CTE - How Worried About CTE Should You Be? | ACD - Ep. 131
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- Опубликовано: 7 июн 2024
- CTE - Chronic Traumatic Encephalopathy is a worrying conditions for many former athletes, military vets, and concussion patients. We know what the media says, but is this narrative actually true? In this episode we break down the latest evidence surrounding this controversial topic to give a balanced view of what we know, and what we don’t.
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0:01 - Intro (edit)
0:57 - Intro to presentation
3:34 - Media sensationalism
9:06 - Evidence pyramid
11:47 - The problem with current CTE studies
18:22 - What we know/don’t know about CTE
19:24 - What we don’t know about CTE (deep dive)
25:24 - Study - Link between professional sports and Alzheimer’s disease
27:18 - Study - Link between professional sports and depression
29:16 - Study - CTE in people with no known participation in contact sports or history of head trauma
30:05 - Study - NHL players with concussions have surprising results
31:14 - Studies - Link between concussion and suicide
34:43 - What does the evidence say and CTE?
36:22 - Improper concussion management
38:34 - Opioid medication in professional athletes
40:44 - Psychology & mental health
43:10 - Chronic inflammation
47:54 - Multifactorial factors affecting negative outcome risk in collision sports
49:02 - How worried should you be about CTE
51:21 - How to reduce the risk of CTE
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Interested in learning more about the treatment and management of concussion?
-- CONCUSSION PATIENTS! Learn how to treat your concussion from home in Dr. Cameron Marshall’s weekly online workshops. Click here to learn more: smarturl.it/workshopcdoc
-- CLINICIANS AND REHAB THERAPISTS (PT, DC, OT, AT, etc.)! Learn how to treat ANY Concussion Patient that enters your clinic in Dr. Cameron Marshall’s weekly online workshops. Click here to learn more: smarturl.it/workshopcc
Follow Dr. Cameron Marshall on Instagram for daily information on concussion: @completeconcussions
Hello thank you for information. Could you do a video on depersonalization or derealization due to concussions ?
Dr. Cameron Marshall I would like to fly out to Canada and get treated by you, which clinic do you work at? I can't find it online. Thank you in advance for the immense help you are providing.
Hello, I was wondering if you could make an updated video on why PCS patients get dizzy from minor bumps or hits to the head, I’ve seen the previous 4 videos but new research has came out and I think I speak for all of us when I say we’d want to hear your opinion with all the new data over the last 2 years
Thank you if you’re reading this, your channel helps many!
On this topic there hasn't been much new. The reason is the same for all persistent concussion symptoms - it's an aggravation of some underlying issue. So the key is to address the issue. Could be neck dysfunction, chronic inflammation, vestibular/visual dysfunction, anxiety, etc.
I would see white spots and my theory is that the hits aren’t necessarily damaging but it’s the stigma that’s been implanted in your head from the concussion and all the constant new information. I believe it could be a form of ptsd or a phobia developed that makes you believe that you have cte because of the fact that you feel more susceptible to damage since the original experience. (Speaking from personal experience and just as a person trying to figure it out myself)
1984 near drowning holiday
1984 loss of consciousness/concussion falling off 12ft wall onto head
Frequent heavy nose bleeds for 10 years
1992 fell 20ft out of tree hit head
1993 slipped on black ice loss of consciousness for over a minute cracked skull on rock, 10 stitches in back of head.
1994 skating backwards down steep bank hit head on iron gate, bad concussion
1994 hit in head with cricket ball at full pace concussion
1994 hit in head with a rock concussed
1995 knocked unconscious with head to head collision playing Rugby at school
1995 hit on top of head with plaster cast, concussion memory loss
1997 concussed after being repeatedly hit several times to head
1999 carbon dioxide poisoning whilst diving
1999 hospitalised after 70mph car crash stuck underneath car lost over a pint of blood
2001 knocked unconscious for over 5 minutes in Riga Latvia outside of nightclub
2002 near drowning in Cyrprus Navy
2004 near drowning whilst diving
2007 concussed after fight with doorman in Perth Australia
2010 -2014 heavy recreational drug
use
2012- Acid in eyes blinded for 3 days
2017 collapsed at work in Belgium with stroke like symptoms. Medically evacuated back to UK
2020 - Nigeria cerebral malaria (hospitalised)
This is my case history I’ve had a lot more head trauma that I don’t recall and the doctors refuse to say I have brain damage as there is nothing on scans…I’m in a lot of pain and discomfort and struggle with focus, memory, feelings, ocd 🔂 looping thoughts, nothing seems real, tinnitus in both ears, wake up screaming most days. No idea what to do now..
