Send us Fan MailThis episode unpacks what "probable CTE" actually means — where the term comes from, what the science can and can't currently tell us, and why a single case (former Socceroos captain Paul Wade) has reignited debate about diagnosing a disease that's only ever been confirmed after death. It walks through the genuine case for and against using this label in living patients, and why the language we use around it matters.Note: This episode is for educational purposes only and is not medical advice or a diagnostic tool. While I've done my best to accurately interpret the cited journal articles, please read the original sources yourself for full context before drawing conclusions. 06:00 - Segment One: What Chronic Traumatic Encephalopathy Actually Is 09:45 - Segment Two: Why You Can't Diagnose It in the Living — Yet 12:00 - Segment Three: "Probable CTE" — Where the Term Actually Comes From 17:09 - Segment Four: Why This Topic Divides Even the Experts — The Dose-Response Problem 21:30 - Segment Five: The Case For Diagnosing Probable CTE in Living Patients 24:00 - Segment Six: The Case Against — Or At Least, the Case for Caution 29:27 - Segment Seven: Why the Words We Use Actually Matter 32:50 - Segment Eight: Where This Leaves Us Episode — Reference List1. Martland, H.S. Punch drunk. Journal of the American Medical Association. 1928;91(15):1103–1107.2. McKee, A.C., Cairns, N.J., Dickson, D.W., et al. The first NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy. Acta Neuropathologica. 2016;131(1):75–86.3. Bieniek, K.F., Cairns, N.J., Crary, J.F., et al. The second NINDS/NIBIB consensus meeting to define neuropathological criteria for the diagnosis of chronic traumatic encephalopathy. Journal of Neuropathology & Experimental Neurology. 2021;80(3):210–219.4. Mez, J., Daneshvar, D.H., Kiernan, P.T., et al. Clinicopathological evaluation of chronic traumatic encephalopathy in players of American football. JAMA. 2017;318(4):360–370.5. Montenigro, P.H., Baugh, C.M., Daneshvar, D.H., et al. Clinical subtypes of chronic traumatic encephalopathy: literature review and proposed research diagnostic criteria for traumatic encephalopathy syndrome. Alzheimer's Research & Therapy. 2014;6(5):68.6. Cantu, R.C., Budson, A.E. Management of chronic traumatic encephalopathy. Expert Review of Neurotherapeutics. 2019;19(10):1015–1023.7. Katz, D.I., Bernick, C., Dodick, D.W., et al. National Institute of Neurological Disorders and Stroke consensus diagnostic criteria for traumatic encephalopathy syndrome. Neurology. 2021;96(18):848–863.8. Dickstein, D.L., Pullman, M.Y., Fernandez, C., et al. Cerebral [18F]T807/AV1451 retention pattern in clinically probable CTE resembles pathognomonic distribution of CTE tauopathy. Translational Psychiatry. 2016;6(9):e900.9. Arena, J.D., Stewart, W., Schneider, A.L.C., et al. Performance of traumatic encephalopathy syndrome criteria in identifying individuals with chronic traumatic encephalopathy. Nature Medicine. 2026;32:2037–2046.10. Iverson, G.L., Gardner, A.J. Risk for misdiagnosing chronic traumatic encephalopathy in men with anger control problems. Frontiers in Neurology. 2020;11:739.11. Iverson, G.L., Gardner, A.J. Risk of misdiagnosing chronic traumatic encephalopathy in men with depression. Journal of Neuropsychiatry and Clinical Neurosciences. 2020;32(2):139–146.12. Iverson, G.L., Gardner, A.J. Symptoms of traumatic encephalopathy syndrome are common in the United States general population. Brain Communications. 2021;3(1):fcab001.13. Grashow, R., Weisskopf, M.G., Baggish, A., et al. Premortem chronic traumatic encephalopathy diagnoses in professional football. Annals of Neurology. 2020;88(1):106–112.14. Eagle, S.R., et al. Interaction of medical conditions and football exposures associated with premortem chronic traumatic encephalopathy diagnosis in former professional American football players. Sports Medicine. 2024;54:743–752.15. Stewart, W., Buckland, M.E., McInnes, K., et al. Primum non nocere: a call for balance when reporting on CTE. Lancet Neurology. 2019;18(3):231–233.16. Hazrati, L-N., Schwab, N. Embracing the unknown in the diagnosis of traumatic encephalopathy syndrome. Neurology. 2021;96(18):835–836.17. McKee, A.C., et al. Chronic traumatic encephalopathy (CTE): criteria for neuropathological diagnosis and relationship to repetitive head impacts. Acta Neuropathologica. 2023;145(4):371–394.18. Atherton, K., Han, X., Chung, J., et al. Association of APOE genotypes and chronic traumatic encephalopathy. JAMA Neurology. 2022;79(8):787–796.19. SBS News. Former Socceroo becomes first Australian footballer to share probable CTE diagnosis. July 2026.20. beIN SPORTS. Former Socceroos captain reveals probable CTE diagnosis. July 22, 2026.21. The Washington Post. Ex-Socceroos captain Paul Wade says he has probable CTE, urges no heading for junior players. ...
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