2429 Investigating traumatic encephalopathy syndrome (TES) in retired athletes, military personnel and victims of assault with a history of sustained, repetitive mild traumatic brain injury

ObjectivesThe SNAP-CTE Study aims to identify features and characteristics of the in-life experience of those who may be suffering from Chronic Traumatic Encephalopathy (CTE) and correlated Traumatic Encephalopathy Syndrome (TES). A cohort of 20 participants were included in the preliminary findings.Methods20 participants with a history of mTBI meeting current criteria for TES were evaluated for features of migraine disorder, cognitive decline, mood disorder and general medical history in a metropolitan neurology clinic. Participants with drug use outside of alcohol were excluded. Participants were included if they have experienced sustained and repetitive mTBI, in the absence of other neurological presentations and negative magnetic resonance imaging for an alternate cause.ResultsThe average age of participants was 55 years old, consisting of 90% male and 10% female participants. At presentation, 45% of participants were experiencing regular migraine symptoms. Up to 90% of participants were experiencing cognitive decline, for up to 3 years prior to presentation. Similarly, 80% of participants presented with mood disturbance, up to 6 years prior. ACE-III indicated MCI with an average score of 90. History of alcohol use disorder was noted in 40% of participants, with only 15% of participants using concurrently.ConclusionsMigraine disorder in TES presents an opportunity for investigation regarding pathophysiological processes associated with mTBI. Longer history of mood disturbance may be a better indicator of TES, versus cognitive decline, and both should be researched further. The TES cohort did not appear to have a predilection for self-medicating with alcohol use.