Philip H. Montenigro

Author response clinical presentation of chronic traumatic encephalopathy

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Neurology 2014, Volume 83, Pages 1991-1993

Neurology 2014, Volume 83, Pages 1991-1993

Montenigro PH, Stern RA. “Author response clinical presentation of chronic traumatic encephalopathy.” Neurology 2014, Volume 83, Pages 1991-1993, PMID: 25404647.

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Excerpt:
Stern et al.1 cited 5 references (4, 7–10; corresponding references below 2,–,6) 3 times to advocate that chronic traumatic encephalopathy (CTE) in younger patients presents as a psychiatric disorder vs cognitive impairment in older patients. Jokl and Guttman6 made no such claim in 1933. In addition, 4 of the references (2–5 below) are misrepresented. In Corsellis et al.,2 the presenting symptoms in 6 of 15 boxers were speech and gait difficulties (estimated age at onset 39 years). Older boxers (n = 3) with no CTE symptoms, including cognitive, died at a mean age of 70 years. We are left with the following question: Can alcohol abuse be construed as a behavior/mood variant CTE symptom in younger boxers (n = 3; mean age at onset 29 years)? Corsellis et al.2 have been falsely cited as reporting that the initial CTE stage is psychiatric.7 Mawdsley and Ferguson3 described one boxer (out of 10) who drank, brawled, and was arrested frequently. Oddly, 3 references (4–6) were in German and decades old. The review revealed that one patient (out of 5) had a psychiatric presentation but an abnormal EEG.4 Another (out of 4) was a prisoner of war who developed irritability upon his release at age 20 years and psychosis at age 26. The authors were hesitant to attribute this to boxing.5 The dichotomy of an initial psychiatric presentation in younger patients and …

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