CTE and Former Athlete Brain Health

What Is Chronic Traumatic Encephalopathy?

Chronic Traumatic Encephalopathy (CTE) is a neurodegenerative disease associated with a history of repetitive head impacts (RHI). It involves the abnormal buildup of a protein called tau in the brain, which can affect cognitive function, mood, behavior, and eventually motor skills.

However, a definitive diagnosis of CTE can only be made post-mortem--through an autopsy examining the brain tissue under a microscope. While researchers have made significant strides, there is currently no objective biomarker (such as a blood test or brain scan) validated to definitively diagnose CTE in a living person.

A History of Concussions Does Not Mean You Have CTE

While a history of repetitive head impacts is the primary risk factor for CTE, it does not guarantee that an individual will develop the disease. Many athletes with a history of concussions or repetitive impacts never develop CTE. Furthermore, the symptoms often associated with CTE can also be caused by other, highly treatable conditions.

Can CTE Be Diagnosed During Life?

As of now, the answer is no. While research is ongoing--exploring specialized PET scans, blood biomarkers, and advanced MRI techniques--these tools are not yet approved or validated for clinical use to definitively diagnose CTE in living individuals.

What About Traumatic Encephalopathy Syndrome?

Researchers have developed criteria for "Traumatic Encephalopathy Syndrome" (TES). TES is a research framework used to describe the clinical symptoms (cognitive impairment, neurobehavioral dysregulation) in living individuals with a history of RHI who are suspected of having CTE pathology. However, a diagnosis of TES does not mean a definitive diagnosis of CTE, as similar symptoms can arise from other causes.

Symptoms Should Be Evaluated, Not Assumed

Because a definitive CTE diagnosis is impossible during life, it is crucial not to assume that every cognitive or mood change is due to irreversible brain disease. Many symptoms common to CTE overlap with other conditions that are identifiable and treatable, including:

Depression, anxiety, or post-traumatic stress disorder (PTSD).
Sleep apnea or other sleep disorders.
Hormonal imbalances (e.g., low testosterone).
Chronic pain and the side effects of pain medication.
Substance abuse or excessive alcohol use.
Cardiovascular issues affecting brain blood flow.
Other neurodegenerative diseases like Alzheimer's or Parkinson's.

When Should a Former Athlete Consider an Evaluation?

Former athletes--or their families--should consider an evaluation if they notice persistent or worsening changes in:

Cognition: Memory loss, difficulty focusing, confusion, or struggling with tasks that used to be easy (like managing finances or organizing a schedule).
Mood and Behavior: Uncharacteristic anger, irritability, severe depression, impulsivity, paranoia, or suicidal thoughts.
Motor Function: Tremors, slowness of movement, unsteadiness, or changes in speech.

What Focus Brain Therapy Can Evaluate

At Focus Brain Therapy, we provide objective, evidence-based evaluations focusing on current cognitive function. While we cannot diagnose CTE, we can measure how the brain is performing right now.

Our evaluation includes cognitive and neurological testing, which provides a detailed profile of an individual's strengths and weaknesses across various domains, such as memory, attention, executive function, language, and processing speed.

Looking for Treatable or Manageable Factors

A key aspect of our evaluation is identifying any contributing factors that may be exacerbating cognitive symptoms. We work closely with a network of medical specialists (neurologists, psychiatrists, endocrinologists, sleep specialists) to rule out or treat conditions like sleep apnea, depression, or hormonal imbalances. Treating these underlying issues often leads to significant improvements in cognitive function and quality of life.

Neuroplasticity and Long-Term Brain Health

The brain possesses neuroplasticity--the ability to adapt and form new neural connections throughout life, even in the presence of damage or neurodegenerative changes. While we cannot reverse neurodegeneration, we can help the brain maximize its remaining resources and potentially build resilience against future decline.

Cognitive Circuit Training® for Former Athletes

For individuals experiencing cognitive challenges, we offer Cognitive Circuit Training® (CCT). CCT is an active, structured rehabilitation program designed to challenge the brain's cognitive networks. Based on the results of the evaluation, we develop a personalized training protocol focusing on areas of weakness, such as working memory, executive function, or attention. CCT aims to strengthen neural pathways, improve compensatory strategies, and enhance cognitive endurance, helping individuals maintain independence and cognitive wellness.

Brain Health After Contact Sports

Transitioning away from a career in contact sports can be challenging, and concerns about brain health are valid. A proactive approach is the best strategy. Just as athletes train their bodies, they can actively manage their brain health through regular medical check-ups, maintaining a healthy lifestyle (diet, exercise, sleep), staying mentally and socially active, and seeking professional evaluation if symptoms arise.

For Families of Former Athletes

Family members are often the first to notice changes in a loved one's cognition or behavior. It can be a confusing and concerning time. The most important step is encouraging a comprehensive medical evaluation. An evaluation provides clarity, identifies treatable causes, and helps establish a support plan. Support from family is crucial in managing symptoms, ensuring medical adherence, and providing a stable environment.

For Former Professional and Competitive Athletes

You spent years preparing for competition; now, it is time to prepare for longevity. An objective evaluation provides a baseline and a roadmap for your brain health. Do not let fear or assumptions prevent you from seeking care. Many symptoms are treatable, and proactive management can significantly impact your quality of life.

What an Evaluation Cannot Tell You

Whether you definitely have CTE.
Exactly how your brain will function 10 years from now.

What an Evaluation Can Do

Identify objective cognitive impairments.
Uncover treatable conditions contributing to symptoms.
Establish a baseline to monitor future changes.
Provide data to guide personalized interventions, like CCT.
Offer clarity and a path forward, rather than fear and uncertainty.

Working With the Medical Team

Focus Brain Therapy operates as part of a comprehensive care team. We collaborate with neurologists, sports medicine physicians, psychiatrists, and other specialists. If our evaluation suggests the need for further medical workup--such as advanced imaging or specific blood tests--we refer patients to the appropriate medical professionals. Our focus remains squarely on the functional, objective measurement and active rehabilitation of cognitive skills.

You Do Not Need a CTE Diagnosis to Take Brain Health Seriously

The conversation around CTE has raised vital awareness, but it can also cause unnecessary despair. The focus must shift from a singular focus on a post-mortem diagnosis to proactive, life-long brain health management.

Start With What We Can Evaluate Today

If you or a loved one are experiencing cognitive changes, do not wait. Objective evaluation is the first step toward understanding what is happening and what can be done about it.