hi i have a question, so i had a ball hit the left side of my head like 3 weeks ago and i was experiencing the symptoms of concussion, after a week i went to do a ct scan and found no bleeding and nothing, so on the 2 week mark most of my symptoms subsided my nasuea was also gone, but during the weekend i drank alcohol for 2 family dinners and after that my symptoms started coming back and it got even worse, my nausea came back too and its been 7 days now. should i get another ct scan? should i eat any medicine for this occasional nausea or should i just rest and wait it out? should i reset the clock and count my symptoms as if the concussion occured during my family dinner and wait for 2 weeks? and like how long should i wait for this 2nd wave of nausea before i go see a doctor
Are the headaches like paroxysmal Hemicrania continua which I was diagnosed
But think it’s from a lot of head trauma and a coma 5 days with 3 weeks amnesia and
Equestrian rider
hi sir i met an accident where i sustained haemorrhagic diffuse axonal injury.can u tell me weather i am able to recover completely or not...please reply me back
In the 1950s, the population was more rural, and organized sports were way less violent. They didn't start a bunch of sedentary, apartment kids, with no strength in muscles, and no density in connective tissues, wearing heavy helmets their necks can't support, doing an hour or two of intense, violent exercise, crashing into each other, before sitting around for hours, doing nothing. Video games and watching videos on phones is changing the physiological development of children. Sitting for 8 hours in desks is actually different than mid 20th Century education. Children can't straighten their backs now. It's a different world, and you really can't compare children of today with the horse riding, bike riding, hill climbing children of the 20th Century. Good studies with large sample sizes need to be done. The long term effects of ONE concussion are clear and devastating, and obvious to anyone with a loved one who suddenly becomes someone else, after worsening physical symptoms, and physical manifestations diagnosed, but there's no help in the medical system.
What you're suggesting is called a "theory". The actual evidence examining long-term effects has not found a strong correlation by any means.
This scares the crap out of me…
How can I find out if I have this? There are times when I feel like I’m getting worse as time goes on, so this is really stressing me out. 😢
Did you actually watch the video, orrr? The video has more of a positive message...
@@CompleteConcussions I think it’s just the thought that scares me. I have OCD so I tend to catastrophize and worry. I appreciate you making a video on it and giving a positive outlook. My fear doesn’t reflect anything you said, it’s just my mind worrying.
My ongoing cognitive issues concern me. I have wobbly uncoordinated movements at times, gait changes, numb feelings in face and arms at times. Extreme brain fog. So yea, it scares me quite a bit. I just want to heal. I don’t want this to get worse.
@@IndialienJones If there are no identifiable organic causes for these symptoms it is likely somatization (look up that term). I have done other videos as well on post-concussion anxiety that may help.
interesting stuff, just curious how is it that some boxers have bad slurred speech, what does that come from if not trauma to the head?
to be clear, I am not saying that it is not. What I'm saying is that we don't know. People with no boxing experience also develop neurodegenerative diseases (parkinsons, alzheimers, etc.) - we've even found CTE in people with no history of concussion or head trauma. So could head trauma be like smoking? ie., not everyone who smokes gets lung cancer and not everyone with lung cancer was a smoker - I think yes! For sure. But could it also be something else entirely? i.e., illicit drug use, PEDs, alcoholism, normal aging, genetics - yes it could! My point here is that the evidence that we currently have is controversial and quite light. But the media portrayal is that we have mountains of evidence - we don't. We have a very hard time proving this in patients with long concussion histories (boxers, pro football and hockey players, etc.) - so the average person with 1, 2, 3 concussions should not give CTE a second thought!
