with brain damage in Parkinsons and AD

Questions: Is there a causual relationship between sports-related concussions and CTE (go through steps to determine this posted in chp 14 notes)
Does CTE exist as a seperate diagnosis
Necessary? Sufficient?

Guskiewicz Article
- Cross-sectional study based on self-reports and literature reviews to compare rates of AD and MCI in population
-Chi squared test for independence
-Alleles-ApoE2=good for neuron repair, ApoE3=ok for neuron repair, ApoE4=suck at repair especially if homozygous
-ApoE4 homozygous+concussions=very increased risk of punch drunk syndrome
Should There be genetic tests before kids play sports?

1. Diagnosis of MCI and AD are based off symptons not looking at brain
2. Self-reported data-are responders representative of non-responding surveys
3. Confounding factors=aggression and steroid use

Comparison of 2 Articles
-McKee article is very subjective in trying to show how CTE is link to sports related concussions-does not give much attention to genetic factos (ApoE) like the Guskiewitz article for possibly being a main reason people may get CTE
-No True control is used in either paper

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