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Four Stages of CTE Found in Latest Boston University Study

January 25, 2013


By looking at the extent of the diseased areas, the researchers determined which brains were stage I, II, III, or IV CTE. And by conducting interviews with the families of the deceased, they were able to figure out how the progression of behavioral and emotional symptoms corresponded to each stage of the disease.

Here’s how they categorized them:

Stage I: This stage is marked by headache and loss of attention. It may also include short-term memory problems, depression, and aggressive tendencies. A couple of the individuals had had problems with executive function and explosivity.

Stage II: In this stage, individuals were more likely to have experienced headache, attention and concentration problems, mood swings, short-term memory loss, and impulsivity. Less commonly they may have also experienced suicidal thoughts and language problems.

Stage III: This stage is marked by the symptoms of the previous stages, with the possible addiction of visuospatial difficulties, more extensive cognitive and memory problems, and apathy. The authors say that at this stage, 75% of the individuals “were considered cognitively impaired.”

Stage IV: This stage is commonly associated with more significant cognition problems and memory loss. “Most subjects also showed profound loss of attention and concentration, executive dysfunction, language difficulties, explosivity, aggressive tendencies, paranoia, depression, gait and visuospatial difficulties,” the authors say. Over 30% were suicidal at some point, and a few experienced problems with physical movement known as parkinsonism.

Interestingly, 37% of the people with CTE also had another neurodegenerative disease, including Alzheimer’s, FTD, Lewy body disease, or Parkinson’s, which could suggest that once CTE develops, it can trigger other pathological pathways.

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