Table 2:
Proportion of sample meeting Core TES Criteria by head trauma exposure group.
| LETBI Cohort | ≥2 Mild TBIs Only | ≥2 Mild TBIs + RHI | Complicated Mild/Moderate Only | Complicated Mild/Moderate + RHI | Severe Only | Severe + RHI | Total |
|---|---|---|---|---|---|---|---|
| N=35 | N=43 | N=32 | N=23 | N=90 | N=72 | N=295 | |
| I. RHI EXPOSURE | |||||||
| TES RHI Criteria | 0(0%) | 43(100%) | 0(0%) | 23(100%) | 0(0%) | 72(100%) | 138(46.8%) |
| II. COGNITIVE FUNCTIONING | |||||||
| 1.Self/Informant/or Clinician’s Report of Cognitive Impairment | 27(77.1%) | 30(69.7%) | 16(50%) | 17(73.9%) | 64(71.1%) | 45(62.5%) | 199(67.4%) |
| 2. Significant Cognitive decline from Baseline | 30(85.7%) | 35(81.3%) | 15(46.8%) | 18(78.2%) | 73(81.1%) | 50(69.4%) | 221(74.9%) |
| 3. Deficits in Episodic Memory and/or Executive Functioning; Deficits in Neurocognitive Performance | 25(71.4%) | 27(62.7%) | 16(50%) | 16(69.5%) | 60(66.7%) | 35(48.6%) | 179(60.6%) |
| OVERALL TES Cognitive Impairment | 23(65.7%) | 25(58.1%) | 14(43.7%) | 16(69.5%) | 57(63.3%) | 33(45.8%) | 168(56.9%) |
| III. NEUROBEHAVIORAL FUNCTIONING | |||||||
| 1. Self/Informant/ or Clinician’s Report of Neurobehavioral Dysregulation | 32(91.4%) | 34(79%) | 21(65.6%) | 17(73.9%) | 65(72.2%) | 55(76.4%) | 224(75.9%) |
| 2. Significant Neurobehavioral Functioning decline from Baseline | 15(42.8%) | 17(39.5%) | 9(28.1%) | 11(47.8%) | 31(34.4%) | 15(20.8%) | 98(33.2%) |
| 3. Symptoms and/or Observed Behaviors Representing Poor Regulation or Control of Emotions and/or Behaviors | 24(68.6%) | 25(58.1%) | 14(43.8%) | 13(56.5%) | 40(46%) | 36(48%) | 152(51.5%) |
| OVERALL TES Neurobehavioral Dysregulation | 15(42.9%) | 17(39.5%) | 9(28.1%) | 11(47.8%) | 30(33.3%) | 15(20.8%) | 97(32.9%) |
| IV. PROGRESSIVE COURSE | |||||||
| 1. Self/Informant/ or Clinician’s Report of Progressive Worsening of Overall Symptoms | 9(25.7%) | 13(30.2%) | 5(15.6%) | 9(39.1%) | 34(37.8%) | 13(18.1%) | 83(28.1%) |
| 2. Progressive Worsening of Cognitive Functioning | 12(34.2%) | 18(41.8%) | 14(43.7%) | 13(56.5%) | 46(51.1%) | 30(41.7%) | 133(45%) |
| 3. Progressive Worsening of Neurobehavioral Functioning | 10(28.5%) | 13(30.2%) | 5(15.6%) | 9(39.1%) | 37(41.1%) | 15(20.8%) | 89(30.1%) |
| Overall TES Progressive Course | 13(37.1%) | 18(41.8%) | 14(43.7%) | 13(56.5%) | 47(52.2%) | 30(41.74%) | 135(45.7%) |
| V. POSITIVE TES DIAGNOSIS | |||||||
| RHI Exposure and all 3 Core Clinical Features | 0(0%) | 15(34.8%) | 0(0%) | 11(47.8%) | 0(0%) | 18(25%) | 44(14.9%) |
| No RHI Required; all 3 Core Clinical Features | 11(31.4%) | 15(34.8%) | 6(18.7%) | 11(47.8%) | 38(42.2%) | 18(25%) | 99(33.5%) |
| VI. FUNCTIONAL DEPENDENCE/DEMENTIA: level of functional dependence (n(%)) by exposure group | |||||||
| Severe Dependence | 7(20%) | 5(11.6%) | 3(9.3%) | 5(21.7%) | 17(18.9%) | 17(23.9%) | 54(18.3%) |
| Moderate Dependence | 12(34.2%) | 11(25.5%) | 8(25%) | 6(26%) | 35(38.9%) | 26(36.6%) | 98(33.2%) |
| Mild Dependence | 14(40%) | 11(25.5%) | 7(21.8%) | 7(30.4%) | 14(15.6%) | 14(19.7%) | 67(22.7%) |
| Subtle Dependence | 2(5.7%) | 14(32.5%) | 6(18.7%) | 2(8.6%) | 14(15.6%) | 9(12.7%) | 47(15.9%) |
| Independent | 0(0%) | 2(4.6%) | 8(25%) | 3(13%) | 10(11.1%) | 5(7%) | 28(9.4%) |
| VII. PROVISIONAL LEVELS OF CERTAINTY FOR CTE PATHOLOGY: criteria met (n(%)) by exposure group | |||||||
| Substantial RHI exposure (5+ years) | 0(0%) | 36(83.7%) | 0(0%) | 18(78.3%) | 0(0%) | 66(91.7%) | 120(40.68%) |
| Extensive RHI exposure (11+ years) | 0(0%) | 23(53.5%) | 0(0%) | 9(39.1%) | 0(0%) | 31(43.1%) | 63(21.36%) |
|
Supportive Features* Delayed Onset |
|||||||
| Motor Signs | 9(25.7%) | 10(23.3%) | 5(15.6%) | 11(47.8%) | 30(33.3%) | 23(31.9%) | 88(29.83%) |
| Psychiatric Features (≥1) | 26(74.3%) | 27(65.9%) | 9(31%) | 13(59.1%) | 47(57.3%) | 33(50%) | 155(52.54%) |
| Number of Supportive Features** (Mean ± SD) |
2.80±1.05 | 2.63±1.29 | 1.91±1.30 | 2.96±1.46 | 2.60±1.38 | 2.32±1.24 | 2.52±1.32 |
| VIII. Overall Certainty (Positive TES Diagnosis with RHI required): level of certainty (n(%)) by exposure group | |||||||
| Criteria not met | 35(100%) | 28(65.1%) | 32(100%) | 12(52.2%) | 90(100%) | 54(75%) | 251(85.1%) |
| Suggestive CTE | 0(0%) | 3(7%) | 0(0%) | 1(4.3%) | 0(0%) | 3(4.2%) | 7(2.4%) |
| Possible CTE | 0(0%) | 4(9.3%) | 0(0%) | 6(26.1%) | 0(0%) | 10(13.9%) | 20(6.8%) |
| Probable CTE | 0(0%) | 8(18.6%) | 0(0%) | 4(17.4%) | 0(0%) | 5(6.9%) | 17(5.8%) |
*
Supportive features include the following: Delayed onset, Motor signs (i.e., parkinsonism, other motor signs, motor neuron disease); Psychiatric features (i.e., anxiety, apathy, depression, paranoia); neurobehavioral dysregulation; severity of functional independence.
**
The number of supportive features reported below refers to the mean ± SD features beyond clinical features included in the Core criterion (i.e., neurobehavioral dysregulation as defined in Table 2) and severity of functional dependence of mild or worse (as defined in Table 2). A minimum of 2 Supportive features are required for Possible CTE; 3 are required for Probable CTE. 13