by Salvador Cefalu, M.S., L.Ac.
The recent publicity around the apparent pandemic of brain injury and the resulting problem of Chronic Traumatic Encephalopathy (CTE) has raised questions regarding how to help these individuals suffering with this progressive disease.
While Western Medicine has very limited treatment options, there is much evidence to indicate that Classical Acupuncture and Herbal Medicine can contribute greatly to the reduction of symptoms and disease progression of Chronic Traumatic Encephalopathy (CTE).
The Impact of CTE on our American Warriors
Since the time of ancient Western civilization, society has been entertained and fascinated by the strength and exploits of the gladiator. Today, the persona of a gladiator can be found in our modern day athletes.
Historically, boxers were a strong representation of the gladiator and today the sport of cage fighting is the quintessential gladiator experience. Football, the most popular of all sports in the U.S., emulates men in battle. Football players garbed in armor and prepared to fight can also be viewed as today's gladiators.
These sports all share a risk; the risk of repeated trauma to the head. We've known about a fighter becoming "punch drunk" from repeated blows to the head and if the problem is chronic and progressive, the term Dementia Pugilistica was coined to refer to conditions of dementia following a boxing career.
Today medical science correlates "punch drunk" syndrome with the condition of Chronic Traumatic Encephalopathy that many former athletes of these sports are developing.
The afflicted individuals are suffering with a progressive pattern of symptoms ranging from severe headaches, to brain fog, memory loss, dementia, mood disorders, depression, motor impairment and even suicidal tendencies.
Brain research has shown that one of the reasons for the symptoms of CTE is related to lesions called neurofibrillary tangles that develop from denatured tau proteins due to hyperphosphorylation. A second type of brain lesion has been associated with CTE as well. These lesions called amyloid plaques form on neurons from denatured amyloid protein. The microtubules of nerve axons become damaged by these lesions. A nerve microtubule serves as a conduit for vital circulating substances involved in nerve transmission and also for transport of waste material back to the cell body for recycling.
As this mechanism of transport within the neuron’s microtubules degrades, so does the neurological function of the brain.
CTE is a progressive disease as lesions spread along these neuronal pathways and over time, in the late stages of this disease, the brain becomes noticeably shrunken due to a lack of circulation of vital substances.
War Veterans also Suffer from CTE
CTE can also develop without direct impact to the head. Autopsies have found CTE in WWII veterans who were likely exposed to repeated concussive impacts from artillery blasts. Some of today's war veterans suffering from similar brain deficits have also been found to be accumulating tau protein clusters associated with CTE.
Research using PET scans which now view the brains of living individuals has provided these insights. Dr. Geoffrey Ling, director of the Biological Technologies office at DARPA (Defense Advanced Research Projects Agency) recently commented on research done on living brains of 14 former athletes thought to have CTE and compared them with 2 former soldiers. The results were similar with tau protein clusters present in both types of subjects (LaMotte 2015).
There is one paradox with CTE patients. Not all people with a history of concussions and noticeable accumulations of tau protein in their brain are symptomatic.
It is unclear why some people are symptomatic and others are not. Research to further understand CTE is still in the early stages and treatment involving pharmaceutical drugs to reduce the damaging effects of tau protein lesions in the brain are still being developed as well.
There is Hope for CTE with Classical Chinese Medicine
Considering Western medicine is still in the process of Research and Development for the treatment of CTE, the time is now to open our minds and look beyond conventional medicine for immediate solutions.
Having had personal success using Classical Acupuncture and herbal medicine for the treatment of brain injury following brain surgery, I have no doubt that Classical Chinese Medicine (CCM) can serve as a viable system of treatment for CTE.
Herbal Medicine (including Essential Oil/Aromatherapy) is an important modality of Classical Chinese Medicine to help CTE. There are many plant substances that can penetrate the blood-brain barrier to help resolve plaques and improve microcirculation of blood and fluids. In addition, recent research from Japan by Jimbo, et al. (2015) shows the profound benefits of essential oil therapy for reversing Alzheimer-related dementia.
Another important modality of CCM is Acupuncture as it can stimulate brain neurological function and potentially reduce the oxidative stress believed to be involved in the development of tau protein and amyloid protein accumulation. In this way, Acupuncture may help to reduce the progression of neurofibrillary tangles from developing.
A study by Parka, et al. (2003) showed that Acupuncture supports restoration of dopamine pathways which can potentially benefit both depression and motor deficits related to CTE.
