Table 1 Summary of published cases describing the clinical features of chronic traumatic encephalopathy
| Â | Clinical features | ||||
|---|---|---|---|---|---|
Study | Sample | Behavioral | Mood | Cognition | Motor |
(total n = 202) | |||||
Parker [16] (1934) | Boxers (n = 3) | Social | Anxiety | Reduced intelligence | Ataxia |
inappropriateness | Labile emotions | Memory impairment | Clonus | ||
Childish behavior | Fatigue | Impaired attention | Dragging gait | ||
| Â | Â | Visuospatial difficulties | Dysarthria | ||
Muscle weakness | |||||
Spasticity | |||||
Tremor | |||||
Herzog [42] (1938) | Boxers (n = 7) | Boastfulness | Apathy | General cognitive impairment | Dysarthria |
Personality changes | Flat affect | Memory difficulties | Masked facies | ||
Impulsiveness | Â | Perseveration | Shuffling gait | ||
Loss of control | Â | Language difficulties | Truncal ataxia | ||
| Â | Â | Alogia | |||
Dementia | |||||
Knoll et al. [43] (1938) | Boxers (n = 3) | Personality changes | Apathy | General cognitive impairment | Ataxia |
| Â | Â | Flat affect | Memory impairment | Dysarthria | |
Loss of interest | Visuospatial difficulties | Masked facies | |||
Prolix | Alogia | Â | |||
Dementia | |||||
Boxers (n = 3) | Boastfulness | Apathy | Reduced intelligence | Ataxia | |
Childish behavior | Depression | Executive dysfunction | Dysarthria | ||
Paranoid delusions | Euphoria | Memory impairment | Masked facies | ||
Personality changes | Fatigue | Impaired attention | Muscle weakness | ||
Physical violence | Flat affect | Altered concentration | Shuffling gait | ||
Psychosis | Insomnia | Language difficulties | Tremor | ||
Short fuse | Irritability | Dysgraphia | Unsteady gait | ||
Explosivity | Labile emotions | Visuospatial difficulties | Â | ||
Social inappropriateness | Loss of interest | Â | |||
Verbal violence | Mania | ||||
| Â | Mood swings | ||||
Schwarz [44] (1953) | Boxers (n = 3) | Personality changes | Fearfulness | Memory impairment | Ataxia |
Short fuse | Irritability | Altered concentration | Dysarthria | ||
Explosivity | Labile emotions | Language difficulties | Masked facies | ||
| Â | Â | Â | Muscle weakness | ||
Stamping gait | |||||
Tremor | |||||
Unsteady Gait | |||||
Soeder and Arndt [45] (1954) | Boxers (n = 5) | Boastfulness | Apathy | General cognitive impairment | Clonus |
Disinhibited behavior | Depressed mood | Executive dysfunction | Dysarthria | ||
Inappropriate speech | Euphoria | Memory impairment | Masked facies | ||
Paranoia | Fatigue | Impaired attention | Rolling gait | ||
Personality changes | Flat affect | Altered concentration | Tremor | ||
Physical violence | Insomnia | Language difficulties | Truncal ataxia | ||
Psychosis | Mania | Alogia | Unsteady gait | ||
Short fuse | Mood swings | ||||
Explosivity | Prolix | ||||
Social inappropriateness | Â | ||||
Grahmann and Ule [33] (1957) | Boxers (n = 4) | Childish behavior | Apathy | General cognitive impairment | Dysarthria |
Confirmed CTE (1) | Disinhibited behavior | Depressed | Executive dysfunction | Swaying gait | |
Disinhibited speech | Euphoria | Memory impairment | Masked facies | ||
Impulsivity | Labile emotions | Impaired attention | |||
Loss of control | Fatigue | Altered concentration | |||
Physical violence | Flat affect | Dementia | |||
Personality changes | Irritable | ||||
Short fuse | Mood swings | ||||
Explosivity | Prolix | ||||
Social inappropriateness | Â | ||||
Muller [46] (1958) | Boxers (n = 3) | Social isolation | Fatigue | General cognitive impairment | Dysarthria |
Personality changes | Irritability | Executive dysfunction | Unsteady gait | ||
Lack of insight | Â | Impaired attention | Spastic gait | ||
| Â | Â | Memory impairment | Â | ||
Altered concentration | |||||
Dementia | |||||
Spillane [47] (1962) | Boxers (n = 5) | Childish behavior | Anxiety | General cognitive impairment | Ataxia |
Disinhibited behavior | Depressed mood | Reduced intelligence | Dysarthria | ||
Impulsivity | Euphoria | Memory impairment | Dragging gait | ||
| Â | Mania | Visuospatial difficulties | Muscle weakness | ||
Payne mood swings | Dysgraphia | Tremor | |||
Lack of insight | Unsteady gait | ||||
Dementia | Â | ||||
Mawdsley and Ferguson [22] (1963) | Boxers (n = 10) | Impulsivity | Apathy | General cognitive impairment | Ataxia |
