Dr. Arman Fesharaki-Zadeh, the neuroscientist, is doing some serious groundbreaking work in the field of neurodegenerative diseases, more specifically chronic traumatic encephalopathy (CTE). His work in this niche began years earlier in Canada and was fueled by his father’s zeal for medicine. He became better-focused during his psychiatry residency in Brooklyn, where he observed a subgroup of PTSD patients who weren’t responding to traditional treatment methods. Many victims also sustained traumatic brain injuries, which made their condition even more complex.
Dr. Fehskaraki-Zadeh did his fellowship in Behavioral Neurology and Neuropsychiatry from Yale University School of Medicine in the year 2017. At present, most of his time is centered on research that uses animal models in an attempt to understand the complex mechanisms underlying the pathology of repeated head injury in the brain.
CTE is a degenerative brain disease usually associated with repeated head trauma. Finding its name in the 1920s and ’30s to describe mental and motor deficits in boxers under the original term “dementia pugilistica,” today it’s been diagnosed in hundreds of individuals who have suffered repeated head injuries. Although the most significant injuries leading to CTE are concussions, it is also known that sub-concussions, or head injuries that do not initially cause functional deficits, are very risky.
Characteristic symptoms of CTE typically come at the symptomatic phases of midlife, with athletes showing symptoms over years, or even decades, after the head trauma. Sometimes, the first symptoms of CTE comprise headache, depression, irritability, a decrease in the ability to concentrate, loss of short-term memory, and suicidal activity. Later, the disease worsens the executive functions of the brain and leads to ever-worsening memory and cognition, aggressive behavior, and complaints that are connected with Parkinson’s disease. At an advanced stage, CTE may be confused for Alzheimer’s disease or other logopathies.
Postmortem analyses of CTE brains have identified selective neuropathological changes of brain structures in the atrophy and degeneration of myelinated neurons. Of particular note is that tau protein in neurons is abnormal in a way similar to Alzheimer’s, with distinct differences in both the distribution of tau and the characteristic amyloid plaques.
CTE research has advanced remarkably in the opening years of the 21st century on the back of increasing public awareness and concern about the immediate dangers of concussive injuries in contact sports and the suspected long-term risks of the same. Studies of brain tissue in deceased military personnel, prominent athletes, and other individuals have made it possible to identify the neuropathology of CTE. Modern imaging technologies, such as positron emission tomography, are likely to be up to the job of detecting early accumulation of tau protein in the living brain.
Despite such advances—much still needs to be learned about the clinical presentation, genetics, and environmental risk factors for CTE, not to mention effective treatment and prevention strategies—a growing rank of athletes who have suffered head trauma have pledged to donate their brains for the study of CTE to brain banks that have been created at such research institutions as the Boston University Center for the Study of Traumatic Encephalopathy.
Research at Yale by Dr. Fesharaki-Zadeh does not just advance research but includes patient care in the Yale memory outpatient clinic. The key elements are described by him to be gaining the trust of his patients, the insight into their personal experiences, and assessing severity using memory tests. He also holds a faculty position at the Yale School of Medicine, teaching in the field of psychiatry and neurology, while helping to shape the future generation of medical professionals.
As the concept of CTE continues to evolve, it remains the contributions of dedicated researchers like Dr. Fesharaki-Zadeh working on this debilitating disease are critical in unraveling its mysteries and improving lives.