|Martha Shenton, PhD, Professor, Departments of Psychiatry and Radiology, BWH, HMS as well as Director of the Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Health Scientist at the VA Boston Healthcare System, Brockton Division, Senior Scientist at Brigham and Women’s Hospital, and Senior Scientist at The Judge Baker Children’s Center. She is also on the Research Staff at Massachusetts General Hospital.|
Chronic traumatic encephalopathy (CTE) is a neurodegenerative disease that currently can only be confirmed at postmortem. Those at highest risk are professional athletes who participate in contact sports and military personnel who are exposed to repetitive blast events, general from improvised explosive devices (IED). In fact, to date, all neuropathologically confirmed CTE cases have had a history of repetitive head impacts. This would suggest that repetitive head impacts may be necessary for the initiation of the pathogenetic cascade that, in some cases, leads to CTE. Importantly, while all CTE appears to result from repetitive brain trauma, not all repetitive brain trauma results in CTE.
Medical imaging has great potential for detecting radiological evidence of repetitive brain trauma, which sometimes is subtle and not easy to detect. Here, we provide an overview of advanced imaging techniques currently used to investigate brain anomalies in repetitive head injuries. An overview is also provided of neuroimaging findings in those exposed to repetitive head impacts in the acute/subacute and chronic phase of injury and in more neurodegenerative phases of injury, as well as post-mortem findings in military personnel exposed to repetitive head impacts that are similar to the post-mortem findings in former National Football Players. Finally, future directions for research are reviewed that will likely lead to a better understanding of the role of repetitive brain trauma vs. those who go on to develop CTE.
Dr. Martha E. Shenton is Professor of Psychiatry and Radiology, and Director of the Psychiatry Neuroimaging Laboratory, Brigham and Women’s Hospital, Harvard Medical School. She is also a Health Scientist at the VA Boston Healthcare System. Her laboratory has pioneered in developing neuroimaging tools to understand brain alterations in schizophrenia, traumatic brain injury, posttraumatic stress disorder, as well as other disorders. She received her A.B. degree in Psychology from Wellesley College where she graduated Durant Scholar (Summa cum laude) and was elected to Phi Beta Kappa. She received her Ph.D. in Psychology from Harvard University, with a post-doctoral fellowship in Biological Psychiatry at Harvard Medical School. She received several career awards from the National Institute of Mental Health, including a K01 Mentored Award (1988-1993), two K02 Independent Investigator Awards (1994-1999, 1998-2004), and a K05 Senior Scientist Award (2004-2009). She has also been the recipient of the Joseph Zubin Memorial Fund Award for Research in Psychopathology, the William Silen Lifetime Achievement Award for Mentoring, and a Distinguished NARSAD Award. She has served on numerous study sections at the National Institute of Health and has authored >400 peer-reviewed empirical articles and proceedings, as well as authored multiple books chapters, and edited two books. She is Associate Editor of Brain Imaging and Behavior, and is on the editorial board of Schizophrenia Research, Psychiatry Research: Neuroimaging, BMC Psychiatry, Journal of Psychology and Clinical Psychiatry, Journal of Neuroimaging in Psychiatry & Neurology, Journal of Neuroimaging, and the World Journal of Psychiatry and she was an invited member of the committee on “Developing Standards for Diffusion Tensor Imaging (DTI) and Diffusion Spectrum Imaging (DSI) through Public-Private Partnerships”, sponsored by the Institute of Medicine’s Forum on Neuroscience and Nervous System Disorders, Health Arm of the National Academy of Science.