Loss of control | Depression | Reduced intelligence | Dysarthria | ||
Physical violence | Insomnia | Memory impairment | Dragging gait | ||
Psychosis | Irritability | Language difficulties | Masked facies | ||
Paranoid delusions | Â | Dysgraphia | Muscle weakness | ||
Personality changes | Â | Dementia | Tremor | ||
Short fuse | Â | Â | Unsteady gait | ||
Explosivity | Â | Â | Â | ||
Social inappropriateness | |||||
Verbal violence | |||||
Boxers (n = 17) | Disinhibited speech | Depressed | General cognitive impairment | Ataxia | |
Disinhibited behavior | Labile emotions | Reduced intelligence | Clumsy | ||
Impulsivity | Euphoria | Memory impairment | Dysarthria | ||
Lack of insight | Insomnia | Impaired attention | Masked facies | ||
Physical violence | Irritable | Altered concentration | Muscle weakness | ||
Personality changes | Loss of interest | Visuospatial difficulties | Tremor | ||
Social inappropriateness | Fatigue | Dementia | Unsteady gait | ||
Short fuse | |||||
Payne [48] (1968) | Boxers (n = 6) | Disinhibited behavior | Depressed mood | General cognitive impairment | Ataxia |
Impulsivity | Labile emotions | Reduced intelligence | Dysarthria | ||
Paranoid delusions | Insomnia | Altered concentration | Unsteady gait | ||
Physical violence | Mania | Visuospatial difficulties | Â | ||
Psychotic | Mood swings | Memory impairment | |||
Verbal violence | Suicidal ideation | Â | |||
Johnson [26] (1969) | Boxers (n = 17) | Loss of control | Anxiety | General cognitive impairment | Ataxia |
Paranoid delusions | Labile emotions | Reduced intelligence | Dysarthria | ||
Personality changes | Irritability | Memory impairment | Tremor | ||
Psychotic | Â | Dementia | Dragging gait | ||
Short fuse | Â | Â | Masked facies | ||
Explosivity | Â | Â | Muscle weakness | ||
Verbal violence | Â | Â | Â | ||
Roberts [49] (1969) | Boxers (n = 11) | Lack of insight | Apathy | Reduced intelligence | Ataxia |
Paranoid delusions | Depression | Executive dysfunction | Dysarthria | ||
Psychosis | Euphoria | Memory impairment | Dragging gait | ||
Short fuse | Flat affect | Perseveration | Masked facies | ||
Explosivity | Labile emotions | Impaired attention | Muscle weakness | ||
| Â | Â | Altered concentration | Shuffling gait | ||
Language difficulties | Spasticity | ||||
Dysgraphia | Tremor | ||||
Visuospatial difficulties | Unsteady gait | ||||
Dementia | Â | ||||
Corsellis et al. [50] (1973) | Boxers (n = 13) Confirmed CTE (13) | Childish behavior | Anxiety | General cognitive impairment | Ataxia |
Paranoid delusions | Labile emotions | Reduced intelligence | Dysarthria | ||
Personality changes | Irritability | Memory impairment | Masked facies | ||
Short fuse | Â | Dementia | Muscle weakness | ||
Explosivity | Â | Â | Tremor | ||
Social inappropriateness | Â | Â | Staggering gait | ||
Social isolation | Â | Â | Shuffling gait | ||
Verbal violence | Â | Â | Unsteady gait | ||
Sabharwal et al. [51] (1987) | Boxers (n = 4) | Inappropriate speech | Depression | Reduced intelligence | Ataxia |
| Â | Irritability | Memory impairment | Spasticity | ||
Labile emotions | Â | Dysarthria | |||
Mood swings | Â | Â | |||
Jordan et al. [52] (1997) | Boxers (n = 19) | Disinhibited speech | Depression | Impaired attention | Ataxia |
Disinhibited behavior | Irritability | Altered concentration | Clonus | ||
Flat affect | Memory impairment | Dysarthria | |||
Mania | Â | Spasticity | |||
| Â | Â | Tremor | |||
Unsteady gait | |||||
Football and wrestling (n = 5) | Paranoid delusions | Suicidality | General cognitive impairment | - | |
Social isolation | Anxiety | Memory impairment | |||
Physical violence | Labile emotions | Language difficulties | |||
Confirmed CTE (5) | Â | Irritability | Executive dysfunction | ||
Insomnia | Impaired attention | ||||
Depression | Â | ||||
Mckee et al. [2] (2013) | Boxing, American football, ice hockey, wrestling (n = 64) | Explosivity | Depression | Memory impairment | Dysarthria |
Aggression | Hopelessness | Executive dysfunction | Gait disturbance | ||
Impulsivity | Suicidality | Impaired attention | Parkinsonism | ||
Paranoia | Mood swings | Language difficulties | |||
| Â | Â | Visuospatial difficulties | |||
Dementia | |||||
Confirmed CTE (64) | |||||