Journal List > Dement Neurocogn Disord > v.12(3) > 1120822

Dement Neurocogn Disord. 2013 Sep;12(3):78-80. Korean.
Published online Sep 30, 2013.  https://doi.org/10.12779/dnd.2013.12.3.78
© 2013 Korean Dementia Association
Dementia Pugilistica with Clinical Features of Frontotemporal Dementia and Parkinsonism: Case Report
YoungSoon Yang, M.D., JaeJeong Joo, M.D., JinHo Kang, M.D., SangWo Han, M.D., SangWon Ha, M.D., JungHo Han, M.D., EunKyung Cho, M.D. and DooEung Kim, M.D.
Department of Neurology, Veterans Hospital, Seoul Medical Center, Seoul, Korea.

Address for correspondence: YoungSoon Yang, MD. Department of Neurology, Veterans Hospital, Seoul Medical Center, 6-2 Dunchon 2-dong, Gangdong-gu, Seoul 134-791, Korea. Tel: +82-2-2225-4106, Fax: +82-2-2225-4105, Email: astro76@naver.com
Received Sep 03, 2013; Revised Sep 09, 2013; Accepted Sep 09, 2013.

This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/3.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.


Abstract

Dementia pugilistica (DP) or chronic traumatic encephalopathy (CTE) is a neurodegenerative disease or dementia that may affect amateur or professional boxers as well as athletes in other sports who suffer concussions. The condition is thought to affect around 15% to 20% of professional boxers and caused by repeated concussive or subconcussive blows. CTE was in the past referred to as dementia pugilistica, which reflected the prevailing notion that this condition was restricted to boxers. Recent research, however, has demonstrated neuropathological evidence of CTE in retired American football players, a professional wrestler, a professional hockey player and a soccer player, as well as in nonathletes. It is probable that many individuals are susceptible to CTE, including those who experience falls, motor vehicle accidents, assaults, epileptic seizures, or military combat, and that repeated mild closed head trauma of diverse origin is capable of instigating the neurodegenerative cascade leading to CTE. We report a 62-year old man suspicious of dementia pugilistica with clinical features of frontotemporal dementia and parkinsonism.

Keywords: Dementia pugilistica; Chronic traumatic encephalopathy; Repeated head trauma

Figures


Fig. 1
Brain MR image shows cortical infarction and atrophy in both frontal and temporal lobes.
Click for larger image


Fig. 2
Brain PET-CT shows severe decreased uptake in bilateral frontotemporal lobes and moderate decreased uptake in bilateral parietal lobes with sparing of the occipital visual cortex, somatosensory and motor cortex, basal ganglia, thalamus and cerebellum.
Click for larger image


Fig. 3
FP-CIT PET shows decreased FP-CIT uptake in the bilateral posterior putamen with relative sparing of the ventral putamen.
Click for larger image

References
1. Roberts GW, Allsop D, Bruton C. The occult aftermath of boxing. J Neurol Neurosurg Psychiatry 1990;53:373–378.
2. Brooks N, Kupshik G, Wilson L, Galbraith S, Ward R. A neuropsychological study of active amateur boxers. J Neurol Neurosurg Psychiatry 1987;50:997–1000.
3. Gavett BE, et al. Mild traumatic brain injury: a risk factor for neurodegeneration. Alzheimers Res Ther 2010;2:18.
4. McKee AC, Cantu RC, Nowinski CJ, Hedley-Whyte ET, Gavett BE, Budson AE, Santini VE, Lee HS, Kubilus CA, Stern RA. Chronic traumatic encephalopathy in athletes: progressive tauopathy after repetitive head injury. J Neuropathol Exp Neurol 2009;68:709–735.
5. Rascovsky K, et al. Sensitivity of revised diagnostic criteria for the behavioural variant of frontotemporal dementia. Brain 2011;134(Pt 9):2456–2477.
6. Areza-Fegyveres R, Rosemberg S, Castro RM, Porto CS, Bahia VS, Caramelli P, Nitrini R. Dementia Pugilistica with Clinical Features of Alzheimer's Disease. Arq Neuropsiquiatr 2007;65(3B):830–833.