@@CompleteConcussions I bet you get a lot of heat for even having that opinion, You swayed me over with a lot of your opinions
@@CompleteConcussions we’ll I took a hit 1 month and 2 days after my concussion a soccer pass to my head :/
@@CompleteConcussions what are your thoughts on hyperbaric oxygen therapy
@@josho_reacts2.0 evidence shows that it is ineffective for concussion symptoms/recovery - no better than placebo
I live with this disease 24-7 and I don't need proof of the dark twisted place I can't escape... Fight or flight mode never goes away is best way to describe... I can't stand ppl that have no idea what this feels like and when the spouse is saying or the person is saying that they are diagnosed with CTE you're taking things a bit too literal here they know that they have it because they're living either with the person that has it or they're living with themselves and I'll tell you this they are a stranger to themselves and they are a stranger to their spouse they don't need a doctor to tell them they don't need you to tell them what the scientific knowledge is and what they don't have proof of because I will tell you personally the number one thing that gets at me and gets under my skin is when someone who has no clue what it feels like to live like this talks about it and then has the nerve to actually mention just the words that you're using when you say say they're diagnosed with it but that cannot be proven to their dead I understand it can't be diagnosed until you are dead but in what way is your video helping anyone with CTE I get no information no suggestions of help no benefits from your video except anger and frustration at someone telling me about CTE that doesn't know this feeling .. ahhhhhh
What I think you are not understanding is that the exact same symptoms that you describe are symptoms of anxiety, depression, chronic pain, and numerous other potential things. What I am trying to get across to people is to not just assume that this is "CTE", but rather to seek treatment for the symptoms that they are experiencing. Persistent Concussion Symptoms for example are NOT due to ongoing brain injury but rather 5 main underlying drivers (Autonomic Dysregulation, Inflammation/Gut/Hormones, Visual/Vestibular Dysfunction, Neck Dysfunction, and mental health issues (anxiety, depression, PTSD)) Each of the 5 things I named are responsible for all PCS symptoms. What I want people to realize is that their symptoms may also be from these issues and not CTE. It is also a much more hopeful proposition since these issues are TREATABLE...whereas CTE is not.
Head trauma causes so many problems
Most doctors and medical scientists have never had even one concussion. Listen to the athletes. What you describe as normal cognitive function doesn't always feel like normal cognitive function. Normal cognitive function can't be reduced to smiley face or unhappy face, either. Unhappy face! Well, at least they are cognitively sound enough to know they're unhappy.
Having a concussion is not a requirement for studying them. The evidence suggests that all sorts of things can make you "FEEL" cognitively unwell despite being perfectly cognitively healthy. And one of those things is the assumption that concussions lead to long-term cognitive issues. If you believe this to be true, and you've had a couple concussions, the evidence suggests that you will be more likely to perceive yourself as having cognitive difficulties (even if you actually test the same as someone with no concussions and perceives no cognitive difficulties). This is the power of suggestion...
@@CompleteConcussions no I agree with all this. It's just in my particular case, which is just my case, I felt a rush of depression immediately after recovering from a few of them, and there is a rush of helplessness and anxiety and even panic attacks, and migraines in my case. A lot of these feelings experienced before I had any sort of drug use or alcohol abuse, when I was in good physical shape, and before I started to struggle with these issues in the long term and these things were given different causes.
@@CompleteConcussions The difficulty is determining when someone is experiencing a relative deficit. As I understand it, cognitive abilities are only considered to be in deficit when they fall below what is regarded as average. Someone may be testing above average but short of where they once were, yet if they do not have old neuropsych testing with which to make a comparison, the deficit they're endorsing cannot be substantiated.
@@Supwisebs This is what is called a baseline. It can be helpful, yes. But the point is that no one has a baseline in regular life. So we use norms and this seems to work just fine for the majority of the population when doing cognitive testing. There is a cut off - you're either impaired or you're not. What much of this research shows is that people THINK they are impaired, but they are not.
