what are the 4 stages of cte

Daniel Parker

2 min read

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17-03-2025

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Chronic traumatic encephalopathy (CTE) is a degenerative brain disease linked to repeated head trauma. It's important to understand that CTE diagnosis can only be definitively made post-mortem through brain examination. However, researchers have identified four stages of the disease based on the severity of brain changes observed. This article will outline these four stages, emphasizing that the progression and severity can vary significantly between individuals.

Stage 1: Early Stage CTE

Symptoms: In the early stages, symptoms might be subtle and easily dismissed. Individuals may experience mild cognitive impairment, such as difficulty with concentration or memory lapses. Changes in mood, including increased irritability or depression, are also possible. These initial symptoms may not be attributed to CTE, often being mistaken for stress or other unrelated issues.

Brain Changes: At this stage, microscopic tau tangles begin to accumulate in the brain. These tangles disrupt normal brain function. However, the changes are relatively limited at this early stage, and extensive damage isn't yet visible.

Stage 2: Mild CTE

Symptoms: As the disease progresses to stage 2, symptoms become more noticeable. Individuals may experience more frequent and pronounced memory problems. Difficulties with executive function, such as planning and decision-making, are also common. Changes in mood can intensify, leading to significant emotional instability and impulsive behavior. Sleep disturbances, such as insomnia, are also frequent.

Brain Changes: The accumulation of tau tangles increases significantly. These changes begin to affect larger areas of the brain, impacting cognitive function and behavior more noticeably.

Stage 3: Moderate CTE

Symptoms: In stage 3, cognitive impairment becomes more severe. Problems with memory become more pronounced, impacting daily life. Significant difficulties with executive functions, judgment, and impulse control are typical. Mood swings can be extreme, and symptoms of depression and anxiety can become debilitating. Individuals may also experience episodes of aggression or explosive behavior.

Brain Changes: The widespread accumulation of tau tangles is readily apparent. The resulting damage to brain tissue is substantial, leading to more severe cognitive and behavioral problems.

Stage 4: Severe CTE

Symptoms: Stage 4 CTE represents the most advanced and severe form of the disease. Individuals may experience profound dementia, losing their ability to care for themselves. Communication becomes severely impaired, and personality changes are dramatic. Behavioral problems, such as aggression, impulsivity, and apathy, are often severe.

Brain Changes: At this final stage, extensive brain atrophy is evident. The widespread tau tangles cause significant damage, leading to substantial loss of brain function. The brain shows significant shrinkage, reflecting the severity of the neuronal damage.

Important Considerations:

• Individual Variation: The progression of CTE and the severity of symptoms vary significantly from person to person. Some individuals may progress through stages quickly, while others may experience a slower progression.
• Post-Mortem Diagnosis: A definitive diagnosis of CTE can only be made post-mortem through examination of brain tissue. While clinical evaluations can suggest the possibility of CTE, they cannot confirm the diagnosis.
• Ongoing Research: Research into CTE is ongoing. Scientists are working to better understand the causes, progression, and potential treatments for this devastating disease.

This information is intended for educational purposes only and should not be considered medical advice. If you are concerned about CTE or experiencing symptoms that may be related, consult with a qualified healthcare professional. They can provide a proper evaluation and discuss appropriate management strategies.