A Proposed Mechanism for Development of CTE Following Concussive Events: Head Impact, Water Hammer Injury, Neurofilament Release, and Autoimmune Processes
1
Department of Kinesiology and Health Education, The University of Texas at Austin, Austin, TX 78712, USA
2
Department of Neurology Dell Medical School, The University of Texas at Austin, Austin, TX 78712, USA
3
Research Imaging Center, Austin Radiological Association, Austin, TX 78705, USA
4
Department of Intercollegiate Athletics, The University of Texas, Austin, TX 78712, USA
5
Department of Population Health, University of Texas, Austin, TX 78712, USA
*
Author to whom correspondence should be addressed.
Brain Sci. 2017, 7(12), 164; https://doi.org/10.3390/brainsci7120164
Received: 20 November 2017 / Revised: 14 December 2017 / Accepted: 15 December 2017 / Published: 19 December 2017
(This article belongs to the Special Issue Novel Mechanisms and Strategies for Neural Repair)
During the past decade, there has been an increasing interest in early diagnosis and treatment of traumatic brain injuries (TBI) that lead to chronic traumatic encephalopathy (CTE). The subjects involved range from soldiers exposed to concussive injuries from improvised explosive devices (IEDs) to a significant number of athletes involved in repetitive high force impacts. Although the forces from IEDs are much greater by a magnitude than those from contact sports, the higher frequency associated with contact sports allows for more controlled assessment of the mechanism of action. In our study, we report findings in university-level women soccer athletes followed over a period of four and a half years from accession to graduation. Parameters investigated included T1-, T2-, and susceptibility-weighted magnetic resonance images (SWI), IMPACT (Immediate Post-Concussion Assessment and Cognitive Testing), and C3 Logix behavioral and physiological assessment measures. The MRI Studies show several significant findings: first, a marked increase in the width of sulci in the frontal to occipital cortices; second, an appearance of subtle hemorrhagic changes at the base of the sulci; third was a sustained reduction in total brain volume in several soccer players at a developmental time when brain growth is generally seen. Although all of the athletes successfully completed their college degree and none exhibited long term clinical deficits at the time of graduation, the changes documented by MRI represent a clue to the pathological mechanism following an injury paradigm. The authors propose that our findings and those of prior publications support a mechanism of injury in CTE caused by an autoimmune process associated with the release of neural proteins from nerve cells at the base of the sulcus from a water hammer injury effect. As evidence accumulates to support this hypothesis, there are pharmacological treatment strategies that may be able to mitigate the development of long-term disability from TBI.
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Keywords:
chronic traumatic encephalopathy; brain structure and function; concussion; water hammer effect; neurofilament release from brain; autoimmune disease
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MDPI and ACS Style
Kornguth, S.; Rutledge, N.; Perlaza, G.; Bray, J.; Hardin, A. A Proposed Mechanism for Development of CTE Following Concussive Events: Head Impact, Water Hammer Injury, Neurofilament Release, and Autoimmune Processes. Brain Sci. 2017, 7, 164.
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