Institutional Affiliation
Chronic traumatic encephalopathy (CTE) is a disease which results from lengthy head trauma. It affects different categories of people which include military personnel, boxers and a recent case is the American football players. The journal sheds light on the studies conducted on athletes such as football players and wrestlers and gives the findings of what causes the disease with focus to American players. It depicts the causes of CTE mostly on the people involved in sports.  It outlines the characteristics of the condition such as behavioural anomalies and cognitive disorders as a result of brain injuries.  The journal outlines the risks that may elevate the development of the condition in an individual, diagnosis and prevention measures. It also points the effects of the disease, the current scope and prevalence of the disease. It also focuses on the future research and recommendations as well as developments in diagnostics, medication and the prevention measures of CTE.
Key words: Chronic Traumatic Encephalopathy, Traumatic brain injury, Axonal deformation, Neurological disorders, American players, Diagnose
In 1928, Martland gave insights with regards to the repetitive brain trauma giving focus to Boxers. He observed that the boxers had the “drunk” syndrome as result of handling repeated blows. The repetitive trauma to the brain cause the neuron-degeneration which causes the characteristics associated with Chronic Traumatic Encephalopathy such as the abnormalities in metabolism and altering of the cytoskeletal which aids in the acceleration of the condition. Autopsy findings from the brains of deceased players of the American football posit that the impact of progressive brain trauma is evident in cognitive deterioration, interruption of the brain structure and unusual images in the brain.
A series of continuous injuries result to accumulated brain trauma causing Chronic Traumatic Encephalopathy. The American Football involves a lot of head injuries which makes the brain get affected by concussion forces resulting to intense injuries. If it goes on over a long period of time without adequate medication and recovery measures it gives way to chronic inflammatory process which is the first level of CTE. Over a lengthy period the tau oligomers form paired shape, the filamentous neurofibrially intertwine hence disrupting the normal functioning of the brain leading to signalling and communication anomalies. The inflammation caused due to activation of chemokine and cytokine cause an obstacle to blood flow to the brain. Therefore, the inflammatory in the brain result to imbalance of calcium, failure of the mitochondria and stress that is caused by oxidation. Tau acetylation in the neurons also accelerates the rise of CTE.
The main risk to CTE is continuous brain injury. In other cases numerous concussions cause neuro-degradation of the cognitive which in the long run cause mental health disorders in some individuals. The magnitude and the extension of time of brain trauma also pose a risk in accelerating CTE. Genetically people exposed to CTE genes are susceptible to be victims. The age of getting exposed to football can also cause vulnerability because the head gets injuries at a tender level which may result to psychiatric problems in old age.
Epidemiology and Diagnosis of CTE
The prevalence of the CTE is mostly in people with a historic progressive brain injuries mostly being the athletes such as boxers, football players and wrestlers. The condition also differs with the level of the players whereby the high school athletes have a mild CTE as compared to national players whom the condition is more sever. In United States there is a high mortality rate due to CTE which poses a great risk to the entire population. Neuroimaging technique has been used for pre-mortem but an elaborative diagnosis is confirmed via the post-mortem autopsy.
Symptoms and Cognitive Functions
The symptoms are evident in the old age mostly after the retirement of the athletes. They tend to be aggressive, have memory lapses, suicidal thoughts and depression. At a young age they tend to have cognitive anomalies, get violent and aggressive. In late onset they have attention deficits and problems with executive functions. CTE is also a leading cause of increased mortality rats and suicide in the United States.
Future directions in diagnosis, therapeutics and Directions
There is a search for diagnosis tools which include Magnetic resonance imaging MRI and Magnetic Resonance Spectroscopy. The recent research has brought the aspect of molecular etiotathogenesis. The modern developments show the advancement in drug targets to curb the development of CTE (Tharmaratnam et al., 2018). The athletes are encouraged to enact different safeguarding measures against direct head injuries and impacts as well as penalties concerning the same. The athletes should adhere strictly to the guidelines of the play. They should timely report cases injury symptoms in order to facilitate quick recovery and to avoid the consequences of long term brain injuries which can give room to CTE.

  1. About what, does the article talk about?

The article talks about Chronic Traumatic Encephalopathy on the American football players, its causes, diagnosis, the current findings and future predictions as well as its prevention measures. It shows that most footballers do not realize the risk of engaging in repetitive head blows and that most people are not quick to seek medication since they are not aware of this condition. The article therefore provides information about the condition and helps people to be careful when doing sports activities.

  1. What did you like about the article?

In the article I like the fact it sheds light on the Chronic Traumatic Encephalopathy which is a rare condition yet it is causing a high mortality rate in the population of the United States. It therefore helps to create awareness of the condition hence reducing the prevalence among the American football players. It clearly poses the need to have instructions and rules mostly for those engaging in professional sports. The penalties and the rules help the players stay away from the brain injuries since the head is being protected as much as possible.

  1. What did you find interesting in the article?

The most interesting thing about the article is that it provides a wide range of information which is vital to help curb and control the condition mostly to the people who are professional football players. The article is interesting in the way it provides such information in a detailed way mostly when stating the causes of Chronic Traumatic Encephalopathy condition to people who are actively involved in sports.

  1. What did you not like about the article

The article fails to focus on giving the solution to this epidemic mostly to those who are already affected. It does not consider a lay man reader since it fails to provide the meaning of the numerous scientific terms used throughout the journal. It provides minimal prevention measures for the CTE and fails to tackle how to help other susceptible such as the military personnel.
The journal has widely elaborated the effects of CTE mostly on the American football payers hence the need to seek medical intervention for those who are actively affected other than allowing them to succumb to these effects. My recommendation would be more research to be financed and conducted to find better means of dealing with the menace. The post-mortem done only to the deceased is a rather late way of determining the disease hence there should be more measures to ensure it is detected early enough to enable ample medication and to reduce on the mortality rates.
Tharmaratnam, T., Iskandar, M. A., Tabobondung, T. C., Tobbia, I., Gopee-Ramanan, P., & Tabobondung, T. A. (2018). Chronic traumatic encephalopathy in professional American football players: where are we now?. Frontiers in neurology9.