Had couple concussions. I was 15 I fell off a car hood he turned left I went right. Right on to my chin broke my jaw both sides was bleeding out of my ear. Had a basiculer skull fracture on the inside I guess. Since then I’ve only been knocked out 3 times . All from hitting my noggin. Im 41 now and my life is going down fast . Depression is horrible. Seems like I felt I wasn’t right anymore when I got older I definitely know I’m not normal . Who do I see?
Sorry to hear about your struggles. A mental health professional is where you want to go! Depression, although associated with concussion history, is actually just treated like any other depression. So a psychologist, psychiatrist, psychotherapist, social worker, etc. Depression is also related to gut issues, hormone issues, exercise, alcohol use, etc. So be sure to also try to live a healthier life all around and see if there are any gut issues that could be contributing! Good luck to you and I hope that you start to feel better soon.
Thanks for sharing... You're right, depression is awful....I'm 40. I've had 4 concussions in the past 9 years, with the most recent one happening last November, A few weeks ago I started going downhill mentally, started getting really frustrated over small things, started to feel really lethargic and fatigued, lack of motivation, isolating myself, it's crazy how the symptoms just come out of the blue. I haven't worked since the symptoms started showing up. I'm taking it day by day in hopes that the symptoms will subside, I can definitely see why people who experience this commit suicide as there feels like there's no escape
@@NarlyNardo I’m very sorry buddy . I smoke cannabis it helps a lot . On the other hand it has a lot to do with why I can’t work , I drive a truck they they don’t like people who smoke . Even though never was in an accident took pride in doing my job safe and the people driving around me safe. Never smoked and drove. Got caught on a pre employment test put me out of work depression got worse. Man still struggling weed kept me in one level it not for everyone I know but it worked when the drs pills didn’t. Been trying to quit to get back to driving, with out pills now cuz of course no insurance have to pay out of pocket it’s a vicious cycle. All I know is if u want you have a brother to talk to or hang with if you want in Northern Illinois. Bout 45 minutes nw of the city.
@@bobby9623 thanks man...I used to smoke in my earlier years, but at around 35 y/o it started giving me major anxiety, so I've been using kratom to cope with the CTE, it keeps me out of the doctors office and off of the government made pills. If I was up north I would grab a beer for sure, I'm in Atlanta. I hope your symptoms get better and hopefully we can both start working soon and making some money
@@NarlyNardo I hear that best of luck to ya . Im going to stop smoking so I can get back to trucking. That’s fun in itself sometimes get into good funny conversations on the cb. I miss just cruising down the road also .
When the players say they feel like that have cognitive decline , then they most likely have. They would know themselves best. When you do a test measuring up to the general public or a bell curve, that could not be 100% accurate, because it’s based on a general scale but individually, the concussed person seems to be getting dismissed on where they should be at ( optimally) cognitively, which can be detrimental to their much needs long time care. Ultimately, the individual needs to be listened to , or a very observant , caring family member / caregiver.
The problem is that many things can make us feel this way. People can feel that they are experiencing cognitive decline when they are feeling anxious, depressed, etc. People show up in the ER every day all around the world thinking that they are having a heart attack that turns out to be anxiety, panic, muscle pain, etc. Just because someone feels that they are having a heart attack doesn't mean that they are...this is why objective testing exists - we look for objective biomarkers or indications to see if there is cause for concern or not. So yes, we should listen to the players when they feel they are in cognitive decline...but if we can test them and show objectively that they are not, do we tell them? Or do we just continue to treat them like they have had a heart attack when they actually haven't. Personally, I feel that the truth is the right approach.
@@dr.cameronmarshall1032 I think over general months you develop idea of cognitive decline. It's not something in moment as hearth attack. Over longer periods you realise you have cognitive decline. I think that's more valid judgment than something as heart attack.
And I think from the age of 14 to 24 years old know I can't tell you how many darn concussions I had but I know it's over a hundred it has no concern how many concussions a person remembers you sound kind of ignorant when you say that they will say how many they had but that's not true they always over suggest are they under they never know the exact amount what are you talking about who cares they have brain issues