The tremendous benefits of Acupuncture for post-stroke motor deficits due to brain ischemia is already well established. Research by Liu, et al. (2013) supporting the benefits of Acupuncture for Alzheimer's has also been established via a study in China that shows results were even better when Acupuncture was combined with eugenol. Eugenol is a chemical component of some essential oils that have shown significant benefit for cases of dementia.
Diagnosing Brain Pathology with Chinese Medicine
Classical Chinese Medicine has a complex methodology for diagnosing pathological processes in the body. One component of this system is based on differentiating the 6 Exogenous Causes that may be presented in each case. These are described as Wind, Heat, Cold, Damp, Summer Heat and Dryness.
There are also two other causes that need to be considered in the context of CTE which are Phlegm and Blood Stasis. An additional assessment is based on whether the condition is based on a Deficiency or Excess and in any chronic disorder there are mixed presentations where some factors are depleted (deficient) and other factors are in excess.
From a Western medical point of view, CTE is rooted in an excess of tau and amyloid protein accumulation. Since CTE develops from the spreading of these protein lesions in the brain, this pathology is an excess accumulation described as Phlegm in CCM. It is also understood that the protein lesions are related to oxidative stress and the activation of enzymes that stimulate the hyperphosphorylation process. In CCM, this can be seen as a problem of Excess Heat. Since we know the substance of these abnormal accumulations is denatured proteins spreading throughout the neuronal network, we can surmise that CTE is ultimately rooted in a condition of Excess Hot Phlegm in the brain.
Where does this heat and phlegm come from and how is it generated? From a treatment standpoint, this is the most important question. In CCM, any excess heat pathology damaging the brain is coming from heat in the Stomach and/or Gallbladder systems.
The brain lesions found in CTE are likely formed from the body's innate compensation to control the excess heat (oxidative stress) with dampness and this response creates the pathology of phlegm. The combination of these factors creates the Hot Phlegm lesions. It is important to note that from this medical model, the greater the heat factor, ie. oxidative stress, the faster the progression of the disease. Furthermore, heat as an expression of a acidic terrain indicates the need of an alkalizing diet to control the inflammatory process underlying the spreading of brain lesions found in CTE.
Classical Chinese Medicine focuses on treating the person, not the disease.
Treatment protocols for Hot Phlegm in the brain have been well established for Acupuncture and Herbal medicine. It is important to note, however, in CCM, each individual needs to be assessed and treated independently based on their specific needs and diagnostic patterns. Even though Hot Phlegm may be diagnosed as the pathology, treatment for resolving the Hot Phlegm disorder will vary from person to person. With this said, standardized treatment protocols are best implemented with modifications to properly support a patient's unique clinical presentation. Otherwise, results will be reduced and a patient's health may be compromised.
In conclusion, CTE is a disease Western medicine is still in the early stages of understanding and developing treatment. However, we need to find answers today as many people are suffering and lives are being traumatically impacted with some ending in suicide.
It’s time we explore alternative solutions beyond conventional medicine.
Classical Chinese Medicine is a viable option with extraordinary healing potential. CCM offers a comprehensive system to treat the symptoms as well as the root causes underlying CTE to slow down its progression and improve quality of life today when it matters most.
Click here to read Part II of this series on CTE.
Salvador Cefalu, M.S., L.Ac. is the Founder & Co-Director of A Center for Natural Healing in Santa Clara, CA, where he specializes in Classical Chinese Medicine & is one of the leading US practitioners of Japanese Meridian Therapy, a rare non-insertion form of Acupuncture. More information at www.acenterfornaturalhealing.com.
1. LaMotte S. Could Veterans Have Concussion-Related CTE? CNN. Tue April 14, 2015.
2. Jimbo D, Kimura Y, Taniguchi M, Inoue M, Urakami K. Effect of Aromatherapy on Patients with Alzheimer's Disease. Psychogeriatrics - The Official Journal of the Japanese Psychogeriatric Society. December 2009. Vol 9(4): 173-179.
3. Parka H, Lima S, Joob W, et al. Acupuncture prevents 6-hydroxydopamine-induced neuronal death in the nigrostriatal dopaminergic system in the rat Parkinson's disease model. Experimental Neurology. March 2003. Vol 180(1).
4. Liu Z, Niu W, Yang X, Wang Y. Effects of Combined Acupuncture and Eugenol on Learning Memory Ability and Antioxidation System of Hippocampus in Alzheimer disease rats via olfactory system stimulation. Journal of Traditional Chinese Medicine. 2013 June 15; 33(3): 399-402.